Email listservers – useful, or should they come with a quality and wealth warning?

A number of groups of locums have been using email listservers to allow practices to inform local locums of work available. For a (normally small) fee, practices can advertise the work they have available and these advertisements are then sent by email to all locum GP members of the group. At first glance, this may seem very attractive, but there are significant problems with this approach which locum GPs should be aware of before embarking on such a system.

ShoelacesOn first glance, locum listservers could be seen to save practices time and money when advertising unfilled sessions to locums, so that every local locum receives an email of those available sessions when the list is published. As well as raising some funds for those who own the listservers, it also allows new locums to the area to compete directly with more experienced locums. And of course, the listserver could inform local locums of services such as medical education meetings.

The concern with list servers however is that they unwittingly create a market controlled by, and therefore biased towards, practices. By having such easy access to a very large number of locums, they are able to dictate their rates and terms, if not directly then certainly indirectly by influencing the flow of job-related information. In certain cases these market forces have reportedly allowed practices in some areas to keep rates artificially low for 4-5 years.

Such a scatter-gun way of advertising individual sessions,  especially as in some cases if this is done at a fixed time every day, allows practices to take advantage of rapidly collecting many ‘bids’ over a very short period of time. In this way, they have the benefit of being in receipt of knowing the availability of potentially dozens of locums and knowing what price each locum would charge for that session. And because all the locums know that they’re competing against each other for the work, they will naturally tend towards offering themselves at their cheapest price.

Thus, any such locum market that relies on such an email listserver will very likely be based on cheapest price and effectively make local locums compete against each other on the practices' terms rather than their own. Unfortunately, factors such as quality, continuity and experience are pushed aside, in favour of market forces, biased heavily towards cost savings to the practice.

Such is the strength of advantage to the practices that there have even been instances of a practice using list servers to re-advertise a large number of sessions already booked with another locum, in an attempt to get a better rate, and of practices playing out locums against one another. It is tragic that large groups of professional locum GPs are having to operate in markets that on first impression seem to save time but in fact serve only to work against them; observe any small child trying on lace-ups for the first time – it seems such a good idea to that child to not spend all that energy on trying to tie them up when they could be up and running around within seconds. It’s only later that they realise their mistake.

Since 2002, the NASGP has strongly advocated the GP locum chambers concept as a means by which local GPs can have a far greater control over their working lives – both based on quality, welfare and income – and allow locums to compete in a fair market, rather than one completely controlled by local practices. Chambers take a while to get established if you don't have the good fortune to already have one in your area, but once established they provide real benefits for the entire local healthcare community.

Why listservers are bad for practices:

  • The cheapest, not the best, locums get booked.
  • Little or no locum continuity – have to re-educate for each session – no built-up trust.
  • Takes time to interact and manage the details.
  • Encourages locums to charge for extra minutes & services later which adds to the administrative load.
  • Discourages doctors from becoming locums.
  • Discourages teamwork and good will between practices and locums.

Why listservers are bad for locums:

  • Drives price down.
  • Drives quality down.
  • Wastes time chasing work with little chance of winning.
  • Adds to the challenge of revalidation.
  • Discourages teamwork and good will between practices and locums.

Have you had any experience of email listservers, good or bad? Have you seen your income increase since using the listserver, or have you managed to increase your rates since joining it? And what's your experience if you're a member of a locum chambers?

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