Physicians Make Money With Locums Work
Do you want to take control over your financial future? Do you feel like others know a secret that you don’t? Remember when you began medical school? That was your first climb. Reaching the goal of becoming a physician felt as if you were about to climb a huge mountain— think Mount Everest.
You made it!
However, now you feel like you are about to begin the climb again.
This time the goal is building your financial foundation (and ultimately your ideal life). You may feel after all your hard work that you should be well on your way to financial wealth and becoming financial independent.
It can feel very disappointing to realize your journey toward this new goal is just beginning, but it doesn’t have to be long hours and sleepless nights.
In fact, when it comes to your money and everything you work for, sometimes it takes just a bit more effort to bring you even closer to your money goals.
Carrie Reynolds, Host of The Hippocratic Hustle Podcast, knows all about what that extra effort looks like. Making extra money as a physician turned out to be a life’s calling that helps other doctors rake in the green too.
Locums work for Carrie, in particular, turned out to be quite rewarding for her. Rewarding enough to bring in a high side income. She’s going to teach us a thing or two about her experience.
Yeah, me too!
What You Will Learn
Carrie is a pediatric gastroenterologist whose home base is in Denver, where her family also resides. She wanted to make more time in her schedule to work on her side hustle, the podcast, The Hippocratic Hustle, and other projects important to her. Since it wasn’t feasible to cut back to part-time work in the full-time position she was working, she needed to find an alternate way to reach her goals. Carrie decided to investigate doing locum tenens as a career. She knew other people who did locums as a career. She did her research and talked to several of those people she knew in the locums positions. She decided locum tenens as a permanent situation would fit her lifestyle. Now the question was how did she forge that path? And what if now, she also wondered what it would take to build wealth?
The Road Least Traveled
Carrie decided to start where she was. She began searching for alternatives when she was still employed as a pediatric gastroenterologist full-time. Carrie was happy with her current employment, but she was invested in planning ahead so that she might realize some future goals that she was considering. As she was researching, she came across not only locums jobs online, but also nationwide agencies that matched physicians with either permanent work or locum tenens positions. She talked to recruiters about the different positions that interested her. As she talked to the recruiters, she realized the work really was a good fit for her. Carrie believes one of the benefits in using an agent is they do the legwork involved in the process –including finding the job. Another thing to consider is the time and effort it takes to become credentialed for locum tenens work. An agency can help a physician with those certifications. However, an important question was posed: How much was Carrie’s time worth as a locums?
Apples and Oranges
Carrie realized that although she knew what the average salary was for her specialty, understanding the compensation for locums work was a whole new ball park. Carrie needed to know if she would be remunerated for the time, effort and travel involved in achieving a locums position. She wondered if she would have the support system that she had in place at her traditional full-time job. Taking all these factors into consideration, Carrie wondered how much was her time and experience worth? How much should she charge? How would she like the work and people?
Carrie did her math and she was aware of how much she made. She knew how much she needed to make in order to consider the jump to locums work. In Carrie’s specialty, the way to figure average compensation is done using eight hours or they take the eight-hour day and figure it up by an hourly rate. Here is a general breakdown:
- Paid for eight hours per day
- For a pager call, emergency return call, and any overtime you are given a stipend or different rate per hour for each of those
Upon hearing what a recruiter thought her specialty would make, Carrie was uncertain if the figure was accurate. The recruiter had assured her that the amount she was asking for was far too high. Carrie had a niggling doubt that perhaps the recruiter was not being honest. If the recruiter’s number was accurate—it was definitely not competitive!
Her uncertainty sprang from the recruiter’s hesitation and the unspoken rule throughout the medical system that physicians don’t talk about how much money they are making—even among themselves. That rule is across the board regardless of a physician’s position of being salaried, hourly or locums. These two things combined to give Carrie the idea that she should find out what other physicians made and what she could expect.
