When internist Dr. William Gruss first went into private practice in the late 1980s, the future looked bright. He was in a city he liked, he had a partner he trusted, and their patient base was consistently growing. So it was surprising and frustrating when, year after year, it became and harder and harder to pay the bills.
“We had two offices and we were always busy treating patients,” says Dr. Gruss “We’d take call in the emergency room and patients were compliant about coming to the office for follow-up care. We did a little advertising, and between that and word of mouth, the practice should have been flourishing.”
Problems with Private Practice
Unfortunately, that was not the case. “It became more and more challenging. The whole medical economics were changing, and the stress of trying to run a practice and handle the insurance while still providing excellent patient care became a nightmare,” Dr. Gruss recalls. “I ultimately wound up in solo practice for 13 years, and my life was a constant scramble. My office and the hospital were just a few miles from my home and my children’s school, and I still couldn’t maintain a work-life balance. Expenses kept going up and reimbursements kept going down, and it felt like everyone was getting paid but me. I was drowning.”
So when the hospital offered to buy Dr. Gruss’ practice, he eagerly agreed. “I was hopeful I would be able to relax a little bit, because by then I was completely burnt out. But in the three years I spent working for the hospital, they kept patting me on the back and telling me what a good job I was doing. Then they would shortchange me every time I was due to collect a bonus for excellent production.”
Locum Light at the End of the Tunnel
When the three-year contract was up, the hospital wanted to renew, but tried to renegotiate Dr. Gruss’ salary at a lower rate. Fortunately, Dr. Gruss had an ace up his sleeve. “During my time working for the hospital, I had contacted Weatherby Healthcare about making extra money through short, part-time locum tenens job opportunities. I tried out some assignments using vacation time and long weekends. I didn’t know it at the time, but I was setting myself up for a future as a full-time locum tenens hospitalist.”
In 2012, Dr. Gruss broke ties with the hospital and hasn’t looked back. “I had always done hospital work, so I was comfortable taking on a hospitalist role. Then I ultimately became a nocturnist, because working overnights suited my lifestyle, especially if I was traveling.”
Taking Advantage of Traveling as a Locum Tenens
Traveling is a big part of the appeal for Dr. Gruss. “I first started doing locum tenens near my home in a busy city in the southeast. But eventually I got other state licenses, and branched out to rural locations in the northeast. I went from a hot, bustling environment to a more serene pace that frequently drops below freezing. The change was exhilarating. I even had time to go skiing, which I hadn’t done for years.”
Over the last five years, Dr. Gruss has taken assignments all over the country, and his Weatherby consultant, Dillen Fogel, Hospitalist Division, checks in with him frequently. “Dr. Gruss is a great guy. Facilities are always happy to have him,” Dillen says. “I know he prefers long-term assignments in rural settings, and we speak frequently on his weeks off. He is a dedicated family man and often says how happy he is to be in control of his own schedule.”
Scheduling Flexibility for Locum Tenens Physicians
Dr. Gruss says, “Creating my own schedule and traveling to different places are huge pros of locum tenens work. Treating different patient populations in different parts of the country has been great for my education. Plus, they put me in nice accommodations and give me rental car. Of course nothing is perfect, there are some cons, too. As an independent contractor I am responsible for my own health insurance. Also, the flexible scheduling is two-sided. Every now and then I think I’m going to be somewhere for an extended period of time, and then the facility’s needs change and I get my 30-day notice that the contract is ending. But in my experience, that is the exception, not the norm.”
All things considered, Dr. Gruss is thrilled that he is free of the business side of practicing medicine. “I wish I knew about locum tenens practice a long, long time ago. I enjoy my time in new places but I also enjoy my time at home more than ever before. When I am home, the bills are paid and I have no distractions. At work I can focus on my patients, and at home I can focus on my family. I no longer have to waste any time or energy focusing on the business of medicine.”
