The most common question I get, after "agency or direct?", is some version of "What should I charge?" Nobody wants to answer it in public, and understandably so. Recruiters won't, because a vague number protects their margin. Other locum docs might tell you privately, but there is so much variability from place to place that it can be hard to gauge what’s actually applicable to your situation.

"What agency should I work with? What recruiter do you recommend?" These are questions I’ve been asked by other BCDs looking to do locums. Many dermatologists start their locum search by reaching out to a staffing agency. Recruiters are the standard entry point for these positions. But I don’t feel this should be the default route for a BCD considering locum work.

You’ve found your first locums derm gig and agreed to the basic terms with the clinic. Now the contract is sitting in your inbox. What do you do from here?

As a locums dermatologist, you’ll eventually hear about the Q6 modifier. It’s a billing shorthand used for Medicare patients that allows a clinic to bill for your services under a permanent doctor’s NPI.

Whether you’re going through an agency or contracting directly with a derm clinic, remember: everything is negotiable. If it’s not in writing, it doesn’t exist. Here is a baseline of what you should consider.

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.