With all the chaos in medical care, and yes, in cardiology practice in particular, it seems to me that locum tenens provides an interesting option to our graduating fellows when they are not yet certain about near-term options.
There are just so many questions for them to consider. Do you join a stand-alone practice? If so, what are the chances it will be bought by a hospital or hospital network the day after arrival? What does it mean to join a group that was just purchased? How much job security will be provided? What does partnership mean today, if anything at all?
It is not wrong to suggest that with locum tenens you can try to ride out the proverbial storm while gaining experience practicing in multiple different settings. Of course, if there is a working spouse and/or children of school age, the equation is more complex. But times have changed, and even the academic center has a new appeal for some of our graduating fellows. At least it is familiar and with familiarity comes a sense of security.
I have no reservations in recommending locum tenens as an option: Pack your bags and look around! An echocardiogram, a left heart catheterization, a pacemaker implant: It can be done here ... or there. So tentanda via, the way must be tried.
Of course at some point, it is likely that the travel will no longer seem appealing, and settling into a stable practice environment may be the most reasonable approach (but good luck finding it). Perhaps as a result of this turbulence, I see our fellows thinking about clinical practice in new terms. Even after 6 years or more of post graduate training, they are open to a discussion about nontraditional options. As faculty, we teach ECGs and cath and nuclear and electrophysiology, but we seem to falter when it comes to the intangibles: the future of cardiology practice.
That observation might explain the success of my "career nights" delivered over Chinese food by former trainees who graduated 5-10 years ago and are invited to share their experiences. There is nothing better than a discussion about the changing landscape from colleagues in the thick of it. And that might explain why about a month after yet another dinner of cold sesame noodles at Wonton King, a fellow approaches me to ask "Dr. Hauptman, when are we having our next career night?"
Dr. Paul J. Hauptman is Professor of Internal Medicine and Assistant Dean of Clinical-Translational Research at Saint Louis University and Director of Heart Failure at Saint Louis University Hospital. He currently serves as an Associate Editor for Circulation: Heart Failure and blogs while staring out his office window at the Arch.