Among the myths about working on a locum tenens basis is “it’s predominantly geared to semi-retired doctors,” according to Medicus Healthcare Solutions.
In fact, “the practice alternative has something to offer at every career stage” — from ‘test-driving’ different practice locations before settling down, to avoiding burnout and invigorating passion for medicine as mid-career approaches, to easing into retirement by working ‘part-time,’ the firm suggests.
Comp Health reinforces that message: “Locum tenens can be a good fit at many points in a provider’s career. Some work locums to make extra money on the side, others use it to fill a gap while transitioning between permanent positions, and still others pursue it as a full-time career.” Especially in the healthcare business where people’s wellness and futures are on the line, timing is everything. However, there’s really no ‘best time’ in a clinician’s career to work locum tenens. There’s really no ‘best time’ in a clinician’s career to work locum tenens.
Right Out of Training
“My experience with locum tenens (temporary work) began the Monday after I finished residency,” Physician on FIRE Leif Dahleen, MD, says. “I practiced exclusively as a locums doc for nearly two years, trying jobs before buying, and was offered a job in just about every place I worked.”
Although this certainly doesn’t happen with every locum tenens assignment, it does happen. In fact, Dahleen made ‘the locums life’ work so well that he achieved Financial Independence by age 39 and Retire(d) Early at age 43 [“FIRE”]! Then the former anesthesiologist started a blog through which he teaches others how to do the same thing.
“I want to help my fellow physicians and others understand what it means to be financially independent, how to achieve that goal, and why it will benefit you,” Dahleen says.
Like The Locum Tenens Guy Vlad Dzhashi, he appreciates the new physician’s motivation to ‘lose the loans’ as quickly as possible. “The average indebted medical student, which is about 73% of them according to the latest AAMC survey, has around $200,000 in student loan debt when finishing medical school,” Dahleen says. “The balance typically grows during a 3- to 7-plus-year stretch of residency and fellowship training before one can start earning a physicians’ salary.”
Scan through locum tenens agency blogs to find scads of stories about how locum tenens has helped young docs “ditch the debt” in short order. “My [residency] program did a great job preparing me to be a capable anesthesiologist in any setting, but the exposure to the variety of workplaces and work styles simply wasn’t there.”
— “Physician on Fire” Leif Dahleen, MD
Earn and Learn
Beyond the financial rewards of locum tenens for new physicians, he notes its benefits as a training ground. “While I can’t speak for every specialty or residency program, it’s fair to say that for me, residency didn’t teach me what sort of job might be a good fit,” Dahleen writes. “My program did a great job preparing me to be a capable anesthesiologist in any setting, but the exposure to the variety of workplaces and work styles simply wasn’t there.”
Like many physicians, Dahleen trained at a tertiary care facility. “I had no exposure to rural medicine, minimal experience supervising nurse anesthetists or other residents, and I only had to cover the OR or OB, but never both.” He noted working locum tenens for two years right out of residency afforded him experience in different states, practice sizes and settings — both urban and rural. Dahleen believes this helped make him well-rounded and more adaptable.
If you’re a resident, stories like these might have you wondering, “When can I get started?”
CompHealth notes that, while it’s possible for physicians to accept locum tenens assignments in their last six months of residency (in some specialties), some residency programs, hiring facilities or agencies won’t allow it. However, “physicians pursuing a fellowship are eligible for placement in their residency specialty as long as they’ve been doing clinical work within that specialty.”
Also, while working locum tenens right out of training is possible for physician assistants and nurse practitioners, ”it can be challenging to find locum assignments if you are a new graduate with minimal clinical experience,” according to CompHealth.
Mid-Career Malaise
Locum tenens agency blogs and websites also offer plenty of stories illustrating the value of locum tenens practice for more experienced physicians.
Physician financial advisory group PhysiciansThrive.com suggests: “Doctors in the middle of their careers work locum tenens jobs as a way to get experience in various locations or environments before deciding to take on a new, permanent position. Other physicians work locum tenens as a way to make extra income. In some cases, they’re temporary physicians, moonlighting (working a second or third job) in order to supplement their income or pay off student loans. ”simply offers a welcome change of pace: “In times like these, when you’re asking yourself whether you want to leave for good or just need a break, the opportunity for a temporary change is perfect.”
