Doctor's Locum Career Dies on the Table
In his third year of being a doctor, Dr. James Jones decided to do some locum work. He had heard stories in the RMO room about amazing rates, easy shifts, and secretly resented his award pay rate after the years of study he had put in. A locum agency had come to give a talk at his hospital, and made it sound even better. He spent a few days setting up some shifts, and arrived for his first locum shift at Backwater Hospital Emergency Department. When he arrived, there was no accommodation organised, and he didn’t have a clue where to go. It was hard enough to get there in the first place, and the rates really weren’t what he was after. James had thought about signing up with that locum agency, but decided he’d give it a go himself - how hard could it be? Alas, once he called the hospitals, the suave negotiator he imagined himself to be went out the window altogether. He ended up with shifts that he was just happy with, and at rates he was just okay with, and it had taken over a week for the hospital to get back to him. James thought that as a locum, there would be hospitals welcoming him, and eternally grateful for his services. Instead, there was no-one to greet him, and it turned out he was just another locum.
In my business, I hear stories like this every single day. Although many doctors have very positive experiences as locums in the public health system, there is an administrative minefield which most are surprised to find - until they try to wade through it. There are often policies, procedures, and paperwork to contend with just to register with a hospital - and that is before you even start work!
An example of this is the drastic changes NSW Health made in January with regard to locums. There were limitations placed on how much hospitals could pay (some metropolitan hospitals can now only pay award rate), there were new standards for training, and documentation that had to be completed. You may not have heard anything about these changes like these, as they often come unannounced.
Locum work can be of great benefit if you are after more experience, money, a working holiday, or all of these. However, before you get started, it is important to consider your reasons for locuming, and what you want out of it.
Think about why you want to do locum work? If it is to make more money, do you have an end in mind (for example, a new car); - and will you stop after you have reached your goal? You need to define how long you will do it for, especially if it is in addition to a full time job. Consider the very real effects of burnout and stress.
Locum work needs to be consistent with your overall professional career plan. Locuming can be an effective networking opportunity. Thinking about applying to a particular hospital next year? Doing some shifts there will develop some invaluable contacts, and a ‘foot in the door’.
Where do you want to go, and what do you want to do? Do you want to experience a remote area, or prefer to stick to the city? It is fairly certain that the further you go out of metropolitan areas, the more you will be paid - but balance the location with the experience you are seeking.
What do you want to be paid? Be honest with yourself. If you are a PGY3, are you really worth $200 per hour? If you think so, good on you! Look at what the market is offering, and don’t push the envelope too much. Once you develop a relationship with the facility, you will have a world of opportunities for ‘desperation’ shifts with much higher rates.
Also, think about additional benefits you would like, such as flights, accommodation, taxi vouchers, meal vouchers, reimbursements, on-call allowances, paid travel time, travelling allowance, milage, and more. Your imagination is limitless, but hospital budgets are not, so be judicious about what you ask for.
Be shrewd. Consider why there is a vacancy at that hospital. Try to talk to somebody who has worked there before to get the scuttlebutt. Is it filled with mad consultants (or no
consultants), does it have terrible accommodation, or poor after-hours
services? Do your research first, or make a small commitment to test
the waters yourself. If it is not good, move on.
Take time to prepare for being a locum.Your resume is your sales pitch to the hospital. You will probably need to do a complete revision on your resume to make sure it is presenting the key benefits of employing you as a locum, as there is probably more competition out there than you realise.
Think about this example - imagine you are buying a plasma screen television.
You approach the salesperson, and you can see she is ready to give you the sales pitch of a lifetime. You ask her for the benefits of buying this particular television, and she tells you: “Well, this one is actually the same as all of the rest. The reason you should buy this is that I get a 5% commission every time I sell a TV. I am saving for a new car, I would love some new shoes, and could really do with this sale”. You are dumbstruck, and walk away. What is wrong with this picture?
Obviously the saleswoman is just telling you how the sale will benefit her - and this is how many resumes tend to appear. Resumes are often a testament to what you want, and what you have done. Your emphasis needs to be on what you can offer that hospital. Read through your resume with this story in mind, and take a few hours to do some resume renovation. Every single benefit you present needs to be specific, and backed up by examples, where possible.
For example, if you have a
list of skills in your resume, rephrase them to show how those skills
will benefit the hospital (e.g. turn “completed EMST course” into
“Completed EMST course, and confident managing XYZ independently”). You
also need to think about the value of what you are writing, and saying.
If something does not add value, take it out (this means photos,
interests, hobbies, and the like).
You will especially impress if you have what the hospitals need at hand - make sure you have at least three referees ready to go, certified copies of all of your identification, qualifications, and a letter from your staff health clinic with your vaccination status. Also visit the relevant State health department website to see what needs to be done before you apply for a locum job (in terms of paperwork, and training).
You will then need to start making calls to hospitals to see what is available. You should have a list of prospects ready, and look at transport options to each location to see if they are feasible. When speaking to the manager at the hospital, be polite and avoid discussing money until the end of the conversation. However, don’t be afraid to ask for details about accommodation, flights, and other benefits.
You may also wish to consider engaging a locum agency, which is always free for doctors (they charge the hospitals). Locum agencies keep up to date with key industry changes, and will often take away the administrative work from you. Pick your agency carefully, because they are not all the same. They range from professionally run outfits to ‘factories’ with young salespeople with no appreciation of the health industry. Look for experience, credibility, a fast response to you, and a good reputation. Do not leave your career to chance, or in the hands of an inexpert locum agency.
So, what happened to James? He continued doing locum work, but spent too much time trying to find it, negotiate with the hospitals, and keeping up to date with the constant changes in the health department regulations. He gave up after a few months. James wasn’t aware of the secrets to successful locum work:
1. Know why you’re doing it, and how long you’ll do it for
2. Use locuming as an effective networking opportunity, and a chance to try a position ‘before you buy’
3. Have a plan about where you want to go
4. Make sure what you do as a locum is consistent with your career plan
5. Be clear about what you want to be paid, but stay congruent with the market
6. Seek out opportunities for added extras like flights and accommodation.
7. Be shrewd about where you go - speak to those who have been there before.
8. Prepare for being a locum - make sure your resume is in good order, and emphasises the key benefits of
employing you.
9. Make sure you have all of the right documentation ready for the hospital to consider you.
10 . Consider a locum agency - you take your car to a mechanic, and go to an accountant for your tax. Why
should your career be DIY?
Above all, keep evolving. Locum work is an
opportunity for growth, and you will develop experience you may never
in your day to day job. Heed James’ cautionary tale - follow these
secrets, and you will succeed as a locum.