Vlad Dzhashi, MD
Locum Tenens with Family:
My Experience as a Father of Two
As a father of two young children, I prioritize family time over everything else. I want to see my kids grow and experience life with them.
After all, how can I help them grow up to be successful when I’m not around to learn who they are? If I never learn their personalities, strengths, and weaknesses?
I think we can all agree that quality family time is of utmost importance… which leads to today’s topic: job flexibility.
Pros and Cons of Hospitalist Shift Work
There’s a perception that hospitalists have one of the best clinical jobs due to time off.
Typical hospitalist schedules of seven days on followed by seven days off give decent time off and some flexibility. They also allow for predictability, depending on how far out you schedule. This is something many parents can appreciate.
- Schedule challenges:
However, if you dig a little deeper, you’ll see that this “flexibility” may not be so great. After all, the typical hospitalist schedule may “trap” you on some important days, including holidays.
Maybe it’s not the end of the world to work a holiday that’s not important to your family. But what about your child’s birthday? Or your anniversary? Do you ask the important people in your life to celebrate on a different day because of your schedule? I don’t know about you, but my family would not be amused!
- Your sleep vs family time:
The next problem is the “bad” shifts —night and swing shifts.
Although some hospitalist programs hire nocturnists, some expect their hospitalists to work night and swing shifts.
Of course, we all know physicians who enjoy working nights, but in most cases, night shifts equal less sleep hence less “quality” family time.
- Vacation time:
Last, but certainly not least, is the issue of vacation planning.
If you like to travel across multiple time zones, 7 days off just isn’t enough. Even if you took a family trip to the beach for 7 days, wouldn’t you like a day or two to catch up on everything at home before jumping back into work? (Sometimes we need a vacation from our vacation, if you know what I mean:-)
Requesting time off as a hospitalist could be challenging, if you even have paid time off. Planning a big family trip often requires doing so several months in advance. This is especially true if it’s a popular vacation time, such as winter break or summer holiday. You’ll probably be competing with other people’s schedules.
Locum tenens may be the way to go
If you’re a hospitalist and find yourself nodding along as you read, maybe locum tenens work is for you. I’ve posted in other places about its benefits. As they apply here, the biggest benefit is flexibility.
Personally, after “pulling the plug” on a permanent job, I’ve found that it’s much easier to plan vacations, avoid working nights, holidays, and other important days like my kids’ birthdays.
Who will factor into your decisions?
Is your significant other or partner OK with you being away from home? Is yes, how many days a month? If not, are they willing to travel with you? If your partner works, can it be done remotely? Do you have children? If so, how old? What are your plans for school?
After you answer these questions, you can start planning. There are plenty of options between locum tenens and per-diem work to “engineer” your lifestyle and schedule.
- Scenario A: No Children
In this situation, the biggest question is whether your significant other will travel with you. Obviously, this depends on employment status and nature of work.
If your partner will be traveling with you, it’s more likely you’ll be looking for work in desirable locations (Hawaii, here we come!).
But if the location you choose is less-than-exciting, there’s a good chance you’ll be traveling alone.
There’s no right answer, of course, so you’ll have to decide what’s best for your situation.
Here’s a good example of how this worked out for a psychiatrist:
- Scenario B: With Infants and/or Toddlers
Unless you and your significant other love to be on the go, I think having a home base is best in this situation. To maintain flexibility and stay close to home, do part-time work plus per-diem or 100% per-diem.
If your partner can care for the kid(s) on their own, and/or temporary outside help is available, you could choose to take on a locums gig for extra money.
- Scenario C: School-Age Children
In this situation, your decisions will likely be driven by your plans for school. Do you plan to send your kids to school or will they be homeschooled?
Option 1 – local school:
Again, if flexibility is your goal, and your kids will be attending school close to home, per-diem work may be a better option for you.
If earning more money is your goal, you can achieve this by finding well-paying gigs out of state or out of town. Just make sure your significant other can and is willing to care for your children alone (or has help)!
Option 2 – homeschooling:
If you want to homeschool your kid(s), you obviously need a designated teacher for your kid(s). This usually ends up being a stay-at-home parent (sorry, honey…).
The benefit of this is that you can travel with your children ALL THE TIME. This is great if you love to travel, and you can also earn more with locum tenens gigs.
Living arrangements will be a big consideration here. You don’t want to end up in cramped quarters intended for a single physician. Consider renting a house or large condo or negotiating that into your contract.
- Scenario D: Adult Children
This might seem pretty obvious, but it’s worth mentioning for physicians in this situation who may feel stuck.
Many folks send their kids off to college and only see them at holidays or other school breaks. Working locum tenens can allow you plenty of flexibility if you want to be near your kid(s) but don’t need to be present everyday.
For example, I know a hospitalist who worked locum tenens in the same town as her daughter’s college. She then flew to a different state to work more shifts.
Money vs Flexibility:
Here’s an ugly truth about locum tenens when you need to balance it with family life: you WILL be tempted to work away from home. A LOT of high paying gigs will be away from your home, and unless you take your spouse and kids with you, you will spend this time alone.
A great option to have plenty of family time AND make more money is to work as a per-diem hospitalist: per-diem rates can be as high as locum rates and even higher and you get a long-term flexible job close to home.
- My experience:
I have a wife and two children, and my goal has been to cut back on travel as much as possible. To maximize my flexibility and family time, I ended up working per-diem at local hospitals and stopped traveling for a couple of years.
I realize I probably could have made much more money chasing higher paid gigs in different states. But that would mean more time away from my family, which I was not ready for. So the choice was easy for me.
Now that my older kid is in school and my youngest is almost 4, I’m fine with traveling for a week per month to work. I should point out that I only do it if it makes sense financially (i.e., I make more when working away from home).
This gives me a chance to work less during winter and summer months during school break time so my family can travel together. This is absolutely the best time of the year we have as a family: so many great memories and experiences.
I especially appreciate the fact that I DON’T have to ask anyone’s permission and set my schedule the way it FITS me and my family (unlike when I had my first permanent job).
Conclusion:
In summary, there are ways to make locum tenens and/or per-diem work for you, depending on your goals. In my experience, you can outearn any permanent hospitalist job and still have plenty of quality family time.
As featured on
Hello
I read your article on locuming with a family. I am curious how do I make that really work? Is there anyway to do it with a wife who works and then raise a child. For example, I cannot take her with me all the time. Also she earns a good deal of money. What would you recommend?
-Locum near the home
-Locum for short periods of time every 3 months
-Get a credit card that gives you good frequent flier miles
What are some things that you recommend I should warn the wife about if this is the scenario?
What are some things they should know when trying to raise a child?
What are some lessons you learned about it?
Hi, Rick!
With your wife working it is definitely harder but the question is, why do you want to work locum tenens? What is your goal?
Vlad.