Using locum tenens experiences to evaluate permanent opportunities
- by Aaron Paul, coordinator of the Premier
Residency Program
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. LL
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About MDA
Founded in 1987, MDA is one of the largest privately held
medical staffing companies in the U.S. MDA is the largest national
multi-specialty locum tenens company that offers Occurrence
Form malpractice insurance to its providers.
The company is headquartered in Atlanta, GA with a regional
office in Dallas and satellite offices located throughout
the United States. MDA provides recruiting expertise for all
physician specialties, allied health, and healthcare professionals.
For more information about MDA call 1-800-780-3500 ext. 2168.
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