Agency as a Buffer


When you start working at a new assignment, you can easily be overwhelmed at first. I think the first two weeks are usually the toughest. You are learning a new system, in a new environment, and with new people. After two weeks, you can start judging if the facility you are working with is fair or not.

Some issues I have come across while working as a locums include but are not limited to:

-High patient load with limited time (example: 30 patients a day where new patients are only 15 minute visits etc.)

-Only having 1 medical assistant to help you

-Having 1 patient room to work out of…

-Clinic Manager/Supervisor scrutinizing you

-EHR system that is not so user friendly


The list can go on and on. Of course no place is perfect, and I don’t typically expect them to be. However, when my license is on the line, I can get pretty frustrated if the site does not have a good flow. Make sure to express your frustrations to your agency liaison (whether it’s your recruiter or the account manager). They can often help improve your situation by reaching out to their site contact. Also, if you end up wanting to leave an assignment early, at least there will be no surprises.

In one instance, I had a fabulous recruiter in which I confided in her some issues I was having with the clinic manager at one of the sites I was working at. She agreed that the clinic manager had said some distasteful things to me and immediately reached out to her contact at the site. The next day, I already had the clinic manager sucking up to me! Not to mention, my recruiter sent me a $25 giftcard to starbucks to brighten up my day.

I ended up continuing with that assignment and completing my 3 month contract even though I had a confrontation with the clinic manager during my first 2-3 weeks. I was grateful for how my recruiter handled that situation.

On the other hand, I worked at a site that did not follow through with their promises. 75% of the time I only had 1 medical assistant to help me, when I was originally promised 2 (and every other provider had 2). Every other day, I only had 1 patient room to work out of which was ridiculous when you have a full patient load.

I spoke to my agency liaison and she said she would address my concerns. I was once again promised by the agency and site that things would get better. They only got better about 25% of the time.

During my last month, the clinic suddenly wanted to add child wellness exams to my already busy schedule. I refused on the basis that their EHR system required using 11 different templates per each physical, and that California has a lengthy list of requirements for child physicals (including a fluoride application, TB screening, hemoglobin check etc). With me only having 15 minutes for new patients and for adult physical exams, I did not see it possible for me to add child wellness exams to my schedule as well.

At first the site said it was okay, but then they suddenly started putting these child physicals on my schedule. I once again complained about the child physicals, and the site pretty much told me I would have to see them. I contacted my agency and at that point they were more concerned about their relationship with the site than with me.

Since no compromise was reached, I opted to leave the site early, and thus my contract ended. I do not like to leave earlier than originally agreed upon because I understand how much help is needed. However, my priority will always be my patients and my license.

I truly wish my agency had stepped up to support me instead of prioritizing the clinic. Was I truly surprised? No. Yet, I showed you how much influence an agency has in the enjoyment of your assignment and on you completing it as contracted.

Feel free to reach out to me if you need suggestions on which agency to use!

2 thoughts on “Agency as a Buffer

  1. I’m so glad I found your blog! I just finished my first locums assignment, and it was a nightmare. Now I’m questioning continuing this type of NP work. I know a large part of the problem was my recruiter was not my advocate.

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