This series is developed in partnership with Dr. Jim Dahle's The White Coat Investor, the leading source of financial tools and information for doctors, and Doximity Careers and Curative (a Doximity company), where doctors can find their next long-term or locum tenens position.
Traditionally, few doctors knew much about locum tenens work and even fewer gave it any serious consideration as an option in their career. More recent generations have different views about their lives and careers, leading to a resurgence in locum tenens as an option for part or even all of a career. In all career fields, newer generations are far less likely to work for a single employer their entire career. They are more likely to rent their home than prior generations and are far more interested in achieving a nice work-life balance rather than climbing the corporate ladder. People are also more interested in travel and seeing different parts of the world. Medicine is not immune to these trends and locum tenens is at their forefront.
Locum tenens is a Latin phrase meaning "to hold a place." In medicine, a locum tenens physician is a temporary worker, who fills a place in a clinic or hospital for a period ranging from a few days to six months or more. These doctors serve a critical function in our health care system. There are communities and locations with critical medical needs that struggle to attract doctors as long-term residents. Even when they can attract doctors, those doctors often find themselves in a position where they are on call 24/7/365 and may not be able to take a real vacation for years. Locum tenens doctors are able to step in to provide a bit of respite for these doctors, allowing them to avoid burnout, obtain continuing medical education, and take a well-earned break.
The service provided by the locum tenens doctors is not simply a charitable pursuit. These exchanges are a win-win for all sides. The community and employer obtains a well-trained, motivated doctor who is willing to work hard and bring in expertise that could not necessarily be obtained by a doctor solely practicing in that community. The long-term doctor, if any, receives the support that allows her to maintain the position in the long run. The locum tenens doctor receives a great salary, unusually good benefits, a change of pace from their usual practice, and the opportunity to "try out" a new place to live. Locum tenens positions can range from a small town an hour away to more exotic locales like Alaska, Hawaii, or New Zealand.
Due to the difficulty of finding a long-term doctor for a position, employers generally have to pay locum tenens doctors very well. This higher income allows doctors to achieve their financial goals more quickly, whether that is to pay off their student loans, reach financial independence, or save up a down payment on a dream house. The position also generally covers substantial living expenses, including travel costs, a place to stay in the new town, and even a stipend for food. Credentialing and licensing costs are also frequently covered.
Different doctors consider locum tenens for different reasons. Some simply want a change of pace. The locum job allows them to do different procedures or see different pathology or a different population than their main job. It allows them to remember why they fell in love with medicine in the first place. They cherish the opportunity to see how a different clinic or hospital runs and return to their long-term job with renewed vigor and a few new tricks up their sleeve. Others are attracted by the travel aspect of the job. A locum gig allows them to see a new state or even country. Still others do it primarily for financial reasons. They exchange some of their vacation or sabbatical time for additional income.
Doctors approaching retirement may find locum tenens work particularly appealing. It may provide them the ability to dictate their schedule, allowing them to do part-time work, avoid call, or avoid working at night, on weekends, or holidays. Doctors at the beginning of their career will appreciate other benefits. For example, a doctor may work a half dozen or more locum gigs in order to find out what kind of practice she wants long-term. Many heavily indebted new doctors choose locum as an initial career due to the financial benefits. With no permanent home and stipends covering most of their living expenses, their higher income and lower expenses can allow them to pay off student loans and build wealth very quickly, especially if they continue to work anywhere near as hard as they did as a resident or fellow. "Living like a resident" for a few years after training will always be the key to building wealth as a doctor, and this is far easier to do as a locum doc than once you settle into a permanent position.
Additional benefits of locum work include getting away from office politics. As the "short-term" person, nobody is going to feel threatened by you. You will not have to serve on any hospital committees or go to partnership meetings. You will not have to hire, fire, discipline, or train the office staff. You can concentrate on your patients and the medicine you love without having to run a business. Many doctors find new long-term positions that started as locum tenens work. Most facilities who hire locum docs hire them serially. If you like the position, you can often stay as long as you want, and since you already know how much it is costing them to fund a revolving door of doctors, you can also negotiate a very good package that will allow administrators to focus on a different problem and you to make a great living.
Practicing as a locum tenens doctor is a great career option, whether you do it part-time or full-time, for part of your career or your entire career, close to home or on the other side of the planet. In the remainder of this series, I will discuss important financial considerations for locum tenens doctors, ranging from contracts to business structures to retirement plans. Done properly, locum work can provide a huge boost to your financial situation.
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