— David Beran, DO Sometimes it simply offers a welcome change of pace: “In times like these, when you’re asking yourself whether you want to leave for good or just need a break, the opportunity for a temporary change is perfect,” writes David Beran, DO, in a June 23, 2020, blog post on HospitalRecruiting.com. “I agreed to cover a set amount of hours each month for a set period of time and when those months were done, I had no obligation to return. By doing locums, I was able to explore new opportunities without having to commit.”
Focusing on changes in geographic regions or clinical settings, Beran notes, “We get tired of the same old thing—the same broken processes, the same roadblocks. By working in a new system, you get a fresh look at situations that have become your norm…You’ll apply your medical skills in new ways, with different populations, and get a fresh perspective on your career.”
Fight Physician Burnout
Along those lines, Weatherby Healthcare offers a scenario in which a physician accepts a position at a great facility only to find it’s not what he or she expected. “Maybe the work environment is toxic, or the workload is heavier than described,” writer Arianna Rees suggests. She points to locum tenens as a way doctors can “test-drive” healthcare facilities to find the ideal physician job.
Rees shares the story of general surgeon Demetri Poulis, MD: “In 2003, Dr. Poulis started a job working alongside another surgeon. Within a few years that surgeon left, leaving Dr. Poulis on call for up to 15 hours a day. He didn’t go on vacation, and he didn’t see his kids for two years.”
Poulis observed, “For the last five years, I was the only guy there — summer, winter, it didn’t matter — every day taking call.” Finally even his ex-wife said, “They’re going to kill you. You can’t keep doing this.”
Looking for career alternatives led him to locums and the opportunity to travel, working at different hospitals without committing long-term. “It let me see how it was done elsewhere, how other people handled things,” Poulis said. “I had more confidence in myself, especially after being burned out after that many years of being on call alone.”
Locums work took Poulis to an Adventist hospital where he eventually accepted a full-time position. He credited his locums experience and relationships with equipping him to set his own terms for joining the hospital’s surgical team.
Heading Toward, or During, Retirement
Many physicians and advanced practitioners work locum tenens as a way to wind down their careers or work less as they near retirement, according to PhysiciansThrive.com.
General surgeon Steven Berman, MD, who’s worked locums on and off for the past six years, endorses locum tenens as a great option for physicians further along in their careers. “It allows them to get back to their roots and do what they love, and it’s ideal for anyone transitioning between employment and retirement,” Berman told writer Arianna Reeves.
“Having worked in medicine for 35 years, Berman discovered locum tenens when he was recruited by agencies while on medical leave recuperating from shoulder surgery and subsequent complications. “Disenchanted by private practice, he decided to pursue locums when he went back to work,” Rees writes.
“I took a couple of weeks’ vacation to do the locums, and when I realized I could enjoy that, I gave notice I was going to leave private practice,” Dr. Berman said. “I knew what I was getting into. I knew the community. I knew the hospital. I knew the politics of the hospital, so it was certainly much easier to take a job knowing fully what that job was before committing.”
— Steven Berman, MD One job took him to North Carolina for six months, where he traveled twice a month for a week at a time, getting to know the hospital and the community. Berman ultimately accepted the hospital’s offer of a full-time position, crediting his locums work for preparing him for the job.
“I knew what I was getting into. I knew the community. I knew the hospital, I knew the politics of the hospital, so it was certainly much easier to take a job knowing fully what that job was before committing,” he said. Still not quite ready to retire, he returned to locums practice when the hospital closed.
Yes, locum tenens can be that flexible.
Use it right out of residency to explore new areas of the country, experience different practice settings, or pay off student loans in a year or two.
With some practice experience under your belt, try it for a change of pace, as a way to keep earning until you find the right permanent job, or to avoid burnout and better balance work and personal life.
Later in your career make it a bridge to retirement, a way to earn while traveling, or an opportunity to keep earning while you pursue a new passion.
Or choose your own timing based on your personal situation. Think of it this way: locum tenens lets you fit your job around your life, rather than your life around your job. How many staff physicians do you know who do that?
