Locum Tenens Combats Burnout: One Neurologist’s View

COMMENTARY

The Merriam-Webster Dictionary defines the Latin phrase “locum tenens” as “one filling an office for a time or temporarily taking the place of another-used especially of a doctor or clergyman.” “Locum tenens” literally translates to “place-holder.” Locum tenens physicians fill in for other doctors when someone is sick, on maternity leave, or the clinic or hospital is overwhelmed with patients and still recruiting for permanent staff.

Ticket to work/life balance

I discovered locum tenens after my medical internship when I needed time to write my first book but still had to earn a living. Since then, I’ve worked locums in academics, private practice, and both inpatient and outpatient settings.

Over the years, the temporary nature of these assignments allowed me to lead medical missions in the jungles of the Philippines, write hundreds of articles, author a handful of books and become a skilled scuba diver and underwater photographer. Had I stuck with a conventional job, I never would have had the time or energy to pursue these outside interests with such intensity and depth.

Practice style

Locum tenens is growing. Twenty-five years ago, approximately 25,000 doctors worked locum tenens. Today, the total approaches 50,000. A recent survey indicated that 11.5% of physicians were contemplating locum tenens work in the next one to three years, up from 9.1% in 2014.¹

Much like a substitute teacher, locum tenens physicians show up and do the best they can in a new, exciting environment. Adapting to a new clinic or hospital can be challenging. To succeed, a physician has to be a quick study and go with the flow. Flexibility is key.

Burnout

According to a recent survey, burnout rates among physicians range from a low of 23% for plastic surgeons to a high of 48% for neurologists and critical care physicians.² It is not clear why neurologists have attained the dubious honor of being tied for first place for burnout, but excessive clerical work, long hours, nights on call, and the pressure to see high numbers of complex patients probably contribute.³

Benefits

One of the great benefits of locum tenens is the lack of administrative hassle. As a private practice neurologist, I worked both as a salaried employee and part-owner of a group of 13 neurologists. Both jobs came with endless frustrating and uncompensated administrative tasks.

In my private practice group, there were frequent early morning meetings, lunch meetings, dinner meetings and weekend retreats, all with great purpose but little result. Sound familiar?

Locum tenens physicians focus on patient care. That’s it.

Travel

Locum tenens opportunities exist across the US. While the highest demand comes from rural areas, I have enjoyed stimulating and well-compensated assignments in downtown Minneapolis, MN, and a suburb of Boston, MA. Locums offers a glimpse into different communities and practice styles. As assignments are time-limited, should there be any significant shortcomings, the end is in sight. With locum tenens, there is always light at the end of the tunnel.

Getting started

Most physicians find locum tenens positions through staffing agencies. The National Association of Locum Tenens Organizations (NALTO), an organization responsible for setting industry standards and ethical guidelines, lists more than 70-member agencies. Physicians dissatisfied with their current employment should consider locum tenens as a bridge to a more desirable clinical position, nonclinical career, or full-time strategy to achieve optimal work/life balance.

Dr Wilner is a neurologist and blogs at www.andrewwilner.com. This article is adapted from his latest book, The Locum Life: A Physician’s Guide to Locum Tenens.

References:

1. The Physicians Foundation 2016 Physician Survey. The Physicians Foundation. September 21, 2016. https://physiciansfoundation.org/research-insights/physician-survey. Accessed February 6, 2019.

2. Peckham C. Medscape National Physician Burnout and Depression Report 2018. Medscape.https://www.medscape.com/slideshow/2018-lifestyle-burnout-depression-6009235#3.

3. Busis NA, Shanafelt TD, Keran CM, et al. Burnout, career satisfaction, and well-being among US neurologists in 2016. Neurology. 2017;88:1-12.