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Using locum tenens experiences to evaluate permanent opportunities

--As Published in LocumLife Magazine, December 2005

Deck

It is not hard to make a choice while standing in line at Pat's King of Steaks in South Philly because your options are basically limited to “with” or “without” cheese. Deciding what practice to join when you finish residency is a more difficult proposition, with a multitude of factors—such as geographic location, practice size, make-up of the patient base, and proximity to a teaching hospital—that need to be weighed carefully.

I am a skier, and the idea of moving to Denver or Salt Lake City is very appealing to me. On the other hand, I have only experienced these cities during the winter, and only for a week or so at a time, so I have no idea what it would be like to live there year-round. Perhaps now that you are on the verge of finishing your residency, you may find yourself in a similar predicament: trying to make choices which potentially can have a large impact on the direction your life takes and making those decisions based on relatively little information.

Your experiences during residency, whether positive or negative, have probably given you some ideas about what to look for in a permanent position. Maybe you think you would enjoy a more diverse case load, a faster-paced lifestyle, or a single-specialty group. However, it is hard to say for sure until you experience what it is like to be in such an environment. To improve your odds of making wise decisions about practice options, you may wish to adopt the strategy of many other residents - choosing locum tenens opportunities for a period of time before accepting a permanent position.

I have regular conversations with residents who are seeking permanent positions, but at the same time are nervous because they do not know exactly what to look for in an opportunity. Since they likely would not purchase a car without taking a test drive, I always suggest providing locum tenens services before accepting a permanent position as a way to consider different practice parameters - a "try before they buy" approach.

Sometimes, a locum tenens contract can be a temp-to-perm arrangement, but even one that is not may provide you with information instrumental to your decision making process. By choosing different locum tenens opportunities, you can build a base of comparables, assign them values based on your personal preferences, and use these elements to evaluate future permanent offers.

Geography

Depending on results of your self-assessment, you may decide that the geographic location of an opportunity is most important to you. After all, accepting a permanent offer is not just about where you will work, but where you will live.

By the time you are finished with residency, there is a good chance that you will have lived in at least three different locations. You may be very familiar with the particular cultural idiosyncrasies of these regions, but what about all the other parts of the country?

Consider accepting locum tenens contracts in an unfamiliar locale to get a feel for the surroundings at distinct times of the year. If you decide you like the area, then you can start looking for permanent opportunities nearby. There also may be openings at places where you have previously provided temporary services. However, you may find that although you love certain aspects of the region, other elements—like shoveling driveways everyday—may get old rather quickly. Such information is much better learned on a 6-week locum tenens contract than in the fifth month of a 4-year permanent contract with an income guarantee.

Practice type and size

Deciding whether you prefer working as a lone wolf or as a member of a team also can be a key factor in your happiness within a practice. Some physicians choose to open solo practices straight out of residency, although most will join an existing group or sign on with a contracting company, providing services to a regional health network.

Finding success straight out of the gate has a lot to do with knowing yourself and what practice environment is best for you. Try accepting locum tenens contracts with different practice profiles—from covering for a non-urban based solo practitioner, to finding out what it is like to provide services in a large urban multi-specialty group, to choosing an opportunity with a single-specialty group. Experimenting with differing combinations of group size and makeup, as well as covering for solo practitioners, will help you determine your personal and professional preferences, which you can then use to locate—and be successful in obtaining—future permanent opportunities.

Cultural makeup of patient base

Do you know what a roly-poly is? If you do, chances are you are from the same region of the country as I am—the Southeast. (If you do not, this segmented creature is also known as a pill bug.)

The above example illustrates the fact that the United States is a very diverse country, and it is entirely possible that, if you make a move, you will experience a degree of culture shock. Many people think this phenomenon is only a factor if you are considering relocation to an area with a significantly different racial or ethnic makeup than to which you are accustomed. However, even communities with largely the same demographics can result in degrees of culture shock. Regional nuances may exist in speech pattern, vocabulary, political outlook, driving style, attitudes about marriage and family, staple foods, and typical leisure activities. Locum tenens practice is a great way to prepare for experiencing cultural diversity. For instance, if you were considering a permanent position in Minneapolis-St. Paul, it might be a good idea to provide locum tenens services in Duluth to understand what it is like to live in that particular area of the country.

Of course, some of the more obvious culture-shock factors should be considered, as well. Does a significant portion of the patient base speak a language other than English? Would you be caring for rural residents, suburbanites, or city folk? Are there high numbers of military families or transfers in the area? The greater the understanding you can gain about a community before moving there on a permanent basis, the greater your chances for personal satisfaction and professional success.

A valuable experience

Providing services as a locum tenens physician is a valuable experience for a variety of reasons, not the least of which is the opportunity to learn more about yourself. Awareness of your likes and dislikes, and the reasons why you tend to be more successful in different situations, will help you make an informed decision when comparing permanent offers. When using locum tenens as a way to “try before you buy,” honing your clinical skills, networking with other physicians, and being paid to see the country is simply icing on the cake.

Press Contact:
Jim Warren
pressrelease@mdainc.com
800.780.3500 x 2163