Credentialing tells you a locum clinician is licensed and cleared to work. It tells the clinician nothing about what's in your building. Urgent care X-ray and lab setups differ from one clinic to the next, and a clinician who worked last week at a clinic with a technologist on every shift and a long point-of-care testing menu will arrive at yours expecting the same.
One clinic has on-site X-ray every hour it's open and gets reference lab results back the next morning. Another has X-ray on weekdays only, sends most lab work out, and keeps a short list of rapid tests on the counter. Both are ordinary urgent cares. A locum physician, NP or PA who doesn't know which one they've walked into finds out in the middle of a visit, and an MA or RN picking up a shift finds out when they're asked to run an analyzer they've never seen.
This is an information problem, and the fix is on the clinic's side: write down what you have, put it in the shift description, and walk the clinician through it at the start of the first shift. What follows covers what to write down. Decisions about who may interpret images, use an ultrasound device or run a given test belong to your medical director and your state's rules, and nothing here replaces them.
Why the X-Ray and Lab Setup Gets Left Out
Permanent staff don't need the X-ray and lab setup explained, so nobody has written it down. The technologist's schedule, the cutoff for the lab courier and the test that's been out of stock for a month are all common knowledge inside the building. A locum has none of it.
The gap is widest on the shifts locums tend to cover. Evenings, weekends and holidays are when a technologist may not be scheduled, when the reference lab's courier has already come and gone, and when the person who knows the workaround isn't on site.
Write Down Your Imaging Setup
Start with what your clinic can image on site and when. For each modality you have, record:
- Which hours it's available, and whether that changes on evenings and weekends
- Who takes the images on each shift
- Who reads them: the ordering clinician, a radiologist, or both
- How an overread reaches the clinic and how long it usually takes
- Where a patient goes for imaging you don't have on site, and how the referral gets started
If your clinic has a point-of-care ultrasound device, add one line stating your policy on who uses it. That policy is your medical director's to set. The locum only needs to know what it says before the shift.
Write Down Your Point-of-Care Testing
List every test your clinic runs on site by name. Don't write "standard rapid tests," because the list a locum has in mind is the one from the last clinic they worked at.
For each test, record:
- Whether it's available on every shift or only during core hours
- Which analyzer it runs on and where the analyzer sits
- Who runs it at your clinic: the clinician, an MA, an RN, or any of them
- How long a result usually takes
- Who to tell when a kit or cartridge runs out
The "who runs it" line matters for every role. A physician, NP or PA needs to know whether to expect a result handed to them or to run the test themselves. An MA or RN picking up a shift needs to know which analyzers they'll be expected to operate, because the same test runs differently on different manufacturers' devices. A few minutes on the device at the start of a first shift covers it.
Write Down Your Reference Lab Arrangements
Anything your clinic can't run on site goes out. Record:
- Which laboratory you use
- When the courier picks up, and what happens to a specimen collected after the last pickup
- Whether same-day processing is available and how to request it
- How results come back: into the EMR, by phone or by fax
- Who at the clinic receives a result that arrives after the patient has left, and who contacts the patient
The last item is the one a locum can't work out alone. They may not be back at your clinic when the result arrives, so the result needs an owner on your permanent staff, and the locum needs to know who that is so they can tell the patient what to expect.
Equipment and Supplies That Vary by Site
Some of what a clinician reaches for during a visit is equipment your clinic may or may not stock. List the equipment and supplies your clinic reliably has on hand, anything that's stocked inconsistently, and anything that requires a request to someone with a key or a login. Include where it's kept.
Keep this list honest about the present. An inventory that describes the clinic as it was before the last equipment contract ended is worse than no inventory, because the locum will trust it.
Put the X-Ray and Lab Setup in the Shift Description
A locum clinician decides whether to take a shift from what the listing says. If the listing describes the clinic's X-ray and lab setup, clinicians who are comfortable in that setup are the ones who apply, and nobody is surprised at the door.
Two or three plain sentences are enough. For example: "On-site X-ray with a technologist until 6 p.m. on weekdays. No technologist on weekends. Rapid tests on site are listed in the orientation sheet, and everything else goes to a reference lab with next-day results." A clinician reading that knows what kind of shift it is.
Say what you don't have as plainly as what you do. A clinic without on-site imaging isn't a worse place to work, but it is a different one, and a clinician should learn that from the listing.
The First-Shift Walk-Through
Before the first patient, have whoever runs the floor walk the locum through the diagnostic setup in person. It covers the same five things the written inventory does:
- Imaging: what's on site today, who's taking images, who reads them
- Point-of-care testing: what's on the menu, where the analyzers are, who runs them
- Reference lab: today's pickup time and how results come back
- Equipment: where things are kept and what needs a request
- Referral: where patients go for anything the clinic can't do, and how to start it
This belongs in the same pre-shift routine as EMR access and the building tour. If your clinic doesn't have that routine yet, what operators get wrong about locum orientation covers how to build one.
Record What Each Locum Clinician Was Told
Keep a short record per locum clinician: the date they were walked through the X-ray and lab setup, which analyzers they were shown, and any decision your medical director has made about what that clinician will and won't do at your clinic. The record saves time when the clinician returns, and it gives your clinical leadership one place to look when a question comes up later.
A returning locum doesn't need the full walk-through again. They need to hear what's changed since their last shift, which is only possible if someone knows what they were told the first time.
Clinics With More Than One Site
Operators with several locations usually have several different setups. A locum who knows your main site doesn't automatically know the satellite that opened with less equipment and a different lab courier schedule.
Use the same inventory template at every site so the differences are visible side by side. When a clinician who's worked at one location picks up a shift at another, the briefing can be limited to what differs. The same habit helps when a site adds a service: a clinic that outgrows its staffing model often gets there one new capability at a time, with the documentation trailing behind.
Service lines with their own rules need their own page. DOT physicals, drug screens and workers' comp visits come with federal training requirements for the people who perform them, which is a separate check from anything in the X-ray and lab inventory.
Start With One Page
A one-page inventory per site, a few sentences in each shift description and a short walk-through before the first patient cover most of the gap. None of it needs new equipment or new software.
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