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What does the term locum tenens mean in your office?

Credentialing Resource Center Connection, July 26, 2007

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Sally J. Pelletier, CPMSM, CPCS, is a consultant with The Greeley Company, a division of HCPro, Inc., specializing in the areas of credentialing and privileging.

Dear credentialing colleague:

As I was collaborating with a healthcare system to integrate and streamline its credentialing process, it came to light that the hospital-owned medical group and the medical staff office (MSO) both used locum tenens physicians, but defined such practitioners in two different ways. As you can imagine, this miscommunication caused confusion and, as a result, there was a delay in processing paperwork related to services rendered by the locum tenens. However, it wasn't until the staff involved in processing these physicians got together in a room to discuss the credentialing process-already known to be rife with other problems-that the issue of conflicting terminology arose.

Before I explain how each group was using the term, let's first look at the root of the word. The term locum tenens stems from the Latin term "to hold" and is widely used to describe a physician who is temporarily substituting for another. 

The medical group was appropriately referring to locum tenens physicians, as defined by CMS for arrangements for physician payment, as "substitute physicians [who] take over their professional practices when the regular physicians are absent for reasons such as illness, pregnancy, vacation, or continuing medical education, and for the regular physician to bill and receive payment for the substitute physician's services as though he/she performed them."

The medical staff office was using the term to refer to physicians that the organization granted temporary privileges.

While The Joint Commission standards do not specifically address the use of locum tenens, they do allow for temporary privileges to be granted based on specific patient care or service need (i.e., ED services, anesthesia services, etc.). Very often, especially in a rural setting, the use of locum tenens is due to an urgent need for patient care, such as a lack of physicians in a particular specialty.

In the end, this particular organization resolved to clarify their terminology and to make sure their processes coincide for the benefit of all parties.

Remember, credentialing has no other master than the patient.

That's all for this week.

All the best,

Sally J. Pelletier, CPMSM, CPCS
http://www.greeley.com/consulting.cfm

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