Infectious disease specialist, Dr. RK Devlin, MD, FIDSA, offers her advice to women who are interested in working locums and factors they should consider as a female locum tenens.
Without a doubt, the experiences of women in medicine is a sharp contrast to that of a male physician. This holds true for locum tenens physicians. Though we continue to strive for job equality and freedom from sexism in the field of medicine, there are a number of issues that women need to consider from their own unique perspective as they enter into locums work.
Caregiving and household management
Women are still the primary caregivers, whether for children, aging parents, or other family members. Research shows that we also run our households. As any woman can attest, balancing caregiving and household responsibilities with medical work isn’t easy. One survey published in the Journal of General Internal Medicine showed that more women than men reported that childcare or caregiving impacted their work, and those women had substantially higher odds of burnout.
Before entering into locums work, we have to consider our caregiving responsibilities, the management of our households, and our own mental health:
- Can I work full time, or should I look for part-time assignments?
- Do I have the freedom to accept assignments that require out-of-town travel?
- Will my partner assume the caregiving and household duties in my absence, or will I need to hire help?
- Do my aging parents need nursing care or other assistance while I’m working or traveling?
- Should I order groceries for delivery or meal replacements for my family while I’m away?
Benefits and compensation
Locum tenens physicians are essentially self-employed. Most of us work through a locums agency, which pays for malpractice insurance and standard travel expenses. But we pay our own taxes, insurance, retirement, and other benefits. These expenses can be considerable, especially if a woman is the primary breadwinner or the family is dependent upon her insurance coverage.
Locums work is very well paid; however, it may vary depending upon specialty, demand, and location. It also depends on overtime and whether the work necessitates a return to the hospital after hours. Monthly health insurance premiums are more expensive without an employer contribution and finding the right insurance plan can take time and research. Life and disability insurance policies must be paid out of pocket. And, locums work does not come with paid maternity leave, sick days, guaranteed vacation, or CME reimbursement. Fortunately, every woman in locums has the choice of assignments to match their personal scheduling needs. And we each can decide if money needs to take priority over free time (or vice versa).
Travel expenses
As previously mentioned, locum tenens agencies pay for transportation and lodging when you accept an assignment out of town. This translates into a small rental car, gas, flights in coach, and a hotel room at a recognized chain such as Marriott or Holiday Inn. Be aware, though, that the standards may not be what you’d prefer if you were traveling for pleasure.
You can choose to upgrade your rental car to a luxury model, your flight to first class, or your hotel room to a nicer suite, but all these improvements are at your own expense. You also must pay for your own food, use of airline clubs or lounges, and any other traveling expenses. I find the joy of travel to be worth the costs of being away from home, and for me, the additional expense for upgrades is money well spent, especially given the chaos of traveling during the pandemic.
Safety
Women always need to be aware of their safety, especially when traveling solo, exploring a new neighborhood, or working in an unfamiliar environment. With locum work, every assignment comes with new travel arrangements, medical systems, and colleagues.
Female locum providers must learn how to protect themselves — both mentally and physically — against the stresses that can come with frequent assignment changes. Every woman must decide whether they feel comfortable navigating travel beyond a simple commute. Fortunately, there are resources that offer travel safety tips for women. Make sure you’re willing to repeatedly practice in unfamiliar medical settings, engage with temporary medical partners, and work alongside different clinic and hospital staff members.
Guilt
Medicine is hard work and practicing away from home has its own burdens. For some, the work-related stresses can be compounded by thoughts of the people and places left behind. I don’t know a single woman who hasn’t experienced some degree of guilt when they’ve traveled away from their loved ones; others miss the comforts of home more than expected.
If a locums assignment is out of state, female providers need to make peace with spending time away from their home and their family and friends. Some locum tenens moms bring their loved ones along and use their time away from home in a hotel as a mini family vacation. Certainly, technology is better than ever at helping you stay connected virtually, and once a locums assignment comes to an end, you return home without any lingering work responsibilities or disruptions.
Sexism and microaggression
Regardless of the work environment, women are still subjected to sexism and microaggressions. If unaddressed and unabated in the medical workplace, research has shown that these issues can cause decreased confidence and performance, increased stress, and lowered well-being. One, and especially all, of these things can lead to low morale, feelings of isolation, poor self-esteem, and burnout. All women should educate themselves on how to respond to harassment in the medical workplace — both personally and as a bystander. Fortunately, many women find that locums work offers some relief of these burdens due to decent compensation rates, flexible scheduling, and the ability to take extended time off between assignments if needed.
