Are You Ready for Locums? #474 Part 4

We answer a listener who asks how to know if locums is the right move and whether they’re truly ready for independence. We break down confidence, clinical readiness, and the mindset shift needed to succeed as a 1099 physician.

This episode hits home for: 

● Medical students 

● Residents & fellows 

● Attending physicians 

● 1099 & locums doctors

● Anyone interested in healthcare policy or physician lifestyle 

If you’re studying, training, practicing, or thinking about locums… this one’s for you. 

Comment Below: 

● Are you considering locums in 2025–2026?

FREE DOWNLOAD -  7 Considerations Before Starting Locum Tenens - https://darkos.lpages.co/7-considerations-before-locums

LINKS MENTIONED 

Study about physician satisfaction from pubmed - https://pubmed.ncbi.nlm.nih.gov/12755252/

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Transcript

SPEAKER_01 1:43

Alright, y'all, we are back. We just finished talking about the upgrades that we're doing with our upstairs tenant. Check out that segment so you can understand the tax implications as well as just the regular living implications of living with someone who is renting from you. Right now, we're gonna jump into this question from a listener. A great uh question about how do I know if I'm ready for locums? So here is the question. This is straight up. This is from JA. How do I know if I'm ready for locums? Basically, this person is interested in locums. No, this is somebody different.

SPEAKER_00 2:24

Oh, okay.

SPEAKER_01 2:25

Right? Wait, I think I might have cut off this question. Let me see. Give me a second. P V actually. I'm sorry, I wrote the wrong, I put the wrong thing. I want to do locums.

SPEAKER_00 2:34

I'm like, I know I heard J A before, but all right.

The Glamour Versus The Reality

SPEAKER_01 2:37

Well, let's okay. Mute up, mute up. All right. So I want to do locums, but I don't know if I'm ready for the independence. See, this is a key context. How do I know if locums is right for me? P. V. So I think that part, this is a great question. I think there is a little bit of um some glossing over that we do on our show. Um, I think a lot of people now who are embracing locums are doing the same thing, but it's hard, right? It's social media. But yeah, it looks locums looks glamorous on Instagram, right? Because we talk about you could travel, you get big checks, you get freedom, you know. But I do want folks to understand that, you know, it's a different way of thinking about things, right? It's you know, we always talk about like there's the traditional way of doing things, and it it may come with its inherent risks and so forth, but you know that's a tried and true method. And when you talk about something that's new and non-traditional, there's inherent risks with that, but you don't really see that many people who are actually doing it. And sometimes when they talk about it, they kind of gloss over it to the point where you really don't understand it. So, you know, I think that you gotta be confident when you're doing locums, you gotta be able to adapt to different structures and different types of environments. Um, and you have to understand self-management, right? So if you're hesitant about that stuff, which for the most part residency has a hard time promoting, I think that's healthy. I think that's healthy, you know. But it doesn't mean that you still shouldn't do locums because you're looking at you're looking at two people who did locums straight out of our training, right? Not like a year of working someplace and then we did locums, but like, yo, I am done being, you know, I'm done getting didactics or whatever I was doing, and now I'm just going into being a locums. And right, it was an adjustment, but I'm so happy I did that.

SPEAKER_00 4:39

I think it's I think it's an adjustment no matter what, right? When you're coming out of residency, being an attending in and of itself is an adjustment. It just is because the buck stops with you no matter what. And so I don't know. Did this person say they're coming straight out of training or no? No.

SPEAKER_01 4:59

But I'm assuming based off of you know how you could tell based off of how people write questions? I think that's what it is. Let's just assume that they are.

Independence After Residency

Partners, Backup, And It Depends

SPEAKER_00 5:07

Right. If you're coming out of residency, the buck is gonna stop with you anyway. You're you're going to have pretty much complete independence, whether you're a locums or whether you're an employee doc. Like that's just gonna be what it is. So whatever pain that you think is going to come that is extra with locums in in with respect to the independence of being a doctor is probably the same pain that you're going to have being an employee doc. Now, the scary part that you might be thinking about is well, am I going to have partners? Right? Am I gonna have partners as an employee doc and you know, versus as a locums? And honestly, the answer is it depends. It depends. It depends on yeah, it depends. You've been watching a lot of Judge Judy, huh? Shout out to James Dockery. It depends. And James Dockery. Uh um, but it does depend, right? It depends on the setting that you're in, right? If you're a hospitalist, you may not have somebody right there with you to, you know, to kind of bounce things off of. But I will tell you that as a hospitalist, and I've been doing hospitalist work for a very long time as an OB hospitalist, there are usually not a dearth, a real long time. There's not a dearth of physicians who you can call on to just bounce a question off of. They usually are like, you know what, if something pops off, just give me a call. I can tell you how things work. Now that's not something that you want to abuse, but you also wouldn't want to abuse that if you were an employee doc and you were working alongside your partners, you know, all day long, because they have work to do too. So quick question. Quick question.

