7:48PM Dec 21, 2019
Andrew Wilner, MD
Cory Fawcett, MD
critical access hospitals
Welcome. I'm Dr. Andrew Wilner. And today I have the pleasure of speaking with Dr. Corey Fawcett. Dr. Fawcett is a retired general surgeon, but he has a new career helping physicians with the challenges of personal finance. Dr. Fawcett is the author of four books on this topic, the Doctors Guide series, and he also has experience with locum tenens. He's recently launched a new course on locum tenens for physicians starting out with this particular adventure and since locum tenens is a topic dear to my heart. Welcome, Cory.
Hey, Andrew, thank you for having me. It's a joy to be here.
So let's get started. Tell me what is your experience with locums?
Well, right at the end of my career, I was ready to retire. Really nowadays I don't like to use the word retired. I'm a repurposed surgeon. I have a new mission now. But I couldn't work part time I was kind of ready to give it up but not ready. And it was kind of in that Limbo zone. And my private practice didn't really allow for part time work. So I had to kind of find an alternative if I didn't want to keep the high pace that we had in general surgery. And so I decided, at that point to kind of look around what were my options, and an old resident called needing some help. And he was in a critical access hospital. There were three surgeons in his group, and two of them suddenly left the practice. And he was all by himself and he was dying. He was on call 24 seven, and they started using some locums to help fill in for him, but he wasn't happy with getting a rotating surgeon come in through because the hospital would just hire somebody else and then someone else. Because he only needed a week at a time, you know, once a month to give him a break. So he called our practice asking if somebody could help, right this time when I'm looking for something to do. So I said, Sure. And so I went out to this little hospital and help out a resident, one week a month, for a few months until his new partner would arrive. And I had a ball. It was so fun to get a change of pace. It wasn't the same hospital. It wasn't the same people. It was something new and it kind of gave me a new start in my my career. Surgery seemed fresh again. And it gave me a chance to say there's another way I could do this. And so I liked it so well. I decided, Well, why don't I go ahead and give up my practice. And just do this part time for a little while, until I'm ready to let go surgery for good. I was off on a, I was going to leave on a one month vacation. And I sent a letter out at the beginning of that vacation to every critical access hospital in Oregon and Idaho and said, This is what I'd like to do, how can I help you? And when I got home from the vacation, I had more job offers than I can handle. And so I got to pick and choose where I wanted to go work one week a month to help out these surgeons who needed a break. And I found that as an older surgeon, whose seasoned and who really knew how to handle the problems and had been, you know, at a steady job his whole life. I was like gold in the locums field, because that's exactly who somebody wants to come in and take over their practice for a short period of time and get a break. And everybody just loved having me because I was helping their community. I was helping that doctor stay healthy in their community and him not leave also and then they have no doctor. And I went from a normal job with 10 surgeons in town and not really any thank yous to every time I turned the corner and the hospital someone saying, Hey, thanks for being here. It was a joy to do and I just I loved it. I did it for three years working about half time in these little critical access hospitals. And I just had a ball.
I love your story for a number of reasons. First of all, the it's a great example of the value of locum tenens to what they politely call the "late career" physician and or pre-retirement and there's a whole chapter in my book "The locum life" directed at that individual because people don't realize and I experienced this in my own practice. Many private groups are not set up for part time. It's either full time, you know, at 100 hours a week, carry your own way take care of the overhead, or we're not really interested. I worked out in my own group some part time, but I immediately became a second class citizen within the structure of the group, even though I was still a full partner, and locums is just a wonderful way for physicians to remain active clinicians as they get older without the burden of competition and working someone else's idea of full time.
I was in private practice also and we had a cost sharing system and the overhead no matter how much I worked, I still had to pay my share of the overhead. And so as I cut back, worked less, my wife was noticing that, you know, if you keep this up, you're going to be paying them to work. And I don't think that's right. And so it became very clear for me that part time couldn't work in the model I was working in. And so a new model was needed.
The other part of your story that I like because I also experienced was how much you're appreciated as a locum tenens physician. I went to the Mayo Clinic in Phoenix because there had been some sort of kerfuffle and three neurologists left overnight, leaving them with a huge burden, patients, telemedicine and clinics and residence supervision. And I happened to be buddies with the chief of neurology, who I'd known for many, many years. And just like your resident friend, tapped me on the shoulder one day and said, Andrew, you know, are you busy? I know you're doing a lot of different things. You think you could come and help out? And it was like Hi, Dr. Wilner. We're so happy that you're here. I mean, how often does that happen in your regular job?
