Plagued by issues of managed care, mounting paperwork, malpractice costs, and diminishing reimbursements, a percentage of physicians are stepping away from traditional practices to explore alternative career options. Some have chosen to hang out a new shingle: doctor for hire.
In previous years, locum tenens (a Latin phrase meaning "to stand in another's place") positions were typically filled by early career and semiretired physicians, but recently more midcareer physicians are choosing temporary assignments. A 2008 survey of 12,000 doctors, most of them primary care physicians, reported that 7.5% expected to work as locums in the next 3 years. In 2009, the number of physicians working as locums is anticipated to increase by 16% over that of 2008, according to a report by the Braff Group, a healthcare merger and acquisitions company.
For some physicians, working as a locum is a bridge between full-time assignments or a way to experience how medicine is practiced in various parts of the country before choosing to move to one area. For others, locum tenens work is a way to supplement retirement savings hit hard by the recession. Yet, for a growing number of physicians, locum tenens work is their preferred form of medical practice.
Clearly, the motivations for working locum tenens are quite varied, but the increasingly rigid nature of U.S. healthcare is driving physicians to consider what practice settings best fit their career goals. What are your career goals? Does locum tenens make sense for what you want to achieve? The New England Journal of Medicine recently explored this topic and noted the following:
A decade ago, physicians who elected the free-spirited locum tenens lifestyle — as a way to try out practice settings or merely explore new places — tended to cluster at either end of the career spectrum: doctors just out of training and those nearing retirement.
Those two groups still account for the majority of medical professionals who take temporary assignments, an estimated 60 percent, but there’s a shift afoot. Surveys conducted in recent years have found that a growing number of physicians who might be deemed “mid-career” are looking to locums as either a bridge to a potential career change or a semi-permanent practice option.
For New York City internist and infectious disease specialist John L. Ho, MD, locums has proved a good foundation for making his move from a 22-year stint in academia to the next chapter — whatever that may be. He is working as a hospitalist at Southern Maine Medical Center in Biddeford, filling in for a physician who is currently serving in the National Guard. He landed in coastal Maine after completing his first Staff Care assignment at rural Eastern Maine Medical Center.
“I always maintained my love of acute care medicine, even though my major activity at Cornell was research based. I truly got tired of running from grant to grant,” Dr. Ho said. “I am enjoying these assignments and all of the patient interactions I have now,” said Dr. Ho. He also likes the non-urban setting far more than he expected. His colleagues have been welcoming and collegial, and the patients surprisingly cordial, based on his previous experience in a large urban center. “They’re much more grateful. They actually say ‘thank you’ — and that has been gratifying,” he said.
Marci Malone, MD, is among the growing number of physicians who take locum tenens assignments regularly in addition to working full time in a practice. In fact, many colleagues look at the New York anesthesiologist quizzically when she talks about spending her “vacation” working locum tenens in remote corners of the Southwest. Since 2001, she has spent roughly a month each year working at Indian Health Service (IHS) hospitals in places like Gallup, New Mexico, and isolated Chinle, Arizona, where she has gone several times. “I have a hard time taking a vacation, so this is my idea of what to do with my spare time,” Dr. Malone said.
She finds both the work and the setting a welcome reprieve from the urban rat race, and the facilities, contrary to what some physicians might expect, she observed, are modern and well run. “The facilities may not be completely computerized, but from the anesthesia standpoint, they have almost all of the toys any of us could want,” she said. “The case load is different at IHS hospitals than at urban centers, however, because we’re not usually dealing with typical ER patients. The cases can be less demanding because most of the patients who need surgery, even if they have four comorbidities, have received a lot of regular and preventive care.”
The OR workday is often slightly shorter than her typical New York shift, but the call duty can offset that plus. “It can be just as brutal at times,” she said. Those challenges are easier to deal with, she added, because she enjoys the patients. She has grown especially fond of the Navajo Nation patients she cares for during her Arizona assignments. “They are very gracious people who have little but are willing to share what they have. Working with them helps me reset my expectations about life,” Dr. Malone said.
Hearing the experiences of these physicians shows that you could get more out of locum tenens than you would have initially expected. In addition to extra radiologist salary, you may also experience a new part of the country or new setting, interacting with patients and colleagues you never would have otherwise. Locum tenens radiology jobs could potentially broaden not only your intellectual horizons but your social ones as well.