This is a guest post by Dr. Andrew Wilner MD, FACP, FAAN. Dr. Wilner is a neurologist who has an interesting tale to tell. He starts out in internal medicine, and meandered his way to the cortex and spinal cord. All the while, he maintained a purpose for Locums Tenenes work, which seems to provide the flexibility that many docs need to fight burnout.
It also allows the flexibility to pursue other dreams, like writing a book on Locums Tenens. I hope that you find his perspective as helpful as I did. Take it away, Dr. Wilner!
Introduction to Locums Tenens
The Latin term, locum tenens, literally means “holding a place.” It’s applied to physicians or clergy who work temporary assignments in different places.
My first locums job arose out of necessity. It was back in 1982, and I had just completed my internal medicine internship at the Long Beach Veterans Hospital in Long Beach, CA. Internship was a great year, but it wasn’t fun in the sun. As my internship drew to a close, I faced two daunting challenges:
#1. I enjoyed every medical rotation! Whether it was cardiology, GI, ICU, nephrology, or pulmonary, it didn’t matter. I liked them all. Although that may not sound like a problem, it was. I wanted to select a subspecialty, but I didn’t have a clue.
#2. I needed to write a book. Ever since high school, I wrote and published fiction and nonfiction. Being a writer was in my DNA, and it was going to be part of my professional life. During my internship, I had pushed writing aside. But the urge to write wouldn’t stay on the back burner any longer.
A Year Off
I carefully explained the above considerations to my VA residency program director who agreed with my plan to take a year off and return as a second-year resident, hopefully with more professional direction and a completed manuscript. The next hurdle was supporting my writing career, as I couldn’t survive on savings from an intern’s paltry salary.
Locum tenens was a relatively obscure option back then. I didn’t know that staffing agencies like CompHealth or Staffcare helped physicians locate temporary assignments. Instead, I contracted with a local emergency room where some of my fellow VA residents were regular moonlighters.
In those days, ER was not a subspecialty and any licensed physician could pick up ER work. My VA had a relatively sleepy ER, and I was woefully unprepared to become an independent ER doc. With the help of a bag full of books and frequent telephone consultations, I treated pneumonia, removed foreign objects from eyeballs, splinted fractures, delivered babies and made it through the year.
An Unexpected Discovery
What I didn’t expect from a year dedicated to book writing was that I would discover my true calling. It turned out that patients with blurry vision, dizziness, droopy eyelids, headaches, numbness, weakness, and other neurological symptoms captured my attention.
When neurological consultants came to the ER, I marveled as they performed arcane examinations. No organ system fascinated me like the brain, spinal cord and peripheral nerves.
My year off completed, I was stunned to find out that there was no room for me back at the VA. For the first time in the program’s history, none of the interns dropped out, leaving no second-year slots. My program director, who had guaranteed my return, shrugged his shoulders and left me out in the cold. I scrambled and grabbed a resident position at the University of Southern California’s mammoth Los Angeles County Hospital, Los Angeles, CA.
During elective time, I examined fish brains in a neurological laboratory at Scripps Oceanographic Institute in La Jolla, CA. On a lark, I interviewed at the famous Montreal Neurological Institute of McGill University, Montreal, Canada. They accepted me to start in two years, allowing time to complete my internal medicine residency before moving the nearly 3,000 miles from LA to Montreal.
After completing a neurology residency and an epilepsy fellowship at McGill, I embarked on a traditional career. After eight years with a private practice neurology group, the work became routine. I left to take an academic position. When the latter didn’t work out, I was without a job.
Not knowing what to do and needing to make a living, I returned to locums. It was great! Interesting assignments took me from Massachusetts to South Dakota and a couple of places in between. I worked when and where I wanted, wrote more books, traveled frequently to Southeast Asia to scuba dive, and earned more than enough money to pay the bills.
As a locums doc, I learned that assignments at teaching hospitals offered intellectual stimulation and reasonable workloads. Indigent patients at county hospitals tugged at my heart and strengthened my sense of purpose.
While working locums, I kept an eye out for the perfect permanent job. For two years, I casually interviewed across the country. With locums as a back-up, I felt no pressure. After a thorough search, I found my current position.
Today, I’m happy as an Associate Professor of Neurology at the University of Tennessee Health Science Center in Memphis, TN. I get to teach neurology residents and treat patients at the county hospital.
In my spare time, I host a medical radio program on ReachMD.com and write articles for Medscape.com, NeurologyTimes.com, and other publications. I also blog regularly at my website. My most recent book, “The Locum Life: A Physician’s Guide to Locum Tenens,” offers strategies for success to physicians considering trying their hand at locum tenens.
On a more personal note, the flexible schedule of locums helped me find time to get married and become the proud father of a beautiful baby boy.
Every physician should be aware of the locums option, whether it’s to earn extra money, find their true calling, locate the perfect job, or make time for other passions. It worked for me!
Have you tried locum tenens? Has it been helpful for you in finding that right work-life balance? Leave a comment below.
I washed out of a all consuming career running a burn center, a place where unrelenting suffering, a fair amount of death and dying, and unrelenting chronic stress of institutional politics robbed me of the joy I once felt caring for patients. Rural locums work in general surgery has allowed me to rediscover the pure joy of surgical care at a pace that rarely leaves me feeling that I’m failing to meet my own expectations to my patients. The nature of locums prevents becoming obligated to committees, too deeply enmeshed in the power games of administrators, regulatory oversight consultants and empire building competitors. The simple fact that you’re filling a gap that really needs filling completely changes the dynamic. I love getting to know small towns, new people, having blocks of time devoted to a single obligation rather than multiple simultaneous ones. I’d recommend part-time locums to anyone who needs to hit the reset button on a career that has careened out of control.