SPEAKER_01 7:05

You ever you ever call an attending, like one of your attendings in residency? You ever call them while you're on a locums for a question?

SPEAKER_00 7:13

Like a former attending?

unknown 7:14

Yeah.

SPEAKER_01 7:15

Like you have a clinical scenario.

SPEAKER_00 7:17

Shout out to Pamela Brug.

Build Your Mentor And Peer Thread

SPEAKER_01 7:18

Yeah, shout out to Dr. Cole. Dr. O'Cohley, I remember 2014. I called him at like two o'clock in the morning. I was, I don't know where I was. I was like Minnesota, something. I had like a uh duodenal perforation, but this one was posterior. Most of the time it's in the anterior portion of the duodenum. But this this guy, it was in a posterior section of the duodenum, old guy, septic. And I was like, wait, can I fix this the same way? He's like, Dr. Darko, what do you think? At two in the morning, he woke up quick, too. Mm-hmm. Mm-hmm. He hooked me up. Yo, shout out to him, yo. Shout out to him. But I'm done it. So just we're safe.

SPEAKER_00 7:55

I've definitely done it.

SPEAKER_01 7:57

That's what they're there for, and that's what they sign up for. For me, that's what if you if you are teaching me in residency, I'm sorry. If particularly we have an okay relationship, I'm calling you whenever I need to.

SPEAKER_00 8:06

We have a mentoring relationship, yeah. That's it.

SPEAKER_01 8:09

I don't care. Yeah. Answer it.

SPEAKER_00 8:10

Oh, absolutely. And the other thing that you're doing is that you're going to be able to do that.

SPEAKER_01 8:13

That's what my tuition dollars pay for, right?

SPEAKER_00 8:15

Right, right, right. Well, no, you don't pay tuition in residency then.

SPEAKER_01 8:20

I pay with sweat. Blood and sweat. Okay, great. Tears. That's what that pays for.

Why We Favor Locums

SPEAKER_00 8:24

So this is what I would say also is get your thread of colleagues that you feel really comfortable with their decision making. Get, get, get yourself like three, four, five of you who you can at any point in time text and be like, yo, this is what is happening. This is what I'm thinking about doing. Anybody else got any suggestions? Anything I should be looking for. Get your thread, your little text thread, your little WhatsApp thread of docs, colleagues, you know, maybe of of different, you know, different um generations. Um, but definitely get your text threads ready. Because then if you need to jump on a call with any one or two or three of them, then at the very least, you know, you have you have them right at your fingertips. So that's that's what I would suggest as well.

Try A Short Assignment First

SPEAKER_01 9:22

I think that's great. Uh great advice. I would say, listen, um, the reason we like locums is because you get autonomy, you get flexibility, you get variety, um, and there's a chance to get financial stability very, very, very quickly. Right. And it's not just me and Dr. Renee who are saying that. There are studies that are out there that basically just says physicians with greater control over their schedule and work environment report higher career satisfaction and lower burnout. Key benefits of locums, right? So as we talked about in previous episodes, also, this is some data that is not PubMed, also, but you know, locum physicians earn 30, 30 to 40% more per hour, depending on specialty than employee docs. So there are advantages to doing locums, but I've obviously it's it's it's not like the it's not a panacea, right? But you trust me, if you're coming from a residency program, I would fair to say that the majority of residency programs have trained you in whatever specialty that you need that you're gonna go into enough. You just gotta make sure you it's like the last dragon. You know what I'm saying? When shownuff is holding, you know, Bruce Leroy over the water, he's like, yo, who's the master? And he don't believe it until he's drowning, right? He's like, yo, I can't breathe. And then he starts to see all these different people and all these different experiences like, wait, hold up a second. I'm the man, right? I did this. That's you got this. So, you know, P V, you got this, Joe. You the man, you the woman, you, you the master, you got this, right? And there's studies, there's information, you got us to let you know that you can do this. So listen, this is the steps that I would tell you. I gotta keep a goal to my notes because I I got I got so many things in my mind. I start talking about Bruce Leroy things, and you know, I'm on on tangents, so I gotta write notes. So I would say this. Listen, if you scared yet, if you are nervous, I would say this. Do a short-term trial, right? Do like a one to two week stint, see how it goes. That's it. Like, remember with locums, like you can get in as quickly as you can get out, right? So if you sign up for an assignment and you know, they want you to do a certain amount of weeks, you only work what you can do. That's it. Right. You get in, you get out. Exactly. So I would just say start for one to two weeks, see how it goes. If you like it, you like it. If you don't, then you know, go work the employed life. And that's fine, also, you know, no shade. Um, and then the other thing is you want to develop uh a relationship with a solid, reputable locums agency. Check out our show notes. We only work with those type of companies, right? That's super important. Um, and then the other thing, too, that always makes people nervous is malpractice, right? Um, malpractice. Just make sure that that locums company has proper malpractice insurance. Those are really, really big important things that you need to focus out. So, and then, you know, sometimes some people are like, well, I, you know, if I go to a different hospital, I gotta go to these different EMRs and all the look, that's life. You get it. Keep a checklist, just keep a checklist, keep a black book. Dr. Renee has one. Keep your passwords together, you know, keep your passwords together, your black book and your burner phones. I don't know, Dr. Renee. Says a lot about you. Says a lot about you.

