Andrew Wilner, MD, FACP, FAAN, shares how locum tenens allowed him to practice medicine while pursuing his other passions – and have time to spare.
Burning the candle at both ends
When I started my career in medicine, full-time physicians had little choice regarding work schedules. I had completed my epilepsy fellowship in 1989 and joined a five-physician private practice in Charlotte, NC. It seemed like an excellent opportunity to launch my neurology career.
Outside of office hours, I was on call every fifth day and every fifth weekend. Additionally, since there were no neurology residents, I drove to the hospital at all hours to treat seizures, strokes, and other neurologic emergencies. I confess to a certain thrill on those late-night forays to the emergency room, but as much as I enjoyed these on-call activities, I dreaded the following day.
Unfortunately, the satisfaction of a full patient schedule following a night of sleep deprivation was soured by an upset stomach, sluggish thinking, enfeebled social skills, and a throbbing migraine. Every minute was misery. Weekends were even more draining, because we rounded at four hospitals and a rehab center. One Sunday morning at hospital number three, I collapsed on a couch before I could finish rounds and drive to the next hospital.
The struggle to find the perfect physician work/life balance
Since my high school days, I have always written fiction, nonfiction, and poetry. But writing requires creative energy, and I was chronically exhausted. I tried taking a half-day off a week, but those few hours were rarely productive. Further, my long work hours eliminated any possibility of a social life. I wasn’t burned out, but I was smoldering. The term “work/life balance” had not yet entered the physician lexicon, but I desperately needed it.
Finally, after eight years, I resigned. None of my partners could understand why I would abandon a prospering private practice!
Perhaps an academic medical position would solve my work/life balance problem? I took a position at a prestigious medical school and dove in. However, the waters were cold and murky, and I nearly drowned in the toxic work environment. I was still unpacking when I realized it was time to leave. Burned by the system, I lived the life of a self-employed medical journalist for the next ten years.
However, I was still committed to practicing clinical medicine and writing, so I continued my search for ways to comfortably do both. Finally, I stumbled on a full-time job at a community hospital in New London, Connecticut. The neurohospitalist schedule, quite novel at the time, was seven days on, seven days off. On my “off” weeks, I traveled to medical conferences and continued my medical journalist work. I enjoyed lots of intellectual stimulation and two incomes, but with two full-time jobs, I rarely had any downtime.
I had previously heard of locum tenens, but frankly, only in disparaging terms by full-time physicians. However, I was willing to try anything, so I signed up with CompHealth and took an assignment in Sioux Falls, South Dakota. I loved the work and took months off at a stretch. Suddenly, there was ample time for writing and travel. I had discovered a whole new world!
Finally achieving work/life balance with locum tenens
Over the years, I’ve worked locums inpatient, outpatient, private practice, and in academics. I discovered that the neurohospitalist schedule of seven days on, seven off aligns with my professional and personal goals. I love throwing myself 100% into clinical work for a week and then transitioning to writing and personal endeavors the next. I even returned to my Connecticut hospital now and then as a locum.
During my “off” time, I spent months in Southeast Asia scuba diving. I led medical missions, made underwater films, and became a PADI divemaster. Locum tenens brought flexibility and balance into my life that I had never imagined possible.
Thank you, locums!