Hiring a locum: rates, agreements and pitfalls.

Maternity leave, a colleague who has left, a schedule filling up: sometimes you simply need someone in the chair. This is what a locum costs, what you put in writing and where it goes wrong.

What does a locum cost?

Most locum dentists work for a percentage of the turnover they generate: between 30 and 50 per cent, with around 40 per cent as the usual middle. An experienced locum in a busy practice with full schedules sits at the top end; someone just starting out, or joining a practice with a lot of gaps, lower.

Do the maths before you agree: 45 per cent of a well-filled schedule can work out perfectly well for the practice, while 35 per cent of a half-empty rota makes nobody happy. Occupancy determines the return, not the percentage alone.

Would you rather settle on time than on turnover? For a self-employed dentist starting out, online rate overviews suggest around € 150 per hour excluding VAT as a guide, rising with experience — which works out at roughly € 1.200 for an 8-hour clinical day. Experience, region and the type of procedures determine where you land.

What you put in writing

Don’t use a home-made contract. There is a model locum agreement from KNMT, ANT and VvAA that has been submitted to the Dutch tax authority — that is your starting point. Make sure it at least covers:

• the period and the days, and what happens on extension;
• the percentage, what it is calculated on and when settlement takes place;
• agreements about record keeping and handover — they remain your patients;
• who is answerable in the event of complaints and how liability and insurance are arranged;
• the notice period, for both parties.

The two pitfalls

Pitfall 1: it looks like employment. A locum who works fixed days for months, is paid the practice rate and is never allowed to send a substitute is, in the tax authority’s eyes, quickly no longer self-employed. Go through the five questions in our decision guide before you extend.

Pitfall 2: turnover-based pay for someone who is really staff. The KNMT warns, with good reason, that all-in pay linked to turnover is risky as soon as someone effectively functions as an employee. If you want to tie someone in for the long term: simply do it on an employment contract, with a normal salary.

Can’t find a locum?

You are not alone — the shortage is felt just as keenly in locum work as in permanent roles. We know the locums in our network personally, including their availability. And if self-employment is no longer possible, we solve it with secondment. How locum work through us works.

Sources

• Dutch tax authority — model locum agreement (KNMT, ANT and VvAA)
• KNMT — all-in pay based on turnover is risky
• De Startende Tandarts — usual percentages
• Kop van Brabant — self-employed hourly rates in dentistry