If You Never Ask…
Carrie had the upper hand in this situation. She was still happily employed, and in no rush to leave her position. However, she was aware that she might want to change things up in the future. While exploring a possible future destination, she began to look around, ask questions, and consider alternatives. She turned to the internet as part of the fact-finding phase.
She put it out there on Facebook, where there is a lot of information, a “hive” of it! She asked these questions: “This is how much a recruiter quoted me. Is this right? How much should I make”? Among those who answered, there were pediatricians doing other subspecialties, surgeons and adult gastroenterologists. The consensus was the recruiter had given her a figure that was way too low. The recruiter presented it as a hospital would not pay her what she needed.
Why would a recruiter low ball a client? Carrie figured it may be due to a conflict of interest. Was the recruiter getting a cut? Did the recruiter have a quota? If he signed on a physician, then the faster he could move down the assembly line to a new candidate searching for another position. Carrie’s gut feeling had been correct. What was her next step?
Calling the Bluff
Carrie was clear with herself, she wouldn’t consider leaving a full-time position that she was happy with for a lesser amount than the going rate. She knew she needed “X” amount of money. She states she just couldn’t jump ship for less, she couldn’t make that choice for her family without something in place that would meet her family’s needs. She told the recruiter that she couldn’t take the job and ended the conversation. Within two days the recruiter called her back stating the practice had changed their mind. They were willing to pay the rate Carrie needed!
Some Things to Consider
Is it possible to make full-time pay within a specialty while doing locums work? Carrie says it is. You must take into consideration the time, effort and travel. You typically don’t get paid for travel; however, you are working fewer days. It is possible to break even.
Taking work-life balance into consideration, locums work might be beneficial. It allows you to use your degree, and continually sharpen skills. However, you are not having to work full-time. If you have your finances under control, with your spending and budgeting planned out, it could be a good move for a family to make.
It is necessary to take into consideration that locums work is not a permanent position. You are there to fill in while they look for a permanent physician. They usually give you a 30-day cancellation notice. Therefore, there is no job security, but you already know that is the nature of locums work and it comes as no surprise!
That is exactly what happened to Carrie. Shortly after she started a locums position, they decided to cancel it. In her personal financial situation, it worked out. Her husband’s salary paid for keeping the roof over their head and food on the table. Her salary was used to pay down the student loans. She states they have just under $500,000 in student loans to pay. Which is a typical amount for a dual physician couple. Carrie and her husband have made it a priority to pay as much as possible to toward the student loans as an answer to her student loan problem. When a locums position ends, her household still functions, but it delays the paying off the student debt process!
Are locums doctors treated any different? Carrie and another doctor shared a locums position. The patients they saw had been on a waiting list that was approximately six months out. Those patients were very grateful to have a visiting doctor! This is a place where the people really need you. That appreciation was motivational when you’re faced with having to commute to a small town and go through the credentialing process. It makes up for the fact that you are not on a routine schedule or working with the same crew every day. She did say it was harder to build relationships and comradery with the other staff because it’s usually a temporary situation. They don’t want to invest their emotions in something that is certainly short-term. However, being a locums tenens did help Carrie become more in-touch with being a physician due to the response of her patients.
A locums position is also a good way to try a position out before taking it on a permanent basis or trying out a location before settling there. Carrie was enthusiastic about locums work being an interesting and fun way to try out a job. She said it gives someone a chance to see different parts of the country or even the world. Carrie indicates that statistics show most people uncommitted to their first job because of the learning curve regarding yourself and the actual position. In this case locums work may also serve another purpose, it allows you to “try on” a position, to see what topical areas you could grow and also shine light on your own personal preferences.
My wife and I lived in Las Vegas, where Taylor did locums work in Fresno. She really loved the hospital and people there.
For residents interested in locums, consider the positives.
While some doctors and hospitals look at locums a little sourly, ultimately Carrie’s answer was to not fear locums positions—they have a lot to offer. It is a great way to explore different regions and opportunities. She has applications in the south, east and west. She is not sure which direction she will be going, but she enthusiastically says they all sound exciting. She thinks it is a fun way to practice medicine!
