Dr. Ripal Patel, MD, M.P.H. nods with an understanding smile when fellow ER physicians chronicle the trials of their full-time positions. Working days they didn’t want to work. Missing family events. Navigating ever-shifting hospital politics. Attending staff meetings on days off. Trudging through the same workplace environment every day. Feeling little control over one’s schedule or, worse still, over one’s own career. He experienced the same frustrations, and tolerated them for only so long.
“I was working day, night, night, day, afternoon, these absurd hours of shifts like all ER docs have to do,” Patel said. “I wouldn’t go anywhere. On my days off I’d be sleeping so I could work. It didn’t matter if I was off because I was completely nonfunctional.”
A coworker encouraged locums
An assistant professor with the Department of Emergency Medicine for Ben Taub General Hospital at the Baylor College of Medicine in Houston, Texas, Patel met another ER physician who was also teaching but was also enjoying a fulfilling career as a locum tenens physician. The freedom the locums assignments provided the other physician was like music to Dr. Patel’s ears. He decided to give locum tenens a try. He hasn’t looked back since.
When he is on assignment, he is all work. But when he’s not at work, he says, “my days off are my days off.”
He likens the experience to working his own private practice: “You’re giving the hospital your brand. You really take a lot more ownership of your patients, and I tell all my patients, ‘I have a locums practice. I am contracted to be here.’ I give all my patients my cell phone number. I tell them to call me if there’s anything they need. Questions? Email me. It’s just a different kind of relationship with a patient. You’re not just like a staff member, you’re being brought there to add that ownership. Patients appreciate that.”
Experiencing hidden gems throughout the country
His locums assignments offer him the freedom of exploring locations he might not have experienced on his own. Such was the case with Vermont.
“Vermont was like going to a vacation spot where I worked four days. It’s really not a state I would have gone to otherwise. It was a rural hospital outside of Burlington, and it’s just beautiful. There are no words to describe it — this little mom-and-pop quaint little college town with a lot of great mountain biking [and] great restaurants.”
An assignment in New Mexico provided a similar discovery. “It’s been just awesome,” he said. “I mean beyond incredible. I love the staff there. I’m actually going with all of them to a conference in Las Vegas. Living in Santa Fe, going biking, snowboarding ten minutes outside the city, making friends. I love meeting new people. Why the heck did I never travel the states before?”
Providing care globally
The freedom he enjoys from locums assignments also allows him to pursue his passion: participating in global health missions.
“I partner with not-for-profits like Amigos de las Americas. I actually serve as one of their on-call physicians now. With them I worked in Costa Rica, Mexico, and Honduras. I went to South India. Most recently I was in Haiti where we were running a clinic, kind of a makeshift ER. I’m planning later on to work with another not-for-profit, likely in northern Iraq, and am going back to Haiti later in the year. Now that I’ve been in locums, I can explore branching out to different not-for-profits because I control my schedule. I just carve time out based on their schedule.”
Travel is not an obstacle
What is the biggest obstacle keeping other physicians from trying locum tenens?
“I think it’s the travel. I think a lot of docs who want to do locums get so bent out of shape about it. It’s kind of scary and daunting. It’s really hard to be away from the family. I just feel if you try it out, you’d probably think a different way.”
Being single, he knows, gives him a perspective some physicians dismiss as making it easier for him to travel. His response is, “More than half of my colleagues are locums and married, and a lot of them do have kids. When I talk to them about it, their reasoning is, ‘When I’m working, I’m in work mode.’ Then some of them will take whole summers off for their kids. You just have more control of what you want to do.”
He adds, “How many people travel for their job? Think about business people. They travel like five days a week for their work. They have families, they have lives. Just because we’re physicians doesn’t mean we can’t travel. I think the pros outweigh the cons so much, like ‘You have to work on Christmas’ or ‘You have to work every weekend’ or ‘You need to come to our staff meeting.’ I just think of all the twenty million other things I don’t have to deal with.”
Advice for residents
So what does he tell the residents he teaches?
“Start out in a staff job,” he tells them. “Try it out like I did, and then, if you don’t like it, branch out and start asking around and see what locums is about. Again, you’ve got to do what’s important to you. This is your life. You can’t have somebody control your life. You’ve worked hard enough to get to where you are, and you should be happy.”
For Dr. Ripal Patel, that is locum tenens in a nutshell. The freedom to be happy.