‘You're just a locum’: professional identity and temporary workers in the medical profession

Abstract

Internationally, there has been substantial growth in temporary working, including in the medical profession where temporary doctors are known as locums. There is little research into the implications of temporary work in health care. In this paper, we draw upon theories concerning the sociology of the medical profession to examine the implications of locum working for the medical profession, healthcare organisations and patient safety. We focus particularly on the role of organisations in professional governance and the positioning of locums as peripheral to or outside the organisation, and the influence of intergroup relationships (in this case between permanent and locum doctors) on professional identity. Qualitative semi‐structured interviews were conducted between 2015 and 2017 in England with 79 participants including locum doctors, locum agency staff, and representatives of healthcare organisations who use locums. An abductive approach to analysis combined inductive coding with deductive, theory‐driven interpretation. Our findings suggest that locums were perceived to be inferior to permanently employed doctors in terms of quality, competency and safety and were often stigmatised, marginalised and excluded. The treatment of locums may have negative implications for collegiality, professional identity, group relations, team functioning and the way organisations deploy and treat locums may have important consequences for patient safety.

Community Pharmacist Consultation Service: A Survey Exploring Factors Facilitating or Hindering Community Pharmacists’ Ability to Apply Learnt Skills in Practice

“…Employed pharmacists/pharmacist managers were significantly more likely to report clinically assessing their patients than locum pharmacists. Locum pharmacists can sometimes report a lack of support for, or opportunities to, undertake advanced roles, and this, in addition to the fact that locums sometimes work shorter hours, may explain this difference [ 23 , 24 ].…”

“…Employed pharmacists/pharmacist managers were more likely to report a good relationship with the local general practices than locums, possibly due to them having more opportunities to communicate with local GPs and build a rapport than locums, who often work in multiple locations and/or part-time [ 23 , 24 ]. GPs may be reluctant to collaborate with pharmacists they do not know well and need to build trust, something which takes time [ 27 , 29 ].…”

Yonder: Locum doctors, testicular pain, chaplaincy services, and mumsnet

“…Historically, there has been a dearth of academic studies exploring impacts of locum working on the medical profession, prompting a cross-institutional UK research team to examine this by interviewing locum doctors, locum agency staff, and representatives of healthcare organisations who use locums. 1 They found that locums were perceived to be inferior to permanently employed doctors in terms of quality, competency, and safety, and were often stigmatised, marginalised, and excluded.…”

Role of locum GPs in antibiotic prescribing and stewardship: a mixed-methods study

“…(16) Studies support the widespread negative perceptions and experiences of employing and working as locums, which can have adverse implications for the professional identity, organisations and patients. (17)(18)(19) A recent narrative review on the quality and safety of locums across settings and countries suggested that the context of locums' work may increase risks, but only eight empirical, methodologically-poor studies were identified. (20) Although locums form a substantial proportion of the GP workforce, there is little research on locums and, to our knowledge, none focused specifically on the role of locums in AMS.…”

“…16 Studies support the widespread negative perceptions and experiences of employing and working as locums, which can have adverse implications for the professional identity, organisations, and patients. 17 – 19 A recent narrative review on the quality and safety of locums across settings and countries suggested that the context of locums’ work may increase risks; however, only eight empirical studies were identified, which were methodologically poor. 20 …”