To the Editor:

I read with interest the locum tenens article (“A Physician's Guide to Locum Tenens,” February 1999). I've been an independent contractor and locums physician my entire medical career, and the examples in the article are not typical of my experience.

I've always been paid in full and on time. The worst lodging I ever had was at a well-known national budget motel. I've also stayed in a lakefront cabin, a well-equipped corporate apartment, a sailboat in Alaska, a waterfront home, a vacation resort, a condominium, a Victorian bed and breakfast, and sometimes in the homes of the physicians I replaced.

I don't believe that all the agencies' loyalties lie with clients or that there is a conspiratorial atmosphere against physicians. A good agency will work just as hard to find the right job for a doctor as it will to find the right doctor for a job. Many times, the agency and the client get burned by physicians who back out of their commitments without cause, agree to be in two places at the same time or misrepresent their qualifications. I developed comfortable working relationships with my contact people at each agency. I trusted their judgment, and they depended on me to deliver the professional services promised.

Still, the agencies are in business to make a profit, so I agree with the article's suggestion to review contracts before you sign them. I've made addenda and revisions to every agency locums contract I've signed.

While I recommend that those starting out in the locums field learn the ropes by working through an agency, I have begun contracting directly with hospitals and practices. In many cases, these clients prefer dealing directly with a physician.

I would not discourage physicians from trying this exciting career option — as long as they take common-sense precautions. I believe my chosen specialty as an independent locum tenens physician is the best job in medicine and the last bastion of physician autonomy in the current managed care environment.