Agencies, Malpractice, And EMRs

SPEAKER_00 12:34

Tito, Jermaine. What does D what does GTD mean? Okay. Tommy.

A Personal Story Of Flexibility

SPEAKER_01 12:56

No, but for real, um, PV, you got this, yo. I I would say start short, try it out for a little bit. Um, you know, make sure you're you're you have a good relationship with somebody or with a company that you think you can trust. See how it goes. But I'm gonna tell you right now, like, there's gonna be a certain level of like, you you should be confident in your skills, or you're gonna be forced to be confident in skills. You you may have to go to different hospitals, possibly. Um and look, you know, this is this is it the way how things in residency are not often the way how things are going to be as an attending. Right. And right this might be one of the first steps to kind of making sure that you can handle it from all different ends. And I always say, like, remember, when I f when I finished fellowship, I was hella nervous about doing locums. But when I started off doing locums, I was going between three to five different states. We weren't married. Um, but you know, the ability for me to work really hard, but also at the same time bring home enough money to help my dad, who had prostate cancer at the time and pay his bills. Like, here we go, dad. Paid, paid, paid, you know what I'm saying? And be able to be there for his radiation treatments, right? Was like, that was amazing. I j I joke, but that's the truth, guys. For real. Like that was a very serious and scary time for my dad and for our whole family. But when you are 10 years out from it, you get to look back and be like, yo, that was dope, right? That was dope. I was able to work hard, but also at the same time make my schedule in a way that I was able to support him financially as well as you know emotionally and be there with him. And that took a big jump for me. But that, to be honest with you, at this point, I could say was would only have been possible with me doing locums. After about a year and a half of doing that, me and Dr. Renee decided to, you know, be employed for three years, and it was okay. Um, but I didn't like it. I didn't like it. And it was to the point that even during those three years, when I had time off, I still did locums just to keep my foot in the door.

SPEAKER_00 15:10

So yeah. Yeah. So if you're ready, look if you're ready to be an attending, you're probably ready to be locums.

SPEAKER_01 15:21

Yeah. I'd say start small, you know. You'll learn faster. Um, and then I think you'll just as you get better and better at this, you'll grow into your freedom. You know?

SPEAKER_00 15:31

Yeah.

SPEAKER_01 15:32

Um, you it's really not about being ready, more so just being willing to get into it.

SPEAKER_00 15:37

Right. Right.

SPEAKER_01 15:38

So I think I think that's the key.

SPEAKER_00 15:40

So I think sometimes we're keeping posted.

SPEAKER_01 15:42

Yeah. PV, keep us posted. Let us know what's going on. Um, and hey, that's a wrap. We did it, Dr. Renee. It's a wrap. We did it. We hit policy, we hit music, we hit taxes, we hit the questions. Um, that's what this show is about. Listen, guys, if you want to hear your question heard on the show, make sure you check out the show notes, the description below. Alfred also put down a text where you can text us and let us know directly about your thoughts, any questions that you have. Remember, I have the answers to everything. All of your questions. Okay. I have the answer. Seriously, we've been through it. We're not far in, we're not in our, we're not like so old that we can't answer and we don't know what the new generation is going in, but we're that much ahead that we know what pitfalls you need to worry about. And trust me, I know.

SPEAKER_00 16:28

We have the answer to everything. Everything. Everything, everything there's not anything. You're the master. Huh?

SPEAKER_01 16:35

Okay. All right, y'all. Listen, if you loved our our our episode today, make sure you leave a review, hit subscribe, share this episode with someone in medicine who needs it. Um, until next time, folks, we'll catch you guys on the next episode.

SPEAKER_00 16:50

Deuces.