Are you up to standard? Ensuring quality care when providing or using locum services

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When a physician provides locum coverage, it’s important both the locum physician and the physician using the locum’s services are aligned and have a common understanding of what is expected from both parties.

What every physician should know about locums:

• Both the locum physician and the physician who uses their services must ensure they comply with all of CPSA’s Standards of Practice.
• There should always be a written locum agreement to confirm the duration of the locum’s services and clarify expectations, especially for continuity of care and patient record retention:

• • A locum physician is generally an affiliate of the physician for whom they are providing coverage. In some instances, such as when a locum physician is doing a trial run at a clinic (as opposed to covering a leave of absence), the locum physician is establishing relationships with their own patients and would be considered a custodian of their patient’s records. In these situations, an Information Sharing Agreement (ISA) would be in place. Review the Patient Record Retention standard and the Physicians as Custodians Advice to the Profession document for more information. An ISA template is available for download.
  • A locum physician is responsible for ensuring there continues to be a system in place to address urgent matters after hours, weekends included. A locum physician is also responsible for any investigation, test or referral they order. The physician they provide coverage for (or another physician at the clinic) will likely provide any needed follow up when the locum physician leaves. However, there must be a plan for how investigations will be followed up on, to ensure patients continue to receive the care they need. Review our standard on Continuity of Care to ensure your patients receive any after-hours and follow-up care they need. You may also want to review the Canadian Medical Protective Association article “Who is the most responsible physician? Check your knowledge”.
  • Any test a locum physician orders must be ordered under their own name. Ordering tests under another physician’s name contravenes the Code of Ethics & Professionalism, as well as the Continuity of Care, Responsibility for a Medical Practice and Transfer of Care standards of practice. To ensure your patients receive appropriate follow-up care, you should carbon copy the physician you are providing coverage for (or another physician at the clinic) on any investigations, tests or referrals you order.

If you would like to know more about locum services, the Alberta Medical Association’s Physician Locum Services program is a great resource. They also have additional information on the benefits for physicians who need or provide locum services, and a job board if this is an opportunity you’re interested in pursuing.

Questions about our standards of practice? Contact CPSA’s Standards of Practice Advisor Chantelle Dick.