For physicians who crave more independence, locums is a great way to build a career that works for you, without sacrificing your lifestyle or passion for medicine. Dr. Robert Miller is a great example; when the pandemic brought unexpected changes to his hospital’s leadership, starting a career in locums allowed him to care for patients on his own terms.
How long have you been practicing medicine, and what led you to it?
I finished my internal medicine residency in 2017. At that time, my mentor was a surgeon, so I thought that might be the career path I would take. Ultimately, I realized it wasn’t a good fit for what I wanted out of my career, and what I thought I could bring to my patients. Surgery fulfilled a lot of things I liked, but I really enjoyed having relationships with patients. I wanted more continuity, and you don’t get a lot of that in surgery.
Primary care internal medicine allowed me to hold onto that side of healthcare, while also practicing a lot of the skills that I learned as a med student. Internal medicine felt like the best fit, because in many ways it’s the broadest specialty. To a certain extent, I get to be a cardiologist, a gastroenterologist, or an endocrinologist for my patient.
What led you to explore locum tenens work?
I remember talking to one of the residents who was doing locums––he planned on getting into gastroenterology, but wanted to do a locums year before applying for a fellowship. He described it as a different way of practicing, where you get the opportunity to see the country, work in different areas, and make a pretty good salary without having to be part of a faculty staff.
I’d never heard of locums, so that planted a seed in my head. But I decided to become a W-2 employee because I really wanted to work in a particular institution where I went to college. It felt like a full circle moment—I showed up there at 17 years old, and then came back all these years later as an attending.
Eventually, I came to Florida, where I was working as a full-time doctor. Then the pandemic hit in 2020, and there were some changes in hospital leadership. The hospital was looking to reorganize the hospitalist group, and it seemed like a good time to look into locums.
I called my friend from residency, who had gone on to do his fellowship in gastroenterology, but eventually went back to locums. He told me that if I were in a position to be mobile, there was no better way to see the country, work, travel, and pay your student loans.
I had a friend at Hayes Locums who I reached out to, and that’s how my career in locums began. I started in Texas because they were looking for doctors during the pandemic. I went in thinking it was going to last for three months, but I stayed for nine. Then another opportunity popped up. And then another one, and another—now here we are, six years later.
Were you worried about anything going into locums?
People who’ve never done locums have a lot of questions about insurance, whether you need an LLC, and all of these other things that start to make you question if maybe it’s too much to take on. But that’s never been my personality. I’ve never shied away from challenges, whether professionally or otherwise. So I did what I do best. I went back to the drawing board. I talked to a doctor I know in Daytona Beach who has been doing locums for 15 years, and he taught me about everything involved with locum tenens work. I got a financial advisor, an accountant, and read books to learn about it.
What I discovered is that this is not rocket science. This is something that can be done. There’s something to be said about being able to make your own schedule, work on your own terms, and be independent, while still being able to provide for your family. You get to enjoy things you want to enjoy without some of the scheduling constraints you have when you’re a W-2 worker.
I respect W-2 workers—I was one for many years. But I realized that being independent was what I was looking for out of my career.
Has there been a memorable or meaningful locum assignment for you? What made it stand out?
I was working at a facility out in Utah, which was my first time in that part of the country and I learned a lot more about myself.
I grew up in New York, so it was a much different environment.
New York was a melting pot; you get everything over there, but when I was in Utah, I worked more with Jehovah’s Witnesses and Mormons. I got to learn more about those religions, what they believe, and how they approach medicine. That was really enlightening to me.
That’s not anything you learn in a textbook. I learned about different people, and also visited a beautiful part of our country, and that made me a better person. It’s a beautiful thing. I made some good friends that I still visit.
What would be in your locum starter kit for primary care providers?
Surround yourself with knowledgeable people. For instance, most people have an accountant that you probably only talk to during tax time, but as a locum, it’s a good idea to talk to them outside of tax season. Find out what services they may be able to offer. Get a financial advisor as well, somebody to help keep you organized.
It’s important to find a good recruiter. It may be hard when you’re first starting out to know where to find a good recruiter, but if you’re working in a hospital, there’s probably a locum floating around that you can talk to. Most of them will gladly put you in contact with the recruiters they’re working with, and you can also interview them [to find out what their locums experience is like].
If you decide to move forward with locums full-time, I would recommend getting an LLC set up. You want to separate your personal life from the business side of your life.
But all of that comes with having the right team in place—like a good CPA, a financial advisor, and a recruiter. It’s important to have that toolkit.
