This series is a deeper dive into what it's like to work as a locum tenens physician. For this article, we spoke to obstetrician-gynecologist Dr. Shyrlena Bogard. She shares her thoughts on locum tenens for OB/GYNs, finding her freedom, and saying “no” to burnout.
"There's not a state in the U.S. that does not have a shortage of OB/GYNs," says Dr. Shyrlena Bogard, an experienced locum tenens OB/GYN. "There's just a huge need in obstetrics and gynecology all across the nation."
When it comes to locum tenens for OB/GYNs, Dr. Bogard found there is no shortage of opportunities. She started doing locums at the very beginning of her career not only because she was needed; she had goals to reach with locums, too.
Why locum tenens?
"When I first started doing locums I was in private practice, and I was at that seven-year mark — so getting that seven-year itch," explains Dr. Bogard. "I wanted to move to California, and so I started doing locums to save up some money. When I first moved to California, I partnered with someone in the practice in integrative wellness. Locums was a way to keep steady income while that practice was building up."
These days, locums continues to provide the income stability that Dr. Bogard needs while pursuing her dreams. She's been working on getting a telehealth business off the ground for the last few years and enjoys the combination of locums and doing her own thing.
"There are some educational things that I'm working on personally to help me to be a better business owner," she says of her telehealth venture. "As a physician, we don't get a whole lot of education in running a business while in medical school."
Living in Memphis, working in California
Originally from Memphis, Tennessee, Dr. Bogard prefers taking locum assignments in southern California to shake things up. She has a penchant for California life, but her kids and the familiar comforts of Tennessee keep her coming home.
"I fly back and forth literally every week," she says of Tennessee and California. "I love southern California. You have the ocean, you have the mountains; it's the best of both worlds. If they could put a lower price tag on it, I would definitely love to stay there year-round. Sometimes, if I have something else going on in California, I will stay a couple of extra days and hang out with my friends or go to an event. But usually I get on a plane and I come back home. By the time my assignment ends, I'm usually ready to come sleep in my own bed."
Choosing the right locums schedule
After a little trial and error adjusting her locums schedule, Dr. Bogard says she now prefers hospitalist assignments over those in clinics.
"When I first started doing locum tenens, I was doing both clinic and call so it was the same as being a regular, full-time OB/GYN," she says. "Over the past two years I made the decision that I strictly wanted to do hospitalist work or hotel call. So if I’m on a hospitalist assignment, that means I’m in-house 12 or 24 hours straight. I go in the morning, I round and see patients, and then for the rest of the day it's pretty much my day, I go in if I’m needed to do deliveries or any emergencies that come up.”
Enjoying the day-to-day
Dr. Bogard likes the variety that she gets to experience working locums. “Sometimes those assignments are working with residents, which I really, really enjoy,” she says. But much of her day-to-day is seeing similar cases. “I would say 85% to 90% of my day is obstetrics, so deliveries, C-sections, and GYN patients.”
And when it comes to continuity of care, Dr. Bogard has found that even as a locum she is often able to connect with patients, just as a full-time permanent physician might.
"There's one location that I've been working at for three years now, so I know the nurses really well," she says. "And for some of the patients, I've delivered more than one of their babies, and they recognize me when I’m in town. I'm lucky in that I've been doing locums long enough that I have developed relationships in some of the places where I do assignments."
Integrating into new environments
While locums can sometimes seem like wading into unknown waters at the start of each assignment, Dr. Bogard finds that most places come to feel like home fairly quickly, especially now that she has a few years under her belt.
"When I start a new assignment, every hospital is essentially like starting a brand-new job, going through orientation, learning the system," she says. "The good part is I know most of the EMR systems, so I can typically breeze through the orientations."
Another good part is getting to know the team at each new place.
"Most of the facilities are very welcoming," says Dr. Bogard. "They're happy to have a locums and they're very supportive and they want to make sure that you are comfortable. For onboarding and offboarding, I do a sign-in just as though I was a part of the regular staff. One of the things I always say is, it doesn't matter where you are, obstetrics is the same."
Saying "no" to burnout
The opportunity to work locum tenens as an OB/GYN has offered Dr. Bogard a freedom she hopes other physicians can achieve.
"Becoming a locum has helped me to keep that work/life balance but to have the flexibility and control," she says. "I control my schedule; I decide when I work, and I decide when I need time off to step away. Locums allows me not to get burned out but continue doing what I love. There's so many of us who stop enjoying it along the way, and I never wanted to become that physician."
Advice to new attendings
Dr. Bogard has these words of advice to graduating residents who are just starting out their careers as attending OB/GYN physicians: "Don't rush to jump into a long-term contract because you've spent the last eight to 12 years accumulating debt. There's a saying we have in the medical field called the ‘Golden Handcuffs.’ It's very tempting to jump at the dollars these hospital corporations are waving at you. So, consider locums as way to have flexibility to allow you to travel."
"Locums really does allow you to travel and go to different places, but it allows you to really test the market before you decide where you want to commit, long term," Dr. Bogard adds. "It really is a very supportive system."