OB/GYN Dr. Derrick Barnes has been practicing medicine for nearly 14 years. And since 2015, he’s moved to locum tenens assignments for over 50% of his working hours. Why? Because with the flexible career options of locum tenens, he says, he can create his ideal medical career, spend more time with his large family, and enjoy a variety of challenges that keep his medical and bedside skills sharp. Here’s how he does it.
1. Dr. Barnes prefers variety in locations and settings
For Dr. Barnes, variety in both location and hospital settings enriches his life. Sometimes he’s looking for a busier, bustling practice and city with a plethora of options. Sometimes he wants to take his family out to places that are quieter and offer numerous outdoor adventures. Locums lets him choose to suit his current mood and needs.
“Location is a big thing for me,” he explains. “I live by the beach, so sometimes I need a little city life and take an assignment in San Francisco. Sometimes a rural assignment may have fewer in-house call, so my family can be at a park, on the lake, and swimming.”
Dr. Barnes especially appreciates the benefits of practicing in rural settings because it keeps his skills especially sharp — and because the communities need him.
“I really have a heart for that rural underserved care; I don’t have to commit to doing that full time because that can be challenging. I’m filling the need of the patients in the community but also filling the need of doctor colleagues,” he says.
A full-time practice would not deliver on all he wants in his life and career. “I like a mix of things. That complete mix is hard to do with employment. Now, if I feel like doing something different, I can schedule it that way.”
2. He takes his family along on summer assignments
Summer offers time for family bonding, and Dr. Barnes schedules assignments in idyllic places in the mountains. “We’re all going to go for two or three weeks. I’ll start setting those up in January because sometimes those are vacation spots, and to find a nice place to stay, you’ve got to plan ahead.”
The spots he chooses are in gorgeous places — “and everyone will come and hang out, which I love,” he says.
3. He’s more available to family
Dr. Barnes and his wife homeschool the kids and do foster and adoptive care, so they may have a couple of foster kids, in addition to their own children, in their home. If it’s a rough time, he can schedule a week or two off to help his wife.
During other times, he can be around more for school events. “We set the kids on a regular schedule with a family calendar. I tell them, ‘At this week of the month, I’m going to be gone. I’ll be back for these events.’ And the beauty is you can schedule it like that. Also, sometimes I can tell my wife, do what you want today; I can drop off the kids, pick them up, and take care of them.”
4. He gets variety in settings and skillset
Getting to practice in different types of hospitals and put different skills to work matters to Dr. Barnes. It’s part of what drives his love for medicine.
Each type of setting offers new opportunities and challenges. “Suppose you’re working in a big urban center,” he explains. “In that case, you might have a very educated patient or maybe someone who is used to seeing a lot of specialties. They typically know more about what to expect. In contrast, in rural areas you may have to take extra time and explain the care they’re getting, as it’s not typically what they’ll receive in rural areas.”
Staffing also works differently between rural and urban hospitals.
“In rural areas, you might have a staff of two nurses running the whole labor and delivery unit. So, you’ve got to jump in more. So, it stretches your skills a bit, which is good.”
That love of variety is why he says, “My plan is always to have a component of my practice be locums. I think it’s rewarding. You can see how other places practice, see the culture of other places, see how the practitioners practice.”
5. He has found ways to provide continuum of care
On one assignment while at a rural hospital, he had to transfer a patient before the weather made it impossible. “She was in preterm labor,” he says. “I transferred her out, rotated off the assignment, rotated back on an assignment at the bigger hospital, and got to take care of her again there.”
He also works to schedule patients he builds relationships with when he is working next. “With pregnancy care, throughout the first half of pregnancy you see them only once a month, so if I’m there one week a month, I’ve been able to keep some continuity. Sometimes those inductions or a C-sections need to be scheduled. If I know I’m coming back, I tell them ‘I’m going to be back here at this time, and if it fits medically and clinically, would you like me to do your delivery? Would you like me to do your C-section or your surgery?’”
6. Assignments at different hospitals requires organization
He uses the Evernote app and keeps how-to notes for each EMR system to keep organized. “I’m fast with computers, so I can usually find someone practicing there and steal their notes.”
He also organizes everything by each hospital. “There is basically each hospital file that’s got my login. It’s got emergency numbers, so if I need to call anesthesia, I know who to call if I need to schedule something — the process may be different at different hospitals. In some hospitals, you call anesthesia. First, in some hospitals, you call the charge nurse, so I just open up my app and say, OK, this is the hospital, this is the procedure, this is what we do.”
7. He urges other physicians to consider locums
“Whatever dream you have of what you want your practice to look like, you can do. And that’s really the message I want to get out there — you’re not stuck in any one position. If you can dream it up, you can probably make it happen with locums, whether that’s a long-term assignment, short stints, rural areas, urban areas, or across the country. You just have to get a good rep and do some research.”