RK Devlin, MD, FIDSA, shares how locums was her solution to physician burnout and is helping her make a worry-free transition to retirement.
I was at a point in my life where I was struggling to find the joy in my work, even before the first news of the COVID pandemic emerged. I’d been a hospital-employed infectious diseases consultant for over 15 years, and truthfully, I was suffering from burnout. I was fried, increasingly frustrated, and frequently frazzled. I felt undervalued by both the hospital administration and my colleagues, overburdened by bureaucratic responsibilities, and underappreciated by my patients.
The realization that I was suffering from burnout
Burnout means different things to different people, but for me, it manifested as frustration and fatigue, superimposed on serious pager rage. I needed more protected time for patient and teaching responsibilities with fewer administrative burdens. I needed to have more productive and less stressful interactions with colleagues. I needed time away from the hospital — without my pager — and better sleep at night.
I debated for months about my next steps. Should I try to find another infectious disease position elsewhere? I suspected I’d be subjected to many of the same struggles, even in a new environment. Should I take a year off? I wondered if it would be even harder to re-engage upon my return to medicine. Should I just leave medicine and retire early? I questioned if I had the courage and financial resources to do so. After serious consideration, I ultimately chose to give notice at my permanent position in December 2019 so I could practice as a locum tenens provider.
Discovering another way to practice medicine
As I came to the realization that I was unhappy at my job, I felt like a failure. Why didn’t I enjoy practicing medicine like some of my colleagues did? Why couldn’t I find satisfaction in the good I did for my patients? Why was I so resentful of the responsibilities that were assigned to me? It took serious soul searching to remember why I’d gone into medicine in the first place and to pick apart the aspects of my work that either sparked joy or made me miserable.
Fortunately, locums work proved to be just what I needed. I practiced continuously through the pandemic. There were some challenges; traveling for work was not always fun and nearly every medical provider found their job to be more stressful during the pandemic.
Finding my purpose
When I finally sorted everything out, I realized my preferences were pretty simple: I really liked running the inpatient infectious disease service and teaching medical students and residents, but I was unhappy when required to participate in outpatient clinics, committee work, and infection control. I needed to find a job that could help me focus on the parts of infectious disease practice where I was most competent and most satisfied. And because of the schedule flexibility of locums, I was able to take a six-month break to finish a major writing project.
Falling in love with medicine all over again
Locum tenens allowed me exactly that. Because assignments vary in terms of location, medical institutions, job descriptions, and responsibilities, I can match with places that are looking for help with inpatient infectious disease consultations, hospital rounds, and teaching. That’s the work that makes me happy and it’s where I can do the most good for the most patients.
Transitioning to locum tenens helped me remember how much I truly love the specialty of infectious diseases. It allowed me the time and space to recoup from the symptoms of burnout. It reminded me that though I might need to work less in order to be more fulfilled, I still have a strong desire to practice medicine.
Recovering from burnout with locum tenens
When considering locums assignments, I can focus on positions that offer a manageable consult list and reasonable daily patient census. I now have a work schedule that allows time for recovery and respite. I’ve chosen a schedule that allows me to practice for up to seven days at a time, every two to three weeks, for up to six months.
I’ve also found that a controlled workload with adequate periods of recovery between assignments eased many of my burnout symptoms. I began to enjoy my time in the hospital again, to embrace the satisfaction that comes with doing right by my patients, and to relish my role in helping students and residents become better providers. Despite relying on truly awful hotel pillows for most of the pandemic, I’ve also managed to return to restful and restorative sleep.
Easing into retirement
When I was debating about leaving my permanent position at the height of my burnout, I did some calculations to see if early retirement was an option. Leaving medicine seemed like a sure way to relieve my work-related stress, but it also raised some serious concerns. Would I feel as if I had failed or given up in the face of burnout? Would I suffer a loss of identity and purpose associated with my medical work and possible financial strain — especially if I lived longer than expected? Would retiring leave me with an unclear plan for what I might do with my free time?
Transitioning to locum tenens allayed these worries for me. Though I work less now, I am still a recognized and appreciated infectious disease doc. I get to practice in environments that offer me the greatest personal satisfaction while avoiding duties that are either beyond my competency or outside of my preferences. I continue to contribute to my retirement fund, easing my monetary concerns for the future.
Although I suspect I may choose to leave medicine earlier than some of my colleagues, working as a locums provider has afforded me the luxury of waiting to retire until the timing is perfect.