The Road Warrior Physician
By Elizabeth Noel Lumpkin, MD
Chapter 2 What’s the Locums Type?
Be yourself; everyone else is already taken. Oscar Wilde
Just who does locum tenens? I am glad you asked! Virtually every level of medicine and every specialty is represented. What are the advantages for the various groups and what are the motivations? Read on!
A number of years ago, when attending a meeting, I struck up a conversation with the woman sitting next to me, who happened to also be an anesthesiologist. We talked for a while, and the subject of where we each worked came up. She told me that she worked for six months of the year in an academic practice teaching residents critical care, and the remainder of her time she working doing locum tenens.
I was puzzled by this because, in my group, we had used locum tenens for the occasional coverage needed when someone had surgery. In years past, they had also hired locums when they were in the midst of looking for a new member for the group. But someone who did locums on a regular basis–well, that was definitely something new to me!
As we talked further, I learned what motivated her to take this direction. The academic center where she worked could not offer her full-time employment at the time of her hiring, so she sought a way to make ends meet, assuming that she would go full-time when the opportunity presented itself. She began doing locum tenens at that time and found that she enjoyed the freedom it gave her as well as the flexibility to do different cases (or actually do cases unlike many of her academic colleagues).
To her own surprise, when she was offered a full-time teaching position, she politely turned them down because she found that this hybrid of practices suited her quite well. In fact, she really could not imagine doing things any differently.
So who does locum tenens? There are several groups of individuals, and just like medicine in general, there is no one type of person. There are four main groups found in this part of medicine:
- Newly graduated residents
- Retired or soon-to-be retired physicians
- Mid-career physicians
- Full-time locums providers
As you can see from the list, it pretty much covers everyone in medicine these days. So what are the motivations that are common to each?
Newly Graduated Residents
The idea that a new resident might choose to do locum tenens comes as a surprise to many as they think that the main focus of your last year of residency is finding the right job. Many of the lectures and brainstorming sessions were about finding a permanent job, not a temporary one. However, there are many reasons that a short-term job might be the best fit:
- Having a spouse who is still completing residency or fellowship
- Having a spouse who is in the military
- Checking out new areas before committing
Retired or Soon-to-Be Retired
While the idea of retirement is appealing to many, there are those who still desire to continue working, just not as much. Of course, your current group or practice may be eager to hire you as a locum–you are a known quantity after all! On the other hand, the desire to be nearer to children and grandchildren can also provide the impetus for looking for work somewhere else.
It is not unusual to see a physician who is retired from the military (often at an astonishingly young age) who still wants to work, but without the commitment required for a full-time job. It can be a great boon to a practice–having a seasoned physician who wants to work without getting on the partnership track.
Some are frankly puzzled by the idea of someone who is established in a practice doing locums for someone else. There are many who do so for several reasons. Depending on the local economy and the economy in general, some choose to supplement their income by doing locums especially when the workload is lighter or even during their vacation times. In fact, I had a partner who did locums taking his family to the various locations. They played during the day while he worked, and they all enjoyed the new area in the evenings and weekends.
Sadly these days, the dissatisfaction among physicians is at an all-time high, so many are considering a job change or even a career change. Working elsewhere can often illuminate the source of the problem. Maybe it’s the current location or even the career itself.
Like the previous category, there are those who do retirement planning by working in a new area–taking the time to check out the area as well as laying the groundwork for some part-time work down the road if the need and desire arise.
The Full-Time Locums Physician
If I had a dollar for every time someone asked where my permanent job was, I could retire myself! Even some recruiting agencies are surprised to find someone who does this for a full-time job, and yet I see more and more people choosing this route.
Initially, a disruption in a group or practice may result in many being without full-time employment with locums being a lifesaver. Over time, some find the new way of working suits them better than they would have imagined. Of course, many continue to do locums until the right permanent job comes along.
Another trend I have seen is those who are transitioning out of medicine into a new career choosing to do locums as a bridge until the new venture takes shape. I knew of one physician who developed his own sports line of nutritional products and did locums as a side line.
The story at the beginning of this chapter illustrates one major motivation for those who do locums work: flexibility. Most people give this as the primary reason they do locums; some, in fact, give it as the only reason. You choose for whom you work, and to a certain extent, you choose when you want to work. You are not wedded to some administrative ideal or infrastructure, and you may come and go without fear of losing your position, because you don't have a position with that practice except for the dates detailed in your contract.
The attraction of greater freedom looms large. Naturally, there can be more free time as there are fewer non-work commitments attached to the locums provider-principally, fewer meetings. Of course, depending on the assignment, you may have evenings and weekends free. That definitely gives you more time to explore your new area, which may be one of the prime movers that brought you there in the first place.
Always bear in mind that this freedom while on the road does not necessarily translate into freedom once you return home. "Just what do you do with your free time?" many will ask me, not realizing that I return home to mail that has to be processed and other home projects that have been in standby mode while I've been on the road.
For some, the financial pull of doing locums is most influential. In the past, I have done assignments with lots of overtime and calls which yielded pretty sizable paychecks. These days, the cash cows are becoming scarcer as hospitals and groups are minding the bottom line more carefully. Of course, if you really want to work, there will always be groups hungry for your presence that will pay you accordingly.
In summary, you will find nearly every age level and experience level working as a locum tenens provider at various points in their career. It can benefit virtually anyone who seeks to learn from this type of employment.
In the next chapter, we'll cover the common question, where do you find the jobs? Do I want to work with an agency, and if so, how do I find a good one?