What I learned working locums the past two years

Illustration - How locum tenens works for one locum physician

Sandeep K. Aggarwal, MD, shares how he discovered that locum tenens is more than just temporary coverage.

I came to a crossroads a couple of years ago. I’d been enjoying the best of both worlds by spending the bulk of my career in private practice settings, while being affiliated with a large academic center. I was trying to come to terms with this model of working commission-only while being employed at the same time. I always subscribed to the principle that if one is employed — especially in the healthcare field — the employer should provide the salary and benefits.

I endured this for a while, until one weekend I took a step back and thought about other possible healthcare models for physicians. It was then I dug deeper into how locum tenens works. I had heard of locum tenens via advertisements but never seriously considered it. I was under the impression that locums was only for temporary workers who cover for other physicians while they’re on leave (e.g., illness, maternity, vacation).

But as I researched more, I decided locum tenens might work for me. The field had evolved to allow a physician to work full-time and work at one or more hospitals per month.

Helping to improve overall health

The main tenet of locums is to fill a need in rural and healthcare shortage areas, allowing hospital systems in small communities to offer both primary care and specialty services to patients rather than relying on university systems that are far away. Small, private practices were dying and many of those that did exist were either just hanging on or under pressure to sell to large hospital systems.

I liked the idea of utilizing my skills as a neurologist to be part of the larger picture of helping improve the overall health of the population. I didn’t have any direct experience with smaller towns or their practice models, and I wasn’t planning on relocating. I still like living in a large metropolitan city. However, I found that locums is more than just covering for physicians in rural areas.

Financially, locum tenens allows a stable income without the politics or administrative hassles of an employed position. With increasing rules and regulations and costly electronic healthcare software, overhead has become cost prohibitive, particularly in smaller practices. Locums provides a viable alternative with the caveat that if you take assignments away from home, you should be comfortable traveling and working in different situations.

Making locum tenens work for me

Initially for me, there was a learning curve to negotiating the logistics of traveling and adapting to new places. I always practiced general (now known as comprehensive) neurology while using my EMG fellowship, which served as a nice complement to my skills. As a result, I felt quite comfortable fitting into clinic settings. Since I had run a solo practice at one point, the financial part was rather straightforward also.

I have found through my stints at various places that I can be dropped anywhere in any clinic and get to work right away. I feel more and more confident as I work in different areas, and I’m quite proud of my ability to fit into the existing patient flow structure. There are the usual idiosyncrasies of practice management and staff personalities, but overall these have been minor and a great chance to learn about others and the smaller communities.

I can finally practice the way I did decades ago when I first came out of training: by focusing on my patients and working together with them to help optimize their health.

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