Andrew Wilner, MD, FACP, FAAN, shares how physicians can be more successful as locum tenens.
Doctors can’t work until they acquire a bundle of degrees and at least one state medical license. Practicing physicians also need a Drug Enforcement Administration (DEA) number to prescribe controlled substances. A state-specific Controlled Substance for Practitioners (CSP) certificate may also be required. Most employers expect board certification or, at the very least, board-eligibility. Physicians must proficiently navigate electronic medical record (EMR) systems or learn quickly. Employers assume that candidate physicians are compassionate, competent, efficient, and well-trained health care providers.
Special skills for locum tenens docs
In addition to the requirements listed above, locum tenens physicians must master numerous “soft” skills. These include collaboration, communication (speaking, writing, and listening), flexibility, and time management. Flexibility is essential as each new assignment presents unanticipated challenges. The cover illustration of my book, “The Locum Life: A Physician’s Guide to Locum Tenens,” depicts a physician parachuting into a new clinical environment. A safe landing into unknown territory describes the start of a typical locum tenens assignment.
The Three “A’s” of Medicine
Three fundamental qualities that enhance a candidate’s chances for success are known as the “3 A’s of Medicine.” These include availability, affability, and ability, listed in order of importance!
Let’s start with “availability. Locum jobs come and go rapidly. If you want a good assignment, you have to respond promptly to job posts. Availability requires an active license in the appropriate state. To increase my eligibility for locum assignments, I carry five state licenses. Some locums physicians maintain more than ten! Other key features of availability include the flexibility to start work on short notice as well as a willingness to show up with enthusiasm.
An “affable” physician is approachable and friendly. Upon your arrival at a new assignment, others will judge you by your dress and demeanor. Most people, including your patients, don’t possess the toolkit to know whether you are a talented physician or not. But they will know whether or not they like you! To be effective at your job, you need to gain the trust of physician colleagues and other medical staff. Affability speeds that process along. Perfecting this skill also facilitates glowing recommendations from colleagues that will help secure future assignments. Those born with a defective “affability gene” can cultivate it over time.
Your medical “ability” is your most important skill as a locum tenens physician, but it is hidden. No one knows how hard you studied, how high you scored on your exams, or how many difficult diagnoses you made during your career. Since locum tenens physicians often work with few, if any, doctors of the same specialty, probably no one will know whether any of your recommendations or treatments make sense. But you do. While availability and affability are essential qualities, your ability as a physician matters most to your patients.
Improvise, adapt, and overcome
Hospitals or clinics hire locum tenens physicians to address an immediate physician shortage. Practice growth, physician illness, maternity leave, retirement, or run-of-the-mill mismanagement may have precipitated the crisis. Working conditions may be suboptimal due to insufficient staffing. (It may even be that suboptimal workplace conditions are responsible for the lack of qualified staff.) Permanent recruitment efforts may be concurrently underway, which can be awkward.
While my past assignments have never presented significant difficulties, locum tenens physicians would be wise to adopt the U.S. Marine slogan, “Improvise, adapt, and overcome.” This mantra does not support trying to “fix” a dysfunctional clinic or inefficient hospital. Chances are you won’t be successful and will waste valuable time and effort. If by some miracle, you improve the workplace, your accomplishments will likely go unrecognized and unappreciated.
My advice: Focus on patient care. That’s why they hired you.
A Guest in Someone Else’s House
Some locums docs approach their assignments as “a guest in someone else’s house.” I think it’s a great analogy. You’re not there to rearrange the furniture or upgrade the appliances. As a guest, you show up on time (availability), be pleasant (affability), and assist your host with the dishes or other tasks (ability). Like a locum tenens assignment, each visit presents positives and negatives and is time-limited. When it’s time to go home, you’re done. If you were a great guest, your host may even invite you to return. (Recurrent locum tenens assignments are common and easier than the first time around!)
Locum tenens physicians regularly work in new, stressful environments. They encounter challenging situations and must swiftly establish working relationships with colleagues. To succeed, locum tenens physicians should cultivate soft skills, such as affability and flexibility. Combined with an excellent fund of knowledge and a good bedside manner, success is virtually guaranteed.