Sandeep K. Aggarwal, MD, shares why he thinks physicians nearing retirement should consider locum tenens as a late-career alternative.
There have always been two times when working locum tenens makes a lot of sense. One is to test the waters after your residency and fellowship training. Working in different geographic areas that interest you can help you decide on a location and type of practice.
The other time is late in your career — when you are nearing retirement but not yet quite ready to fully leave an established practice and patient base. Your options include working in areas around the country or staying local. However, you may ask why you would consider leaving a thriving practice completely when just reducing your hours to part-time at your current job would make more sense.
Why physicians turn to locum tenens
There are a variety of reasons to consider locum tenens at the end of your career. Most physicians these days are employed either in hospital systems or large group practices and many find the administrative control burdensome.
Maybe running on the treadmill day after day to see more and more patients in order to make ends meet for both the administration and your own salary is simply too tiresome.
Others yearn for the autonomy they had when they were in small group or solo practice prior to the sweeping changes in healthcare structure and economics.
Some physicians like to travel and see other parts of the country that are not necessarily always linked to vacation. This may be a good way to scout out areas for eventual full retirement.
Finally, there are noble reasons, such as filling in where there are shortages of physicians.
Moonlighting and gig work
Provided there are no moonlighting clauses, you may be able work in a part-time locum capacity during your vacation at your current place of employment. This is a good way to experiment with this type of practice and see if it is something that interests you. There is a learning curve to adapting to new environments and hospital systems, and leaving the comfort zone is also not always that easy, so this is a good way to ease into locum tenens.
In addition, the side gig economy has blossomed. Many physicians have been searching for work in positions linked to their field like consulting, telemedicine, writing, or legal work. Some pursue non-income-generating hobbies such as painting or gardening. Locums allows for greater expansion in any of these areas as there are fewer restrictions due to the greater degree of freedom.
Choose how much you want to work and when
Older physicians can work in various capacities with locums, including full-time inpatient with biweekly shifts, or part- or full-time outpatient work in the clinic. You can work from one to four weeks a month or only occasionally as an adjunct to your current practice. All of these options offer a sense of autonomy and a rebirth of the passion you had for medicine in those early days when you first entered the field.
Locums does allow more autonomy. For example, you can choose a hospital system that permits a mix of inpatient or outpatient care, including utilizing any technical skills and procedures. Depending upon your financial status, part-time work allows you to work less but still have the satisfaction of treating patients and staying up to date on skills without the administrative hassles or attention to RVUs inherent to employed positions. There is also an economic benefit.
A sense of purpose
Working full-time locum tenens as a late-career physician can be rewarding, challenging, and satisfying.
With the greater degree of sub-specialization these days, you may not necessarily see the wide spectrum of disorders that you treated during the earlier years of your practice or training. Locums can allow you to maintain a comprehensive general practice with the flexibility to send to subspecialists when needed.
Furthermore, you can achieve a great sense of purpose by using the skills you learned in past practices to treat patients in underserved areas — while keeping up to date with your skills at the same time. In my experience, the staff and colleagues at these facilities are wonderful people who are compassionate and committed to taking care of the patients in their communities. They truly appreciate and value physicians who are willing to travel to their locations to help them achieve these goals.