An open shift at an urgent care is a different problem for each role. Covering it from outside depends on what the clinic can do without that role, what has to be in the clinician's file, and how much of the work is specific to your clinic. This guide goes through the roles an urgent care staffs and what makes each one harder or easier to cover with a locum clinician.
Three Things That Decide How Hard a Role Is to Cover
What happens if the shift stays open. Without a physician, NP or PA on the schedule, the clinic has no provider to see patients. Without an RN or an MA, it may still open, and each visit takes longer. The first kind of gap closes the clinic, so it needs a backup plan before anything else.
What the file needs. Each role has its own credential items. A role with more items, or with an item that depends on another person, needs more lead time.
How clinic-specific the work is. Your rooming flow, EMR templates and point-of-care testing setup belong to your clinic. A clinician whose shift depends on them needs more orientation, whatever their license.
Staffing a Physician Shift
A physician can work as the only provider on site, so the shift doesn't depend on a second person being available. That makes the schedule simpler to cover.
The file is where the lead time goes. It includes a license for your state, a DEA registration that covers your state if the physician will prescribe controlled substances, and whatever certification your policy requires. A physician licensed only in another state can't cover a shift next week.
A permanent physician may also hold duties outside the shift. They may be the collaborating or supervising physician for your NPs and PAs, or your medical director. A locum physician who covers the shift doesn't take on those duties unless you've arranged it. Decide who holds them during the gap, and ask your attorney what your state requires.
Staffing an NP or PA Shift
An NP or PA shift is a provider shift, so an open one can close the clinic. What makes it harder to cover is the state's practice rules. Some states require a collaborative or supervisory arrangement with a physician, and the details differ by state and by role.
Where your state requires that arrangement, the shift depends on two people: the NP or PA and a physician who can be reached. If an agreement has to be in place before the first shift, that adds lead time. Whether an NP or PA can be the only provider on site is also a matter of state rules and your own policy.
Your medical director and your attorney can tell you what applies to your clinic. Urgent care licensing by state explains how these rules change at a state line.
Staffing an RN Shift
An RN's file is shorter than a prescriber's. It has a state license and no DEA registration. RNs in states that belong to the Nurse Licensure Compact can hold a multistate license, which helps a clinic near a state line. Licensure compacts for locum clinicians explains how it works.
The harder part is the job description. What an RN does in an urgent care differs from clinic to clinic. Write the task list before you post the shift, and name who the RN reports to. A locum RN can't tell from the title alone what your clinic expects.
Staffing an MA Shift
A medical assistant doesn't hold a DEA registration, and state rules on MA credentials vary. Check your state's rules and your own policy, then write an MA checklist that's separate from the one you use for providers. A provider checklist sent to an MA asks for documents an MA doesn't have.
An MA's scope depends on the state and on what the licensed clinicians on site delegate. The work is also specific to your clinic: rooming, intake in your EMR, your testing equipment, and sometimes the front desk. A locum MA needs a working EMR login and a walkthrough as much as a provider does.
When an MA shift stays open, the providers room their own patients and see fewer of them each hour. Urgent care staffing ratios covers how skill mix changes what a provider can get through.
Assistant Physician Shifts Depend on Your State
An assistant physician is a medical school graduate who has passed USMLE Step 1 and Step 2 and hasn't matched into a residency. Only some states license the role, and the title differs from state to state. An assistant physician is not a physician assistant.
If your state doesn't license the role, you can't staff it. If it does, state rules set the supervision the role needs, and your medical director and your attorney can tell you what that means for a shift.
What to Say in the Shift Details for Each Role
| Role | What to state |
|---|---|
| Physician | Only provider or second provider; any supervising or medical director duties; ages seen |
| NP or PA | Only provider or with a physician on site; who the collaborating or supervising physician is and how to reach them |
| RN | The task list; who they report to |
| MA | The task list; front office, back office or both; who they report to |
| Every role | Rate, hours, expected visits, the EMR, and whether x-ray and lab are on site |
What locum clinicians look for in an urgent care shift covers the rest of the listing.
Plan Urgent Care Staffing by Role Before a Gap
- For each role, write what the clinic does when a shift isn't covered: close, shorten hours, limit services or run slower.
- Start with the roles whose absence closes the clinic. Get more than one outside clinician cleared for those shifts.
- Write a credential checklist for each role. The urgent care locum credentialing guide has a table of which checks apply to which role.
- Settle the state questions for NPs, PAs and MAs with your medical director and attorney now, while no shift is waiting on the answer.
Rediworks is a self-service marketplace for urgent care shifts. You post the clinician type, dates and shift details you need, and clinicians see the rate before they apply. Sign up to post shifts.