This Today’s Classic post is republished from Physician on Fire. The original post can be found here. I've only had one job in my short career and am very happy where I'm at. However, the one thing I've learned is that change can come when you least expect it. Who knows, one day I might be doing Locums for the flexibility and for some of the reasons listed below. Enjoy!
Locum Tenens, Latin for “To hold a place”, describes a unique way for a physician to practice medicine as a temporary or traveling doctor. I’ve had ample experience working as a locum, which I have detailed in a guest post @ whitecoatinvestor.com.
My various turns as a locum tenens physician have been quite positive. A competent physician with the ability to easily adapt to new surroundings can be in high demand.
Anesthesia lends itself well to fill-in work, as do other specialties where established relationships between physician and patient are not the norm, such as emergency medicine, radiology, pathology, etc… That being said, opportunities exist in every specialty.
The Top 5 Reasons to be a Locums Doc:
1. You are just starting your career.
When you finish residency and sign on for a “permanent” job, there’s a decent chance the job won’t last. According to Medical Economics, it’s a roughly 50 / 50 proposition that will remain in your first job for 2 years.
While I can’t speak for every specialty or residency program, it’s fair to say that for me, residency didn’t teach me what sort of job might be a good fit. My program did a great job preparing me to be a capable anesthesiologist in any setting, but the exposure to the variety of workplaces and work styles simply wasn’t there.
I trained at a tertiary care facility. Most likely, you did too. I had no exposure to rural medicine, minimal experience supervising nurse anesthetists or other residents, and I only had to cover the OR or OB, but never both.
Working locum tenens allowed me to work in a wide variety of places and practices both large and small, urban and rural. I had a chance to be assigned to work hands-on in 1 room every day, and to supervise 3 or 4. I became more well rounded and adaptable, and I had a chance to “try before you buy”, learning what kind of practice best suited me.
If you are just starting out, working in a few places as a locum can gain you valuable experience and help you find a practice that works for you. Fortunately, many of the places using locums would welcome the full-time services of a capable physician, and your favorite locums job could potentially transition into something more long-lasting.
2. You would like to boost your income.
So you’ve settled into a great permanent job. You have a good work / life balance with ample time off. You’re making good money choices, following your IPS, and life is good. But you want a Tesla.Or to erase your school debts. Maybe build one of those amazing treehouses Pete Nelson tosses up on TV.
You can’t justify the cost based on your current income, you may be able to use locum tenens work to give it a boost. You might work on your own vacation to cover someone else’s (been there, done that). You might work evenings at an urgent care, read EKG’s on weekends, or cover extra call for your senior colleagues.
Using only the after-tax take-home pay from locums work makes it easier to justify what might otherwise feel like an extravagance. Of course, if one luxury need begets another, you could be locking yourself into a higher standard of living, and a decidedly longer career, or at least delaying financial independence, so proceed with caution.
3. You are tired of the politics.
As a physician who has previously served as a department chief, committee chair, and president-elect of the medical staff, I’ve been immersed in medical staff politics. I’ve also spent about a quarter of my ten post-residency working years as a locums doc.
Freedom from the entanglements of local hospital politics is a vastly undervalued benefit of being a locum. You won’t be expected to attend early morning or after-hours meetings. Your input on policies won’t be sought. I’m talking about the policies and bylaws that live in a binder (or folder on the intranet) that are rarely seen or used, but require revision and renewal at regular intervals.
You can go about your business without being sucked in to the ugly business of your colleagues. As a locum, your role in resolving the conflict between Dr. Demanding and Dr. Unwielding will be nil. At most, you might be a curious bystander to the spectacle. Being a short-timer has its perks.
4. You want a different experience
I’m being intentionally vague to keep this down to a Top 5 list. Your locums experience could be different in terms of the type of work you do, the place you do it, or the schedule you keep.
In anesthesia, you may do some locums work at a larger facility that does a wider variety of cases to keep your skills up to date. A surgeon might do locums to work with surgeons using newer techniques or technologies. A psychiatrist could consider working locums at a facility that offers electroconvulsive therapy to maintain that skill. A clinic-based internist moonlighting as a hospitalist can better maintain her inpatient skills.
You might be looking to work in a different locale. If you’re like me and live “Up North”, you might migrate south with the snowbirds to help meet the higher demand for medical care “Down South” in the winter months. Is Naples not exotic enough for you? Opportunities exist in far away places like Australia, New Zealand, the Caribbean, Tasmania, and Guam.
Your quest for a different experience may be more calendar related. After years of working 7 to 6 Monday through Friday, you’re ready to try a week on / week off schedule. Or work just 10 days a month. You can take the winter off to ski the Rockies or the summer off to take a mighty RV road trip with the family. If you’re working exclusively as a locum, you can better control how much or how little you work.
5. You are winding down your career.
Reason #4 offers a great segway to #5. Years of 50 to 60-hour workweeks may have taken its toll on your well-being. If you are financially secure, you could easily afford to scale back. If your current job doesn’t offer the option, or you’re looking for a change of scenery, locums work can deliver the schedule or beachside location you’ve longed for.
The twilight of one’s career rivals the dawn as the best time to practice full-time (or part-time) locums. If you have an empty nest and the freedom to travel, you can carve out a working life that appeals to you. You may even find yourself reinvigorated professionally as you meet new people and discover novel ways of delivering care. If not, you can wind your career down completely, and walk away for good.
Retiring as a locum, you are in an enviable position to make a stealthy exit. You don’t even have to tell anyone you’re calling it a career. Just buy doughnuts on the last day, say thank you and goodbye, and stroll on out with a big smile on your face and perhaps a small tear in your eye.
I think that’s a good way to go out.
Have you had any locum tenens experiences, good or bad? Do you have a 6th reason for doing locums? Share with the community in the comments below!