Dear locums physician recruiters,

After completing medical school and a three year emergency medicine residency, I spent twenty years in the private practice of emergency medicine, in a fee for service group.  Then around 2013, I embarked on my locums adventure.  I needed a change of pace and scenery.  I needed some emotional recuperation. And most of all, I needed some control.

I’d like to thank you all for what you did.  You were wonderful and helped me to rediscover my love of my work. And you gave me a chance to see many different types of emergency medicine practice.  Best of all, you helped to confirm my deep love of, and passion for, America’s small, rural and critical access hospitals.

You arranged my contracts, kept my credentialing straight, put me on the right flights,  and booked me into nice hotels.  You ensured that I was paid on time.  I appreciate all you did.

Eventually I moved back into more local work and became an employee once more.  However, things change.

Lately I’ve been looking at the locums world once more.   And having talked to some recruiters again, I’d like to remind you all of a few things.  (Not all of you; please just bear with me…this may help you in the future.)

What we do as physicians is often very difficult and very stressful.  (I speak as an emergency physician but this applies to other specialists and generalists as well.)  Unless you have personally done this job you can’t really have any idea what it’s like to face that full ED, to resuscitate that man, or woman or pronounce that child dead.  You cannot imagine what it’s like to struggle with a lost airway or uncontrolled bleeding.  You generally have not told someone their treasured loved one is dead.

Add to that satisfaction scores, the opioid epidemic, fear of lawsuits, arguments with other professionals who are toxic, the aching fatigue of nights and the nights and holidays worked, birthdays, funerals and weddings missed, and you get a faint glimpse of what we face.

As such, please do your best not to treat us as commodities to be traded.  Which is to say, speak to the physicians you call with respect for their experience, their years of education and the difficulty of their work.  They are worthy money to you and your company; and they should be treated as valued assets.

Do not call them by their first names when you first meet them.  Get to know them; ask about their career trajectories. Ask what motivates them.  If they are willing, ask about their families and interests. Try to understand why they are doing locums and what they want.

Do not tsk tsk, or sound disappointed when they report that lawsuit or those lawsuits.  The practice of medicine is fraught with legal peril at every turn and lawsuits are not generally a sign of poor quality, but of someone who has been in the difficult practice of medicine and has been willing to see difficult cases in difficult circumstances that are legal landmines at every turn.  Sure, there are bad doctors and tragedies; even some terrible, avoidable outcomes. But there are also a lot of unlucky physicians and patients as well.  Keep that in mind.

If you ask them to do something for a potential job, of if a hospital has some new requirement, try to find a way to make it easier. They aren’t sitting around twiddling their thumbs.  They have endless busy-work at any time, from continuing education to licensing, to local hospital education requirements and other minutiae. They also have loved ones and want to spend time doing fun things.

And when new rules arise, or when hospitals are difficult, ask your company to advocate for your physician.  The old ‘I know it’s silly but it’s just the rule’ is not helpful.  A better answer is ‘I know it’s silly and we’ll reach out and see if we can change it.’

Physicians today are frustrated by medicine in general and by abusive employers in particular.  Many are ready for the freedom and respect that locums can offer.  This can be a wonderful symbiosis if you’re willing to establish a relationship with a physician. He or she can send other physicians your way. Your physician can be a superstar that makes you money, adding value to your company brand.  Or, you can treat that physician like one more product to be bought and sold.  But that’s bad for all of you.

So dear recruiter, do your best for your physician and let your physician be free to do her best for you.

In the end, everyone can win.


Edwin Leap, MD

Diplomat, American Board of Emergency Medicine




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