Are you wanting to utilize your midwifery skills and have flexibility of changing settings frequently? Locum contracts work perfect for someone wanting 3-6month employment contracts at a time. You can choose where and when you want to work. It works great for filling last minute needs at private practices like maternity coverage, medical leave, and staffing shortages until hiring occurs. For being available last minute with your knowledge, licensure, and training, private practices and hospitals pay top dollar for these assignments.
You can choose to work with a locum agency or directly contract with need. Pros of using a locum agency is they find the contracts, advocate for you directly, complete paperwork for contract, and have middle man resource to communicate with practice administration. Down side is losing percentage of profits to this agency.
It also depends on how flexible you are. I have seen midwives directly contract with local hospitals, practices, and needs by taking the initiative to stress benefits her services would provide. For example, I met with local physicians and hospitals to learn about current challenges with area. A Family Practice office was having two Physician Assistants retiring in next 6 months. A Certified Nurse Midwife wouldn’t have initially been their first choice.
A lot of misunderstanding is present about what the full scope of a midwife is. That is a perfect opportunity to educate and stress the benefits of your services have to their needs. After discussing midwives can do full scope women’s health care and primary care (just can’t do kids and men), I was able to negotiate a contract to see all the women in his practice and bring back women’s health expertise within the office while other staff was found to fill needs in community.
If you want to travel somewhere warm in the winter and no as picky location, a travel agency that specializes in working with midwives is a great option. Getting a relationship with multiple agencies is a good idea and make sure their contracts with you don’t have exclusive rights to you. A midwife should be able to work with many agencies at a time, because each one will have access to different opportunities for you to choose from.
Another contract I have negotiated was 6 month Laborist coverage with local hospital. The Obstetricians were really drained and short staffed. There was already a CNM that worked with their team and lag of time before finding another provider to work with growing practice. The doctors needed some sleep at night. We did a contract to cover in house Labor and Delivery coverage after office hours and weekends. Doctors only had to be available for high risk situations, assisted deliveries, and cesarean sections. Three CNMs were a quick fill in of the hospital needs to get Obstetricians some less call coverage responsibility. It was a huge success and physicians really appreciate the resources available at night time while additional doctor was found.
Negogiating a hourly rate is crucial with these assignments. Too many midwives accept too low of a rate. W-2 salaries for Certified Nurse Midwives range from $80-120k year with benefits. Many locum contracts are around $60 hr which is almost identical to what a midwife would get working for another practice with additional employment perks. You need to pay your own insurance, retirement benefits, self employment and social security taxes. I wouldn’t even consider accepting a contract for less than $70 hour with additional benefits like housing and food stipends. Typical locum contracts are $80-120 hr. Brag your skills, certifications, experience, and availability to fill their urgent needs.
When you can create the value of your services and reinforce how you can fill their needs more than what they anticipated. For example, I stress how I can do newborn care on top of labor coverage for additional billing opportunities when delivery occurs compared to an Obstetrician. Finding the driving factors of exactly why an assignment is available creates an advantage for you and the negotiating process.
Remember, independent contractor means you are your own boss. You can be presented with an offer, but ultimately you get to choose the work hours, rate of reimbursement, lodging, mileage, and food reimbursement. Everything is negotiable. When you create value for another organization with your skills and availability, the ball is in your court. There are many needs all over the country and far less midwives doing locum contracts. Don’t forget that!