Finding a work/life balance might be the most important thing in your career as a hospitalist.
Everybody would agree that family time is extremely valuable—you want to see your kids grow, be part of their life experiences, be a good parent and share wisdom.
Full-time hospitalists are often portrayed as having one of the best jobs due to time off and job flexibility.
There’s some truth to that since typical hospitalist schedules do offer some flexibility and a good amount of time off.
However, there are inevitable problems:
Because of the seven on/seven off schedule, some years you work lots of holidays. We all know that those occasions are the best times to gather and celebrate with family and friends.
Another problem is that many hospitalist programs expect you to work night and swing shifts, which can make your schedule and lifestyle messy and unpredictable.
Requesting vacation also could be challenging. If you are planning a trip during holiday season or summer break, you’ll need a lot of advance planning (six or more months ahead). Other people’s schedules and hospital workload can interfere with your ideal time off. So, if you are not so lucky, you’ll be stuck.
In other words, you don’t have as MUCH flexibility as you may have thought.
Here’s how to avoid those problems, and it’s often overlooked:
I’m not talking about locum tenens, at least not the typical way we think about it.
I am talking about per diem, or what’s sometimes called PRN employment.
Using this approach, you neither have to travel and spend nights away from home, nor do you have to have a full-time job. You can call it locum tenens with a twist.
What is per diem?
Per diem is a direct agreement between the physician and the hospital with minimal obligation on each end. You don’t have any set schedule and can work when you want as long as there are open shifts.
Facilities like it because they use your services without paying agency fees. Therefore, they are not in a hurry to get rid of you, and this relationship can work for you and the hospital long term.
The other good news is per-diem hourly pay tends to be close to the locum rates. Hence, you can have great income and actually work less if you’d like.
Keep in mind that as a per diem, you typically don’t get any benefits (with the exception of matching your retirement if you work a certain predetermined number of shifts), but you easily make up for it with a higher pay rate.
I discovered per diem for myself when, due to family circumstances, I needed to be home every day. At that time I already had worked full-time locum tenens for a long time, both locally and out of state.
I really didn’t want to lose my flexibility and income, so I decided to steer clear of all the inherent problems of having a permanent hospitalist job.
So, I signed a per-diem contract with two local hospitals and one big hospitalist company that was looking for local doctors to cover “occasional” needs. As it turned out, I was needed quite frequently and have worked there for a few years now.
How to find PRN jobs
A good place to start is to google your nearby hospitals and check out their websites. Pick up the phone and talk to the hospital recruiter.
Some hospitals advertise the position openly, but some don’t. The key is to talk to them directly since many would be interested in considering your offer as an option—even if they do not have a need at that particular moment.
Keep in mind, if you want to make it work long term, you need to work with multiple hospitals. All of them have ups and downs in terms of demand, so it’s wise not to put all your eggs in one basket.
That’s why it’s important to contact as many local hospitals and hospitalist companies as you can as I described here.
To per diem or not to per diem?
I’m convinced that per-diem employment is a great option for hospitalists looking for more flexibility and a better work/family balance at the same time.
If this approach makes sense to you, do not hesitate to give it a try and let me know how it goes!
About the Author:
The LocumGuy is the hospitalist obsessed with career freedom. He lives in Seattle with his wife and two children and has successfully worked locum tenens and per diem for years.
Check out his blog to learn about his unique insight on how to have a more flexible and fulfilling career.