One of the most intimidating parts for me with locum tenens, at least early on in a wavering job market due to COVID-19, is the lack of stability. While many cite this as a reason that they can’t do what I do, I am cautious to remind them that not everyone has to function as I do. Working exclusively locum tenens isn’t for everyone and the travel can be difficult among other things. Nonetheless, the risk and the gambling has paid off for me in multiple ways and I would time and time again choose to take this path. However, learning to manage risk and the feelings of uncertainty is a tough but doable task, if you are able to be present in the moment.

At the beginning of my locum tenens career, the job market was absolutely dry for a General Pediatrician. Contrary to the adult world and the pandemic that rocked the world, the pediatric population experienced quite the opposite affect on the job market. As disease spread, lockdowns occurred. As lockdowns broadened, so did staying home from school, and as a a result, less kids got sick. With less sickness, there was less of a need for Me – work was sparse and although not talked about very openly or very much, some Pediatricians actually went out of business from the decreased volumes they experienced. During the nadir of demand vs. supply, I accepted compensation much less than my peers and prayed to have work the next week. Living paycheck to paycheck, there were times when I didn’t know if i was working at all the next month. I had saved enough money and lived conservatively to pay rent and make sure that I had food on the table, but it definitely took a lot of work and was a little stressful. I would talk to my recruiters hoping to get some sort of work, and beg for dates so I would know i could meet bill deadlines. My planning attempts months ahead were overshadowed by my needs for work in a day’s time. But, I persevered and was tenacious.

In 2021 after the world began to slowly attempt opening schools again, the need for Pediatric Locum Tenens began to experience a revival. Over the coming time, just as the stock market and the world experienced, the demand began to recover miraculously. Suddenly, I was getting bombarded with work and was able to book out my dates weeks advance. Coming into 2022, and I was booked for months – it was an incredible feeling to know that I had some bit of stability.

However, there is still a fine balance that I dealt with for a significant amount of time after which is the qualm of every full-time locum tenens provider. By the contracts established with hospitals by locum tenens agencies (and also direct per diem/locum agreements), a job may be cancelled either by the provider or the client (eg: hospital or clinic) more than 30 days in advance from the start date. Under those 30 days and one owes the other some sort of fine or reimbursement. As such, even if one has work booked out in advance, there is the chance it falls through and they will be unemployed. It’s happened to me, and it was awful. Less than 2 months out from a big job in Pennsylvania which had promised and asked for 10 shifts a month for at least 3-4 months, I got a call that a permanent provider had been found and i was no longer needed.

When these things happen, I have scrambled for more work immediately. But the paperwork and credentialing is a barrier that is often times difficult to overcome in a limited amount of time and the chances of finding work to fill in a lost job within 30 days are generally fairly low – although in true emergencies with a dedicated staff, a hospital can grant emergency privileges fairly quickly I’ve also learned.

So, naturally it is important to leave options open and be able to balance scheduling work ahead with not over-booking oneself. Being ready to take some unanticipated time off is helpful for some. For myself, although slightly neurotic, I have made sure to credential at places that have endless needs so that if a gap presents itself, I am often able to swing in to pick up an extra shift here or there. Interestingly, this places me in a position to often be asked to work more than 60 days in a month among various jobs. Obviously impossible to do, it helps as a back-up if needed but can lead to overbooking myself. I spend around 30% of my time double-checking my schedule to end up at the right place on the right day, hoping to have work but not too much work in the end.

In the end I find the best way to handle working as a locum tenens is to let go of things beyond my control and be present in the individual moment I’m in. Planning ahead but focusing on today is the only way to jump from one log to another as they fall over the waterfall. But, if one can find a balance, it will always be worth it.