The Executive Suite: Changing the mindset of how we perceive medicine

Trevor Cabrera, MD

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Although most in the healthcare industry have heard of travel nursing, especially during the COVID-19 pandemic, a lesser known field of medicine is the world of locum tenens. Like travel nursing, locum tenens encompasses physicians, physician assistants, and nurse practitioners who work in temporary assignments around the country. A Latin phrase coined by healthcare staffing agency CHG Healthcare in 1972, “locum tenens” means “to hold in place of” or “one holding a place”; and contrary to popular beliefs, this musty Latin term has the potential to spark a larger cultural shift in how we practice medicine in the future.

It’s never easy navigating the workforce fresh out of residency, and with the advent of the COVID-19 pandemic, many pediatricians were faced with a growing paucity of work. As my peers were seeking out jobs in academia, private practice, and fellowship training, I drew up blueprints to walk an uncommon path toward exclusive work in locum tenens. From my perspective, jumping into the market of locum tenens was akin to entering an underground society of traveling doctors targeted at helping to fill gaps in healthcare throughout the United States.

While my colleagues were settling into their new careers, I was busy obtaining multiple state licenses and preparing to broaden my experiences through working in myriad healthcare facilities, geographic locations, and various practice settings. To deepen my medical experiences and continue down the path of eternal education, I sought out work in some of the most isolated spots in the country. From the desert of New Mexico, to the greater plains of North Dakota, to the lakes of Central Maine, the more I practiced in these rural areas, it became clear that these are the regions most in need of providers. According to the AAMC, “Of the more than 7,200 federally designated health professional shortage areas, 3 out of 5 are in rural regions. And while 20% of the U.S. population lives in rural communities, only 11% of physicians practice in such areas.”

As I traveled from job to job, acquiring new skills, new connections, and reaching a level of flexibility that historically doesn’t exist in medicine, it allowed me to appreciate the ever-changing landscape of hospital needs and how I could use my skills to help meet them.

Locum tenens work has given me the ability to create my own schedule. While I could have easily chosen a life of frequent vacations, I instead chose to maximize my work schedule, navigating from one assignment to the next. In February 2020, I sold 80% of my belongings, moved the remainder back to my mother’s house in California, and gave up my “home base” entirely. With no rent or utilities and most expenses reimbursed by my agency, locum tenens has allowed me to pay off medical school loans at five times the speed of my colleagues, all while quenching my growing wanderlust to travel around thecountry. In less than three years after residency graduation, I will be loan free — seven years sooner than had I sought public service loan forgiveness.

In 2021, I traveled a total of 320 days across multiple states and hospitals, covering for facilities awaiting permanent providers, clinicians on maternity leave and vacations, and physicians who are constantly overworked. I quickly learned the art of business negotiations, the variations in hospital contracts, the ins and outs of an organization’s infrastructure — essentially, the parts of medicine that are often not taught in medical training.

Locum tenens is not for everyone, but it does provide a meaningful alternative to traditional workplace settings in medicine that are prone to provider burnout, constant employee turnover, and a loss of focus as to why we went into medicine in the first place. While my peers have found themselves navigating the complexities of a singular job, I have already navigated working in over a dozen hospitals and clinics. I have learned flexibility, fostered exploration, and experienced compounding personal and professional growth. Today, I am proud to call myself The Nomadic Pediatrician and look optimistically toward the future of locum tenens and where it may take me.