It just didn't happen anymore. Because after 20 years, they expected you to be there. And, you know, you became old, you know, it was just routine. But when you go to these new places, you're there helping somebody and they know it, and you gave up whatever you were doing to come there. And they just really are appreciative.
Now one question that physicians who are interested in locums often ask is well, how do I get a good assignment? You mentioned critical care hospitals. I mean, how do you go about sort of finding that that first job?
Well, those were critical access hospitals, I think there's a big difference between the critical care and the critical access! I was actually looking for a lighter job. Okay, so in my case, I wanted to cut back. So I did not send any information to big hospitals that had, you know, like a level one trauma center. I did not want to work in a level one trauma center anymore. I had enough trauma, I'm ready to lighten up a bit. And so I got to actually choose my work environment. I only sent letters out to critical access hospitals, they're small hospitals, they are level four trauma center. So most trauma gets shipped out and not dealt with there. In fact, sometimes I didn't even get called to the trauma, it would arrive to the emergency room, the emergency room doctor would just check and make sure everything was okay and then it would ship out. And so they just kind of kept moving with those patients and so on. I actually got to pick and choose what I wanted. And I wanted a slower life. So what's really cool is with locums, you can just ask for exactly what you're looking for. And it's likely to be out there. And you just need to connect up with these people. Whether you do that through an agency, I did use an agency part time. And I did go on my own. Most of the time it was on my own, but occasionally an agency would call me with a really cool job. And I said, Well, yeah, I've never been in that town. I'd go for that. And I got to actually pick and choose the towns I was working in and and what activities that were around. So for me finding a job turned out to be pretty easy because the thing I wanted to do was in high demand, rural America needs doctors. And so if you want to work a lighter schedule in rural America and you contact these places, man, the sky's the limit. There's a lot of need out there.
I understand that based on your personal experience and your research, you've put together a video course for physicians interested in locum tenens. Can you tell me about that?
I noticed that a lot of the locum tenens doctors were just kind of flying by the seat of their pants. They didn't really know how to make this work. And I heard a lot of complaints. Well, I don't like this or I don't like that or don't like this. And I realized most of those complaints weren't true. It was mostly that they didn't understand or know what to do to make that better. And so since they couldn't fix it, they just didn't like it. And I thought, you know, I need to take the experience that I have, and put it in a way somebody can actually use it and make their locums life better, because I had a great locums life. Most of the times I heard somebody complain, there was a solution to their complaint, and they didn't know it. So I put together this course, to try and take the wisdom that I had gained and give it to somebody, especially somebody who's never been in locums or who's thinking about doing locums so that they can get on the fast track to success and do things well and have fun. If someone were interested in this course, where would they find it? I you can go to my website, drcorysfawcett.com. And in the top left corner, you'll see it sitting right there. And you can just click on it. And then you can explore and see is this something I'm after? It gives you a kind of little sample lists all of the chapters that are in there. And if that's of interest to you, if you really want a good start. I think that's what it offers.
All that's great. You know, I wrote my book on locums because I started doing locums way back in 1982. And apart from what you see on the internet from various locums companies where there's information but of course, it's not an unbiased source, right? It's coming from the various locum tenens agencies. There really wasn't any kind of resource and your video courses from an experienced physician help new locums doctors navigate and avoid errors and become more profitable. I think all that is terrific.
Yeah, and I've noticed over the last few years, there's some books popping up. I've seen your book, I liked it. There's a few courses kind of popping up. There's a lot of websites, there's like your video blog here. There's a lot of resources that are now coming available to people who want to get in locums. I think it's probably now a lot easier to do than it was a couple decades ago. Back when you started, you were probably flying by the seat of your pants was your only choice. But now there's an opportunity to stand on the shoulders of people who've done it before and not have to repeat all their mistakes. I think now is a great time for locums.
Well, before we finish, I want to take this opportunity to thank you. You may not remember but several years ago, I sent you the first chapter of my book, because I knew you are an experienced guy and you published several books and you might help me a little bit with my own manuscript. Well, you sent me, scathing comments that were very discouraging and then I thought about them for a while and I said you know he's right about this and he's right about that. So I want to thank you because your your comments on the very, very, very early draft of my book helped me make a better one.
Well, thanks. I do the same thing when I'm writing a book, I send it out to people and say, tell me what you think. And it really does help make your book better if you get some outside feedback when you write it yourself. You kind of know what you're saying. But the person who reads it has to get that clear picture and sometimes you don't do that. And I've found a lot of help by having other people read my material before it gets out officially, and I'm glad I was able to help you as others have helped me.
Well, Dr. Fawcett, I want to thank you very much for taking time this morning for talking about locums.
Well, thanks for having me. It was a lot of fun.