Everyone has their own reason for working as a locum tenens provider. Whether it’s for work-life balance, control of scheduling, exploration, increased salary, or experience, there is a calling for everyone that varies from person to person. For myself, I have written at length on this blog on my inspiration and why I have chosen to do one thing or another. However, one of the most significant points of my career that has been endlessly gratifying is the humility that has come with learning to lead as a locum tenens physician. I have spent hours working with multiple groups of people throughout the country and the single trait that I have continued to foster, among many, is that of Leadership.

In my opinion, a Physician must take on the role of leadership. We should be willing to take on the brunt of responsibility and command such worth by our actions. When the ship goes down, the captain is the last to get off the ship. When there is a fire and someone is accidentally left behind, we should be the ones running back in. When our teammate is down or hurt or subjugated to criticism, we should fight for them. It might not be for everyone, but we should be one that others look to for help and someone that can be trusted when one finds themselves in a pinch. We should feel the pressure and live in it. Finally, we should be the type of leaders that do not thrive only in our own success, but are able to help others succeed and by doing so find their own brilliant potential – a leader’s job is to pull others forward, not stand alone at the front. I chose to become a Physician, in particular, because I wanted to be a Leader; but to be a Leader means understanding the dynamics of a team and realizing that it is our actions and not our titles that define us.

In the world of locum tenens, it is common to be cast into smaller places that require the guts (or insanity) to be there. There are small places or rural places that often seek our help and with less resources or more fragmented care, the importance of strong leadership becomes proportionately more crucial. I have walked into critical access hospitals with minimal resources and been asked to immediately garner the trust of a team for a difficult resuscitation. I have shown up to new places with judgmental eyes wondering If I know what I’m doing, and had to ascertain immediately the strengths and weakness of the group around me. And, the most endearing thing, I have become part of teams that are like family where, with time, we move as a single perfectly in sync unit, able to gauge what the other will do by eyes and silence. But, it takes continual introspection, retrospection and prospection to make these factors all merge into a successful unit.

I will never forget watching Dr. M run a code blue in the emergency room while in my residency training. A toddler had fallen into a pool and drown. CPR had been done for far too long by the time he even made it to our hospital, and then, while we waited for the parents to get to the hospital to cease resuscitation, I watched him lead the most beautiful attempt at saving a life I had ever seen. The rooms next to us had no idea that in this trauma bay, a child had die, because of the shear control and compassion that overflowed the room. He was calm, direct, responsive, and outside of making decisive and clear calls for the next step in attempts at saving this life, he was humble. At every cessation of chest compressions, he asked the entire room if there were any ideas or suggestions of what to do next. I will never forget, “If anyone sees a reason we should continue or something we have not thought of, please speak up.” We were not successful at saving that child, but we were never going to be. However, at the end of the 30 minutes of attempted epinephrine, bicarbonate, chest compressions and shocks, the group paused in reflection to sort through difficult emotions and each was silent, somnolent and sober to the teamwork that had just occurred. That child died that day, but the level of teamwork that I was lucky enough to witness was monumental and lives with me as one of my main sources of inspiration to this day.

When I walked into my 2nd or 3rd locums assignment, I remember an older nurse tell me she had thought a baby had a broken clavicle – a common unavoidable outcome of some more traumatic deliveries. She had mentioned it to the doctor before me who had hushed her and ignored her thoughts. Yet, I will never forget when she told me the same thing, unsure of herself after being brushed off the day before, and I listened. I recognized immediately the strength of experience for decades my senior and ordered an x-ray. Sure enough, broken. I reiterate this experience over and over and over again to my learners as well as silently to myself with each new day that occurs. The point being that to be a good leader, one must be a more superior listener and ultimately be extremely aware of one’s own limitations. Teamwork is complicated and part of the reasons I returned to the world of Neonatology – a specialty that can not at all have success without it.

I write this as a caution and a chance for audacity. I write this as a hopeful inspiration for those daring enough to jump out of the safety net and push the boundaries of comfort with locum tenens assignments. Not all situations may be as intimidating, but the will to lead teams on multiple levels should always be there. Even though I was a locum provider at many places, I came to lead. With great power… Comes great opportunity.

Image Credit: https://www.cleanlink.com/cleanlinkminute/details.aspx?id=57772