Beyond the Day Rate: Your Intangible Worth as a Locum Tenens Dermatologist

When you look at a locums contract, it’s easy to get fixated on the daily rate as if it’s a simple trade for your time. That number is only a fraction of what you actually provide to a practice. To negotiate effectively, you have to understand the revenue and stability you provide the second you walk through the door. I didn’t fully realize the leverage I had until I was a few months into the game.

Here is the "intangible" value you bring to the table:

1. Stopping the "Patient Leak" In a private practice, the most valuable asset is the patient list. If a clinic loses a provider and the wait time jumps to six months, those patients often go to the practice down the street. They may never come back. By being there, you are protecting the practice's long-term referral base. 

2. Feeding the Downstream Machine This is particularly relevant in practices with in-house Mohs and dermpath. As a general dermatologist, you are the engine for the entire office. Every biopsy you take and every skin cancer you find feeds the dermatopathology lab and the Mohs suites. If you’re clearing a backlog of new patients, you’re also generating a massive pipeline of surgical and follow-up revenue for the permanent staff.

3. Clinical Continuity It’s easy to downplay the term "coverage," but someone has to ensure followup for isotretinoin patients and manage biologic starts. In all three states where I worked, I diagnosed melanomas. How long of a delay would there have been were I not there, and how would this have impacted these patients’ morbidity and mortality? Your presence prevents poor outcomes and keeps patients well taken care of.

4. Helping your Fellow Dermatologists When a physician leaves a group, the remaining partners usually have to absorb the extra labs, messages, and urgent fit-ins. That leads to partner burnout. You help prevent that. 

The next time you negotiate for a locums gig, remember these invaluable, "hidden" benefits that you bring to the table and ensure that this value is recognized in your final contract.