Locum tenens is an extremely flexible and lucrative way to practice medicine. You become your own boss and can plan your schedule and lifestyle to fit your own needs. Here are real life examples from hospitalists that I have worked with who chose a locum tenens lifestyle for different reasons:
Locum tenens is an extremely flexible and lucrative way to practice medicine. You become your own boss and can plan your schedule and lifestyle to fit your own needs. Here are real life examples from hospitalists that I have worked with who chose a locum tenens lifestyle for different reasons:
I’m currently a second year resident, soon to be a third year, in family medicine. I’m thinking about become a locum teen as soon as I graduate next July 2020. I’ve been trying to get in contact with a locum tenen to get some advice and see what they think about becoming a locum tenen right out of residency?
I also have a list of other concerns.
1st: I’m concerned about the constant change between hospitals or clinics and the different EMR systems. I briefly worked with a traveling doctor who was covering an OB/GYN shift at my hospital during one of my night shifts. The patient had a recent miscarriage and was hemorrhaging and the traveling doctor didn’t know our EMR, our Codes, didn’t know how to put in orders or how to contact any specialists or how to get the OR setup for a D&C. This was very frightening to me and makes me wonder how difficult it is to work in different hospitals/clinics as a locum tenen. Besides, getting familiar with your hospital, any other advice?
2nd: Would you recommend starting in a clinic or a hospital or both.
3rd: I’ve seen a lot of med students and residents drop out or fail boards and they can’t get back into medical school or residency. I have the same fear when it comes to not immediately getting a full time job after residency. But I would really like to take some time off and being a locum tenen gives me that option. Still, I wonder how hard is it to get a locum tenen job or any job for that matter after taking a few months off. I’ve also heard it’s hard to get a job as a hospitalist after spending several years in a clinic because you lose your hospital skills. What do you think about this?
4th: I’ve also spoken to a concierge doctor and he definitely recommended getting some experience first before starting your own practice or going off on your own as a locum tenen. What do you think?
5th: One of my colleges, told me about a locum tenen working in a rural hospital over a 4 day weekend/holliday and she ended up admitting around 40 patients to their service. She had no help and didn’t sleep for 4 days. Do you think locum tenens are sometimes taken advantage of and do you have any advice on how to avoid this?
Thank you very much for answering my questions!
Sarah, Hi!
Those are all great questions!
I’ll answer them one by one.
Locums after residency?
I’ve started locums after practicing as a hospitalist for 2,5 years. I think the fact that I had previous experience helped a lot. Although I thought I knew everything and felt very confident even in my 3rd year of residency, I definitely learned a lot in my first a couple of years as a fresh-minted hospitalist .
Having said that, I’ve known lots of docs who did it straight from the residency, so I know it’s doable.
1st – this locum doc you describe seemed to be clueless.
The only way to avoid this is to have a really good and thorough orientation before you start: make sure they teach you how to use the EMR, electronic orders, give you a tour around the hospital or clinic, introduce you to the key people as well as axillary staff.
Also, you always want to make sure you’ve got all the important phone numbers on you, although in the worst case scenario you can call operator or ask RN if you are totally lost.
I typically take a screen shot of all the important data during my orientation – this way it’s always with me and I think this saves time.
As to the EMR, every time I learn new system, I almost feel physical pain. But once you work in different places and use different EMR’s, you’ll be comfortable with all of them, since there’s only 3-4 major ones.
2nd: Would you recommend starting in a clinic or a hospital or both.
It really depends on what you like to do and what your long term plan is. It may be easier to start from the clinic since you’ll see lower acuity. On the other hand hospital work probably pays better.
3rd:
Sarah, I think it’s totaly find to take a few months off. The demand for physicians is so high, that they won’t have any problems with finding a locum or permanent jobs after a little break.
4th: I think the experience always helps. Personally, I started locum after almost 3 years in a permanent role.
Having said that I’ve seen a lot of freshly-minted hospitalists, taking on locum gigs straight from the residency.
I think you have to be smart about what locum assignments you sign up for. For example, I would not sign up to work at the critical access hospital straight from the residency.
I would stick to the hospitals that are mid-size with reasonable subspecialty coverage. I would also avoid crazy busy places e.g.>20 patients a day.
These are all specific to the hospitalists but you get the point.
5: Are locum tenens are sometimes taken advantage of and do you have any advice on how to avoid this?
Yes, those things may happen but they are uncommon in my experience.
Few things you can do to prevent this from happening:
1 – You have to know what you are signing up for and communicate the expectations with your locum company/hospital: the average census, the average number of admissions.
2 – If you are working much harder that you’ve been told – call your recruiter and explain what you are going through.
You can tell them you are not seeing more than X number of patients. This also should be communicated to the local leadership – hospitalist director, team lead, CMO.
3 – If they are still trying to give you more work than you are agreed on, you simply leave!
You are not a slave, you can leave anytime and it doesn’t matter what your contract says, if you feel you are not able to practice medicine safely, you quit right there on the spot!
I hope it helps.