A version of the following article is a repost that was was originally published on CompHealth.com at https://comphealth.com/resources/clinical-settings-locum-tenens-pediatricians
I’m often asked what exactly it is that I do as a locum tenens provider and Pediatrician. To start, I do NOT deliver babies… Well, except for that one accidental time working a job at a small critical access hospital in the middle of nowhere New Mexico when one fell out into my hands… but that’s a story for another day.
So, once we get that out of the way, there still seems to be so much ambivalence towards my day-to-day work. For starters, a General Pediatrician is a provider that has the capability and training to take care of any human from the age of 0 days to 18 years old. This may occur in a clinic setting, a hospital setting, or both, and can have some variability based on practice preference, location and culture. To clarify, here’s an actual breakdown of the actual jobs I’ve perused as an exclusive locum tenens Pediatrician:
Exclusive Clinic/Outpatient Pediatrics
This doesn’t take a lot of explaining, I hope. These are office visits for “Well Child Checks,” when we make sure they’re growing/developing normally, or “Sick Visits,” when you bring them in for coughs, fevers and tummy aches, Oh My!
Exclusive Inpatient General Pediatrics Hospitalist
I was never hospitalized as a child, and as a generality most kids aren’t hospitalized; so, I sometimes this is harder to fathom. One of my more favored types of jobs, this is taking care of any patients that need to get ADMITTED to the hospital for any number of reasons between the age of 0 days and 18 years old. Usually, this does NOT include newborns, but occasionally these roles mix. Maybe it’s a 2-week-old with a fever that requires an admission for poor feeding, or a 6-year-old with asthma or a 17-year-old with complicated mental health issues. In the Adult world, I believe these units are called Med/Surg. As a GENERAL Pediatrician, this normally does NOT include the PICU (Pediatric Intensive Care Unit).
Exclusive Inpatient Newborn Hospitalist / Delivery Attendance
My favorite job as a pediatrician interested in the world of Neonatology, a Newborn Hospitalist takes care of new babies as soon as they pop out. To repeat, I DO NOT DELIVER THEM, but if they come out and don’t breathe, the OBYGN will toss them to me, I try to fix them, and then afterwards make sure they’re all settled before they go to their new homes. Nurseries are categorized into Levels with increasing acuity from 1 to 4; as a GENERAL Pediatrician, my work is generally limited to Level 1 and 2 – Care for babies generally born no earlier than 34-35 weeks of pregnancy and not requiring serious interventions such as breathing tubes. For the most part, this job is fun and easy-going, but there are very scary deliveries and neonatal resuscitations that will often require stabilization and transfer to more equipped hospitals. I’ll never forget the 2lb 28-week baby I helped to save while we awaited the neonatal transport helicopter’s arrival to take him to a larger hospital with more resources.
On Call, Home Call, but Please Don’t Call
A majority of the above jobs are traditional work in which I am working when I’m at work, and I’m off when I’m off. However, as a locum tenens provider, I’m often in small hospitals that function with older models of care where I’m the ONLY pediatrician around. This leads to any combination of the above with the chance of me being summoned to come back into work, after I complete my daily duties, in the case of an emergency. For an example, for some jobs I’ve been on daily call out of the hospital just for deliveries, in others I’ve been on call for ER consultations and emergencies, in others once I leave the clinic, my call time starts for the hospital; it all varies. To give the grandest example of a day in my life at those jobs: 6AM Nursery Rounds on new babies born overnight in the hospital. 8AM-6PM Outpatient Clinic then going home to the hotel. 7PM ER consultations over the phone. 2AM Emergency Delivery requiring my presence. Repeat. Old school, full-scope, exhausting medicine.
Depending on what you want to do, the nice thing about working as a locum tenens Pediatrician, is I can have a variety of any or all the above. It keeps me on my toes, always gives me something new or different to look forward to and allows me to keep up multiple skills and facets of my training. Sometimes I feel like a cowboy in the wild west and other times I’m coddled by all the support you could ask for; either way, I definitely never get bored.
Image Credit: https://www.wakeforestpediatrics.com/the-expecting-parents-guide-to-choosing-a-pediatrician/