Read time: 3 minutes
Whether you have just started a locum tenens contract with a new client or you have been at a place for months, anything can happen.
Let’s look at 2 horror stories so that we might learn how to avoid such circumstances in the first place, if possible.
Sight unseen
My friend Mike finds a great gig through his recruiter at an agency he has recently worked with for a short-term assignment.
Everything looks great on paper: great rate, schedule, electronic medical record, staffing ratio, hotel accommodation, etc.
So what’s the catch?
They practice “dangerous” medicine.
The anesthesiology group is split into partners and non-partners (some are full-time, a few are locum like Mike to fill some staffing “gaps”).
Everyday the partners leave at 3pm and turn over to the non-partners who stay later or take call.
So where’s the danger?
The partners prefer to manage the scheduled cases for the day and then leave.
So if there is an emergency case that should “bump” a scheduled, healthier, more predictable case, then they beg/borrow/steal in order to push it until after they leave at 3pm.
The first week, Mike, takes over a vascular surgery room from a partner at 3. He finishes the case that was ongoing and then starts an emergency vascular surgery – amputation for an infected foot.
Long-story-short the patient dies in the operating room shortly after the surgery begins.
My friend finds out that the patient was listed to come to the operating room as a Class 1 emergency at 0630 that morning.
The partner had evaluated the patient and deemed the patient not a true Class 1 emergency, and so the case is pushed back until after the elective, scheduled patients.
Mike faces the potential of a lawsuit from the family – not because he did anything wrong (most of us get sued because inevitable things happen, not for malfeasance) – but because of the malpractice of a selfish partner.
He left as soon as his agreement allowed.
New generation
Natalia finds her first locum job to be a blessing: the situation has proven ideal after 3 months of work, it just happens to be in an undesirable location and so they use a lot of locum help to staff their site every day.
She works with a combination of anesthesia residents and nurse anesthetists each day.
Until one day, a leadership-level anesthesiologist ask to have a talk.
Long-story-short, Natalia learns that a junior resident she was working with earlier that week found her to be “too critical” of their performance.
Natalia is surprised because she thought her job was to keep patient’s safe while educating residents on the practice of safe anesthesia care. Being “critical” was literally a core piece of her job, when it came to resident education.
The leadership-level anesthesiologist said there would be no discussion about what the junior resident had claimed and that her contract would end that very day.
The client-site claimed a breach of professionalism by Natalia so she lost the expected income of the next 6 weeks of scheduled work dates, per her agreement.
She wouldn’t be credentialed at her next assignment for another 3 months.
Mitigating risk as best you can
We can debate the ethical considerations in the Mike example or the educational responsibilities in the Natalia example.
But neither site seems like a good place to work for various reasons: patient-safety, legal risk, supporting the attending physicians, balancing patient-care and education.
The real issue is that neither had a backup plan.
Neither was credentialed at another site and both had down-time before their next assignment.
Luckily both lived within their means and were able to move on.
But imagine if they were living paycheck-to-paycheck to pay for a “doctor” house, “doctor” cars, and private schools.
Those aren’t good candidates for locum tenens contract work. (Honestly that’s horrible financial management no matter the job, but that’s besides the point.)
Instead what could Mike and Natalia have done better besides living within their means:
- credential at multiple places
- have privileges at multiple places
- supplement with a part-time w2 job
- vet each opportunity better before signing on
Diversification is key for any business – especially if YOU are the business.
And so is doing everything in your power to find out why the client is in such desperate need of your help and expertise.
It’s not always because of the location or the sub-specialty; sometimes it’s just a horrible culture to work in (see above examples).
Summary
Understanding that many things can go wrong at any given time is at the crux of being a great clinician.
The same also applies to working a new locum tenens assignment.
Know that with all the benefits in schedule flexibility, time away from home, pay-rate, etc. comes the trade-off of job security.
Nothing lasts forever, so be prepared.
Whenever you’re ready, here are 2 ways I can help:
1) Let’s talk through what choosing your own path through medicine looks like. Over the phone, confidential, free:
https://calendly.com/tonyvullo/20min
2) Free Guides and Resources to Help You Reclaim Your Time and Autonomy:
Help Patients. Work Less.
Do More of Everything Else.
