Locums with a Family- The Good, The Bad, and The Awesome

Locums with a Family- The Good, The Bad, and The Awesome

 “We think, mistakenly, that success is the result of the amount of time we put in at work, instead of the quality of time we put in.”     - Arianna Huffington


When I meet with potential Locum Tenens doctors, they fall into three main groups. The first is the newly graduating residents, strapped with profound debt but limitless in their career path. They are often unattached to a geographic area or lifestyle inflation, and the benefits of locums are quite evident to many of them. Second, on the other end of the life spectrum, are doctors about to retire. Not quite ready to throw in the towel, but having a big empty house, these physicians are looking to reframe their practice and turn to locum tenens to finish out their career. However, there is a big gap in the middle, full of 35-55-year-old doctors with families. Most of these doctors will immediately tell me why locums couldn’t possible work for them. While I acknowledge having a spouse and children represents a high complexity to life, I tell them I am also married with kids, and have found locums allows a customized lifestyle they might find beneficial.  Let’s break it down…

The Good

Reclaiming your time

For most doctors, the largest benefits of locum tenens work are born out of the ability to manage your own time. On a large scale your year is set up ahead of time by choosing the assignments that meet your desires. The month has a defined schedule and the hours in a day are under your control, as you have negotiated exactly what you want. Flexibility in all aspects of practice is a powerful tool in the journey to happiness and controlling your time and energy is incredibly valuable. When it comes to locum tenens work with a family, it boils down to working your hours and then focusing on uninterrupted time with your family. How many doctors work 8-10 hour days only to go home to unsigned charts, dealing with prior auths, or putting out fires that come with managing a practice? The answer is most. Months turn to years and it’s easy to get in a rut and stuck in a viscous cycle. Locum tenens can be designed to eliminate many of the administration aspects of medicine, allowing you to focus on caring for patients, and leave each day knowing your work is done. There will be some time in the beginning of each assignment when you learn the EMR or get the lay of the land, this is typically true. We have recommended negotiating an on-boarding day into your contract whenever possible to put these downsides back on the health system. Doing this affords you the ability to be present with your spouse and kids and to leave the headaches of paperwork and management of a practice up to others. A wise man once told me, “You only have so much energy in a day, it is up to you to determine where you exert it!” Utilizing locum tenens work can allow you to reclaim your time and energy and redirect it to your family.  

Decreased Stress

Burnout amongst physicians is an epidemic. When is the last time you heard your hospital administrator put YOUR HEALTH on a metric they want to focus on? Stress in medicine is at an all time high and the reasons have changed. Over 50% of doctors report emotional exhaustion, a sense of ineffectiveness and a loss of meaning in work. The reasons are clear to those of us in the trenches, and it’s not the patients that burn us out. This subject hits home for me, it’s the reason I decided to pursue locums as a career choice. We as doctors can handle the stress of a very sick patient load, we have the most advanced tools to care for our patients and we have access to more information than ever before, so why are almost 40% of physicians reporting feelings of exhaustion and depression? It’s the growing stack of administration paperwork, the EMRs designed to make doctors transcriptionists, the constant meetings with middle management about quotas and metrics, and the distancing of our work from what we signed up for; patient care.  Locum tenens allows you to define where you practice and the hours you work in a week or month, but perhaps more importantly, it allows you to define what you will do in your shifts. Remember, you are the one in demand from the hospital and you are the one with the bargaining power when it comes to locum tenens work. If done well, you can strategically create an environment of clinical excellence and minimize stress. How does that apply to your family? Ask yourself how you would feel if you arrived home every day knowing you had taken great care of people and there was nothing lingering on your to-do list. No meeting at 530 to discuss the credentialing of a new Cardiologist, no division meeting to review performance metrics, and no prior office decisions to worry about. Reducing stress with locums work profoundly impacted my relationship with my spouse and provided me with more head space for family. Imagine a career with limited anxiety the night before the work week because you are excited to be there. It can be yours.

