To Locum Tenens or not to Locum Tenens, that is the question.

Written by on September 28, 2012 in Insight - No comments

Read about the research one physician did when considering the life of a locum tenens and what she learned.

I first heard about locum tenens when I was in residency. As most readers know, locums work is temporary employment for physicians in order to fill short-term staffing assignments wherever they are needed; in single practices, hospitals and even government facilities. In its inception, it was primarily utilized by small, one-physician practices in rural areas.  If the doctor became ill or went on vacation, there was no need to close up his practice.

Initially temporary work did not appeal to me, as I enjoy establishing relationships with my co-workers and getting to know a city. However, the more I learned about it, the more interested I became. I was especially interested in the international opportunities, so I began to do some online research and seek out advice from those who were well-versed.

According to surveys, reasons for choosing locum tenens work are many, but they tend to vary by age. One survey published in 2004 indicated that older (>54 years of age) physicians chose this work because of a desire to work part-time. However, younger physicians were seeking a more flexible work schedules and the ability to experience several different practice environments to help them learn where they felt most comfortable.  Schedule flexibility was also the dominant reason among women who may, for instance, have children and a home to care for. So, while some physicians would like to experience how health care systems operate elsewhere, others (including myself) appreciate the opportunity to be free from administrative responsibilities.

Another interesting thing I learned about locum tenens positions is that the duration of employment is totally variable, depending upon the needs of the hiring organization. The job could last anywhere from one week to several months or longer. The temporary nature was appealing to me at the time because I wanted to experiment with different locations and explore life in different parts of the world. There is no long-term commitment, which is ideal for a young physician fresh out of residency. At the time, I was nearing the time of residency, when it’s time to look for a “real job.”  I thought, “Why not try a new location? I’m not married; don’t have kids… perfect time to do this.” My fellow residents who were also looking into locum tenens work at the time were in the same social boat. Of course, we knew that oftentimes these temporary positions can transition into permanent work, if the temporary position is a good fit for the physician and the hiring organization. They didn’t really give too much consideration to the long-term, however. They were more interested in the adventure of finally being done with residency and relocating to a new city or country.

Another reason I wanted to look into short-term work was the competitive pay. After researching his options after residency, my family medicine friend was attracted by higher salaries offered in some locations, especially in more rural areas. This was appealing to those of us coming out of training with six-figure loans.   Other perks of locum tenens are not limited to competitive pay. Often, housing, local transportation and professional liability insurance are also covered. One physician I know was offered a position in a small town in a not-so-desirable state to address a shortage of anesthesiologists. However, her husband was finishing his residency in another state. At the end of the day, she couldn’t turn down the offer because of the highly competitive pay. Another locum I worked with requested an assignment in a coastal town near the ocean.  He packed up his family, worked only 3 days a week and they spent quality time together for a few weeks in a beautiful, vacation like setting.

I found plenty of advice online, mostly from physicians offering advice about the contract you sign with your placement agency. They recommended confirming details of on-call and  practice hours, expectations of duties performed, payment schedules and professional liability insurance.  All the specifics of your agreement should be in writing. I could only assume that these words of wisdom were spoken from experience.

Overall, I have no doubt that locum tenens work can be an enjoyable and exciting experience for a physician seeking change or exploring his or her options. My anesthesiologist friend had such a good experience that she recommends it as a way to search for a permanent position. She cautions that it is not fitting for all personalities, though the same could probably be said for most aspects of medicine.

As for me, I didn’t end up doing any locum tenens work at that time. I went on to complete a fellowship and, in the meantime, met my future husband. Although I found a position in a good location after fellowship, my husband and I dream of moving around some before having children. I still foresee working as a locum tenens physician in my future.  We haven’t yet decided where we want to settle down and the locum field allows for employment and the much needed paycheck much quicker these days than searching for a full time position.  I also believe I may want to consider shorter work weeks after my first child is born.  It is reassuring to know that there are options available through the locum tenens industry that will allow for the work schedule flexibility physicians may want or need.

By Mandy Huggins Armitage, MD

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