Physician Resources

How does locums work for orthopedic surgery?

Othopedic surgeon examines knee of a patient while assistant looks on

Nicholas Kusnezov, MD, a board-certified orthopedic surgeon who practices in Tennessee, shares his tips on how to be successful as a locum tenens orthopedic surgeon.

Speaking as an orthopedic surgeon who has been actively and successfully engaged in locums for the past few years, I feel that I have a solid understanding of the intricacies of orthopedic locums and am uniquely qualified to share my experience.

Why do facilities need locums?

Portrait of Dr. Kusnezov, an orthopedic surgeon
Dr. Kusnezov

Where do orthopedic surgeons work locums? Just about anywhere a full-time staff orthopedic surgeon works. Facilities need locums for a variety of reasons. This may include simple call coverage during a planned vacation, periodic coverage due to loss of a provider, or even as a form of “tryout” for facilities seeking a more permanent position in the future. As a result, there will always be a need for locum providers.

What types of procedures do locum tenens orthopedic surgeons do?

Locums is attractive for many reasons. As a locum tenens orthopedic surgeon, you can select assignments requiring procedures that you enjoy but that you may otherwise not have as much exposure to in your primary practice. You have the opportunity to perform whatever procedures you are qualified to do and which you feel comfortable with. As a result, this may involve simple elective procedures such as carpal tunnel releases or outpatient low-acuity traumas like ankle fracture fixation, or it may range to more high-acuity trauma, such as musculoskeletal poly trauma, complex periprosthetic fractures, or joint replacement surgery.

Quote from Dr. Kusnezov about choosing the procedures you take on as a locum orthopedic surgeon

I would caution you that, despite being a locum and potentially having no follow-up with these patients, you should only commit to procedures you are qualified and comfortable with performing to ensure the best possible patient outcomes. Personally, having extensive experience with high-acuity trauma and complex joint reconstruction surgery, I am comfortable managing anything that presents to my trauma center. However, many of these patients and cases may require staged procedures and prolonged aftercare; therefore, it is paramount to establish and maintain open communication to facilitate optimal patient care.

Make sure you’re ready: How to prepare for a locum tenens orthopedic assignment

Are there continuity of care issues?

As you can imagine, there may be continuity of care issues as a locums surgeon if you do not anticipate and plan for it. This applies not only to those patients you would care for during your assignment but also to patients at your primary practice.

It is paramount to ensure continuity of care for your patients, even though you may not personally be seeing them back depending on the structure and time commitment for the given locum assignment. This can be done a number of ways but is most effective through direct communication with the local orthopedist or physician assistants with whom your patients will be following up.

Learn more: How to ensure continuity of care while working locums

Dr. Kusnezov performs orthopedic surgery as a locum tenens physician
Dr. Nicholas Kuznesov in the OR

How can orthopedic surgeons maintain continuity of care when working locums?

I maintain open communication with these individuals for all assignments I undertake. At a minimum, this entails communicating post-operative restrictions, follow-up, and the overall game plan for your patients. Additionally, this means making sure that you are available in some regard for questions regarding care or even unanticipated complications that may arise. It is easy as a locum physician to write off patient aftercare, given that this is not a requirement, but I would strongly encourage active engagement in your patients’ care to foster quality and ensure the best possible outcomes.

Quote from Dr. Kusnezov about doing aftercare as a locum orthopedic surgeon

Additionally, depending on how much time you commit to locum assignments, you want to ensure that the patients at your primary practice are not neglected as a result of your absence. This involves, as I touched on previously, communicating a game plan to your partners or mid-levels which can be effectively carried out in your absence, and again, being available for any questions or potential unforeseen issues that may arise in your absence. Orthopedics, like other surgical specialties, is a full-time job. 

More from Dr. Kusnezov on this topic:

About the author

Dr. Nicholas Kusnezov

Nicholas Kusnezov, MD, is a premier, nationally recognized, board-certified, and fellowship-trained orthopaedic surgeon currently practicing in Southern California. He specializes in total joint replacement with extensive experience in managing complex sports and traumatic injuries. In addition to a highly decorated career in the U.S military, Dr. Kusnezov is the recipient of numerous national meritorious awards and is actively engaged in graduate medical education and clinical research, having co-authored over 100 peer-reviewed publications to date. Click the YouTube logo next to Dr. Kusnezov's name for interviews expanding on the topics of his blogs.