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Locum tenens dentists can help fill vacancies, but it’s important to plan ahead

February 26, 2019

By David Burger

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Editor’s note: This is the 23rd story in the Decoding Dental Benefits series featuring answers and solutions for dentists when it comes to the world of dental benefits and plans. The series is intended to help untangle many of the issues that can potentially befuddle dentists and their teams so that they can focus on patient care.

Bel Air, Md. — Dr. Edgar Radjabli had a problem.

In 2017, the practicing dentist was in a car accident. His shoulder and a finger were injured, and he knew almost immediately that he would need to stay away from his practice for a while and recuperate. He and his business partner didn’t want the practice to suffer financially, so he found a locum tenens dentist

“I didn’t want the practice to fall apart,” he said.

The definition of locum tenens, roughly translated from Latin, means “to hold a place.” 

Locum tenens dentists fill in for other dentists on a temporary basis for a range of a few days to even a year or longer. When a dental office faces temporary staffing shortages due to vacancies, illness, death, vacations, maternity or paternity leaves or other causes, they hire locum tenens dentists to fill those vacancies.

Dr. Radjabli
Dr. Radjabli
“The American Dental Association has recognized the need to educate dentists and dental offices on the administrative practices and policies of third-party carriers to address instances where the absent dentist is in-network with the plan and a temporary dentist, who is not in-network with the plan, has been hired to treat patients expecting to be treated by a network dentist,” said Dr. Christopher Bulnes, chair of the ADA Council on Dental Benefit Programs.

“Plans have various practices and policies when it comes to locum dentists and while some of these policies may be similar, they do have their differences. It is important for dental offices to understand the need for locum tenens dentists and to completely understand how this is handled by various dental plans.”

Dr. Bulnes continued: “When a dentist is away, practice activities can continue smoothly — especially if he or she is in a group practice. In solo practices, it is possible to hire a semi-retired or retired dentist or a recent dental school graduate who has some time available. Often, the local dental association will have a list of locum tenens dentists who will be able to cover the practice during your absence.”

Illinois-based dentist Dr. Madalyn Davidson knows all about locum tenens dentists. She’s been one. Multiple times.

“The first six years of my career I worked in private practice,” she told the ADA News. “When I decided to move from my hometown, I had a classmate call and ask if I would stick around for a few months before I moved to help her with her maternity leave. I decided to stay to help and that turned into the beginning of a string of locum jobs helping classmates cover maternity leaves and even a few paternity leaves. I have helped a dentist friend as a locum to help expand his practice in anticipation of him hiring a full-time associate. Sometimes it’s hard to know if your practice is busy enough to expand, so locuming is a great way to test this. I sprinkled in jobs covering doctors’ practices who needed to be out of their office for surgery or medical leaves. I helped another dentist while she took an extended trip of a lifetime to Africa. I volunteered my time for a classmate who passed away unexpectedly to keep his office running till his wife could find a buyer. I’ve locumed in rural and urban public health departments who were desperate for dentists.”

Why would Dr. Davidson do such a thing?

“I enjoyed the freedom in my schedule,” Dr. Davidson said. “I could pick and choose when I wanted to work. It was a great way to explore different parts of the U.S. to determine if I wanted to relocate and it gave me a trial run on different locations. I was able to take a cycling trip for a month in the Netherlands and another two-week trip in Africa, and many others in between jobs, so if you enjoy travel it’s a great way to have the best of both worlds.”

“Other dentists I know who locum, use it as a way to transition to retirement. They sell their practice and cover dentist absences for two to six months out of the year,” Dr. Davidson said. “Other newer dentists have used locuming to explore different parts of the country or a city before deciding on a location to buy or start a practice.”  

Dr. Davidson is so passionate about the subject that she created a website to help connect dentists to locuming opportunities called DMDwhere.com.

It’s no surprise that businesses have sprung up to help connect dentists with locum tenens dentists. Justin Perez is divisional vice president of Staff Care, a company that works with dentists and other physicians to provide flexible employment options across more than 40 specialties within a variety of health care organizations and settings.

“The physician workforce has evolved over the last five to 10 years similar to the common themes you’ve seen in the general workforce,” Mr. Perez said. “Physicians see locums as a path to greater flexibility while also having the stability of a consistent income.  Whether you’re looking for flexibility in your schedule as you start a new family, seeking an opportunity to support yourself as you enter retirement, or you simply need full-time work that provides you an opportunity to work in new locations and access to a variety of patient needs, being a locums tenens dentist is perfect for you.”

Mr. Perez was cognizant of some of the issues facing dentists when dealing with locum tenens dentists. “There are unique challenges related to customer reimbursement for the services provided by a locum tenens provider,” he said. “Depending on insurance contract terms specific to locums billing, some customers choose to ensure their patients have access to the health care providers they need, despite the practice’s inability to be reimbursed by insurance. We understand this is not sustainable for our customer’s long-term success. Navigating the locums billing policies with your dental plans can be tricky, particularly if you have a short-term need.”

Mr. Perez added: “Most dental plans provide for a locums billing option in the event of death or disability. States like Texas have made some recent changes to support dental practices who have a more temporary need that’s less than 90 days for services provided by a ‘substitute dentist.’ As this locums segment continues its rapid growth, I believe it’s likely that we could see additional changes to ensure greater patient access.”

Denise Martinez is manager of provider relations, Western Region, for Delta Dental of California. She stressed that practices need to communicate with them as soon as they become aware they will need a locum tenens dentist to fill a vacancy. “If there is a change in who is treating patients, we need to know,” Ms. Martinez said.

In addition, patient care and comfort need to be addressed, and patients need to be communicated with as much as possible, Ms. Martinez said. “Patients may get upset if there is a dentist they’ve never seen before. We want to keep the process and experience seamless.”

It all comes to down to “life planning,” according to Ms. Martinez. “If anything, think about what happens if you’re in a car accident. Do you have things in place?”

Dr. Radjabli ended up never returning to practicing dentistry. He had a refrain that echoed Ms. Martinez’s message: You have to plan ahead.

Dr. Radjabli, Ms. Martinez and Mr. Perez joined Dr. Cynthia Olenwine of the ADA Council on Dental Benefit Programs in a free ADA webinar Feb. 26 called Locum Tenens Dentists: Opportunities Abound. The webinar will soon be posted on the ADA Center for Professional Success’ website, Success.ADA.org.

The ADA Center for Professional Success website contains “General Guidelines for Mutual Aid Agreements,” at Success.ADA.org/en/practice-management/general-guidelines-for-mutual-aid-agreements, that outlines a process in which a formal contract with colleagues is made in the event of the sudden illness, injury or death of a dentist-signer to such an agreement with the other signers promising to temporarily cover for the stricken colleague until either his or her recovery or up until the time when a deceased dentist’s practice is sold.

The ADA’s online landing page for dental benefits information that can help dentists address and resolve even their most vexing questions is at ADA.org/dentalbenefits, part of the ADA Center for Professional Success.

Staff from the Center for Dental Benefits, Coding and Quality can help dentists with dental benefits-related and coding problems, questions and concerns. Call the ADA’s Third Party Payer Concierge at 1-800-621-8099 or email dentalbenefits@ada.org.

Previous installments in the Decoding Dental Benefits series are available at ADA.org/decoding.