The locum Tenens Starting Gate
So, there you have it. A flexible way to either start your career, change it up, or meet your family’s needs. You have the option of deciding what type of schedule you want. It could be just what you need to stave off a bad case of burnout. It’s a creative way to keep up your skill set, but at the same time check out our country or see the rest of the world. It’s a perfect way to try the environment and hospital culture of any place where you might want to set permanent roots down.
You’ll need to figure out what your time is worth. You’ll want to either find a position on your own or contact an agency. If a regular permanent position was cancelled, you would be given a three-month notice. You will keep in mind that the position is meant to be temporary. When the hospital administration is ready to terminate the position, you will be given a 30-day notice. On the flipside, you have the choice of leaving after giving similar notice. Locum Tenens work is another avenue of opportunity, so that you have flexibility and financial control in your life!
Journal Club: Life of a Med Student
I’d love to take a moment to shine light on an article posted on the site: LifeOfAMedStudent.com titled “Top 5 Financial Mistakes I’ve Made During Residency.”
In it, the author discusses, just as the title suggests, his top 5 financial mistakes that he made during residency. We have mentioned several of these on the show, even highlighted a few of these in detail, but I think having a recap from a physician who comes clean about some of the mistakes they have made is an excellent way for the rest of us to learn from.
The first mistake he made was not funding his retirement accounts. I quote “Start the mindset to “pay yourself first” with retirement savings. Even if the amount ends up being relatively small – it’s the MINDSET to establish now that will serve you well later. He’s right, setting up good financial habits early in your career will help you throughout the rest of your financial journey.
The second mistake he made was rolling over one whole life policy onto another whole life policy. Ouch. OK, so the first one wasn’t really his fault as it was purchased when he was 2. He shows some of the math on what was going on… It was a $100,000 coverage, costing $425/yr and had a cash value of $14,000. adding up how much his parents have paid in premium, he said $12,000, they didn’t really make much of a return (in his example $2,000) over the past 28 years. That’s seems pretty typical as these products are loaded with fees and generally capped in returns, but I have no idea what he bought, just general biases towards these products.
Not only did he cancel this, but he then bought a universal life policy stating that the sales pitch was great. Double ouch. This time it was $800/yr but all of the cash value was locked away in this new policy and if he surrendered it, it was only worth $2,000 due to all the high penalties. Triple ouch.
His third mistake was being under-insured. Funny how he went from buying insurance to saying his third mistake was being under-insured but its because he bought the wrong TYPE of insurance and it sounds like he figured this out a bit late. Hes referring to disability and term insurance in his post and we did an entire episode with Larry Keller on this back in April called Winning Tactics for Finding the Right Insurance Policy so go back and check out that show if you are interested.
His fourth mistake was not having his attending contract professionally examined. Basically hes referring to the concept of getting a second opinion. Lots of horror stories out there and hopefully he isn’t one of them but based on the article, he had a fairly simple contract and was confident at the time that he understood it. In my opinion, I’d always default to an expert that spends all day every day doing a particular activity that I am not an expert in. Having a second opinion never hurts. We actually have a show coming up in a few weeks with a physician contract expert, stay tuned!
His fifth and final mistake was not knowing any of this in medical school or residency. Taking the time to learn and understand what he was getting himself into. He talks about how some of his mistakes have cost him thousands of dollars or more in his lifetime and he wished he put in some of the work to understand what is happening in his finance. Good news for all of you listening, you are putting in that time and effort so hopefully this wont be a mistake that you share!
What I like really about this article is how honest Charlie was about what he did wrong and actually gave a few real examples and how it went bad and how he plans to fix it.
In my experience, I see these mistakes a lot. You don’t know what you don’t know and if you don’t search for the answers and verify how it is applicable to your own financial circumstances, you have a higher probability of making a mistake like Charlie did.
Charlie at LifeofaMedStudent.com: thanks for showing us how to do it. Excellent work.