Personal Finance

You probably have heard it before, LIVE LIKE A RESIDENT while you can! Well, we agree. Early out of residency, locum tenens can allow you to sock away cash and pay down med school debt while the spouse and children aren’t used to the fancier things in life. A couple years of locums can do wonders to debt, when you save more of your income with your housing, travel, auto, and means covered or tax deductible. Unfortunately, most residents have delayed gratification long enough. They nEED that BMW 5 series and that big house they promised their spouse years ago. You deserve it after all that work! Stop for one minute and think about the finances here. Piling more debt onto that already big mound will only set you back on the real goal in life, freedom from stress because of financial freedom and security. The last thing you want to be doing is paying for your kids college t the same time you are still paying for your own!! For those already working and looking to change the trajectory of your life toward true financial independence, locums may be the trick you need. Married with kids? Big home and 2 cars? Boat? Beach Home? These things begin to steal your freedom. We have interviewed numerous doctors mid-career who wake up one day and realize lifestyle inflation has snuck up on them and they can’t change careers or locations because they are in too deep. We dint have an quick fix for this precarious position, but we have a plan. Locums work often pays more than your private practice or hospital employed peers and decreases expenses. It also pays living expenses and travel. Many of the derails are tax deductible. What does this mean for you? It equates to a larger chunk of your hard earned money going to paying down debt and increasing your net worth. We find this reset often give doctors their independence back, its big jump, but at the bottom is significant rewards.

Travel for fun, family, or special events

On a simpler note, part time locum tenens work allows doctors to take advantage of long stays in areas they may need to be in for family oriented reasons. We find that the practitioners who utilize “family friendly” part time locums will choose assignments in locations where they have wanted to visit for pleasure, where they have family, or where a special event is happening. Working in New York but your wife is from Ohio? Taking a month-long position near her home town allows for paid vacation time and a longer, more meaningful visit with family over the holidays. It can also mean taking the spouse and children with you for long stays in desirable areas and provides a way to immerse yourself in other areas that you may only visit for a short time. Summer in Jackson Wyoming and weeks in Yellowstone with the family, its about quality time. 

The Bad

School Aged Children

Full time locums with children in school requires some preparation. Let’s be honest, although possible, moving your 10-year-old from one elementary school to the next is both disruptive to their education and not fair to their social evolution. This is a clear limitation to doing locums with kids. We don't have an easy answer for doctors in this situation. You have to look deep at your family and their needs, especially if one of your dependents has unique requirements. As a response, many doctors will utilize intermediate duration locums as summer assignments with kids of all ages. A wonderful hybrid model would allow short term locum tenens work over winter and spring break, or longer summer assignments traveling with the whole family. However, schooling does provide a limitation for many seeking the freedom of locums life. 

Living Arrangements

The average locum tenens assignment will place you in an extended stay hotel that easily satisfies the needs of a newly minted residency graduate. Hell, it might even feel like an upgrade from that 400 square foot apartment in San Francisco or New York, especially since it is free! However, when it comes to living with a spouse and two kids out of a single hotel room, it might not feel all that perfect. In response, many locums agencies will allow practitioners to make their own travel arrangements and reimburse for the costs. This doesn’t mean you book the presidential suite at Mar-A-Lago while working as a hospitalist in Florida next June, but it does mean you can choose family friendly lodging and control the situation. Negotiating this with your staffing agency isn’t hard, and most will allow you a large amount of wiggle room in our experience. 

Spousal Occupation

One of the biggest barriers to entry at mid career for many physicians relates to their partner's career. If your husband or wife is a trial attorney in a law firm, moving to Moab Utah may be a little tough to pull off. We have found some magical situations where both partners are doctors, and can couples match in locum positions all around the country (or outside!). We have also found numerous situations where the significant other is mobile with their career because of what they do- this works great for graphic designers, salesmen, and other independent contractors. In some situations it won't work, thats clear. Before even considering locum tenens work, it would be wise to evaluate your partners career situation and their expectations. 

Travel with Kids

As much as that locum tenens gig in Hawaii sounded amazing during the cold Vermont winter, getting there can be tough with a family. Packing for four people, for four weeks and then making it happen can be downright miserable. Most locum tenens agencies will bend over backwards to help with arranging everything needed for the travel and often times they have staffed the hospital before. Utilize your staffing agency for advice on what each site will require, both inside and outside the hospital, can be highly beneficial. We don't think locum tenens assignments are much different than an extended vacation, but we also realize most doctors have never taken more than 10-14 days off in a single stretch with their family. How to plan? What to pack? These are all very site specific, but more importantly, they are specific to your family. Remember, you will likely have  water and dryer where you stay, a grocery store near you, and the location you pick can be designed to have amenities to make the transition easy. 

The Awesome

 As you get more comfortable with locum tenens, assignments with your family become fun and exciting. You learn to pick assignments that provide educational and cultural advancement for you and your family. Other like-minded doctors and their families become your new friends on your journey. You focus on clinical care, decrease stress, save more and set in motion a new lifestyle that starts to feel like you hoped it would. We aren’t saying its perfect for all families, but we hope we can continue to shine some light on the details of that make it work for us.

~The Locums Life~