Diversity, balance, and freedom—how one doctor found the practice that gave him everything he needed
Over the years, my perspective on work-life balance has shifted dramatically. Today, I view it in a completely different light than when I first started practice. Back then, as I was approaching the end of my residency, I was focused on pursuing work full-time in rural emergency and expected to jump into it right away. But it turned out that fate had different plans for me: shortly after I graduated, my wife and I had our first child. Family became my first priority, and I ended up working closer to home than I expected.
As I worked in urban clinics, year after year, I would often think about working rurally. I wondered if the opportunity might have passed me by for good, and worried that it might be too late to make the change. However, after some chance conversations with a few rural doctors, I sought out more information and was able to find a great rural community and connected with an experienced physician there with whom I was able to locum.
With that (and some additional training) I was able to finally live out that dream: working as a rural locum. And it was worth it—I absolutely loved it! As time went on, though, I began to realize my idea of work-life balance actually looked very different than full-time locum work.
There’s a certain degree of uncertainty involved in locuming; your schedule is like a jigsaw puzzle and you’re constantly looking for work, assessing options, and perhaps not knowing where you’ll be months or years in the future. But I find that kind of uncertainty exciting, so maybe that’s why I’ve been drawn to locuming. The way I see it, nobody knows what the future holds—for me, in particular, my values have transformed and evolved as my life has changed, and I’ve been able to experience more that life has to offer. Today, when I look closely at my roles and obligations, both personally and professionally, I realized that the flexibility that locuming affords is very important to me. It allows me to balance where and how I invest my time and effort: being with my family (two kids, now!), providing high-quality care to patients, volunteering, and enjoying variety in my life through discovering and pursuing passions.
I couldn’t have picked a better time to locum as a Family Physician, because it’s a locum’s market right now. I’ve found it incredibly easy to find work, and this has given me the freedom to determine when, where, and how much I work. And because I have that freedom, I’ve been able to experience a wide variety of clinical practice types and settings across Canada. So now that I’m settling down into more permanent work, the experience that I had as a locum has given me confidence to know my interests and the practice style that helps me best serve my patients.
I find my work through a wide variety of formal and informal channels, from cold-calling clinics in communities where I’d like to work to getting recommendations from friends (and just about everything in between). I found locums.ca and Locumunity to be very helpful. I judge a work opportunity, first and foremost, by location, then by how much support I’m likely to receive from staff, regional specialists, and local doctors. I’m always interested in the pay structure, but, ultimately, I’m more concerned about working with a cohesive, engaged, and supportive team in a good community than I am in remuneration (I’ve also learned the many different forms of value one can negotiate when starting a new opportunity).
At first, in addition to the clinical and academic side of being a physician, I did a lot of my own bookkeeping. I was able to figure it out, but only by dedicating a lot of my time to it—which took many hours away from the things I really wanted to be doing. At the time I also didn’t realize that the time I spent managing my corporation actually took away from the time I could have been pursuing my passions and discovering new ones. Though it took me a few years, I ultimately found a good accountant who provided a bookkeeping service that could take some of the weight off my shoulders (honestly, I wish I had done that a little bit sooner—it has been well worth the time). My professional team now also includes a lawyer and financial advisor; I am more comfortable knowing I am getting guidance from professionals, especially those who have experience working with physicians. The truth is, managing the logistics of locuming can be a challenge. While I’ve been fortunate to find some wonderful clinics that are accommodating with my flexible schedule, it can nonetheless be a challenge to coordinate multiple schedules (almost as challenging as trying to explain to my mortgage broker and accountant why I have multiple pay stubs from different departments in the same university).
Gathering a quality team early on is an important part of transitioning. There’s a lot more I wish I would have known when I was just beginning my practice, which is why I gathered advice from colleagues and developed an infographic for residents and new doctors that brings together all the essential things you need to know, in an easy-to-reference tool.
Now that I’m out of the first few years of practice, I am realizing that my career in medicine is so much more diverse and multifaceted than what I ever thought it would be. I have spent six years as a locum in multiple clinical settings, from family practice, to surgical assist, rural emergency medicine, covering maternity leave, and even a large amount of teaching. My schedule is different almost every day, which, I think, has given me a unique perspective on the practice of medicine in Canada.
That perspective, combined with the agility I have in my practice, allowed me to help co-found The Review Course in Family Medicine, the country’s only national CCFP exam preparation course. Over the course of two high-energy, fast-paced days, we cover the 99 topics for the exam, and in 2019, we’ll be hitting five cities across Canada. My colleague Dr. Paul Dhillon and I are also about to announce something called The Medical Circus—a primary care update in a presentation format like you've never seen before. It’ll launch at the SRPC Rural and Remote conference in Halifax in April 2019.
Though I’ve transitioned away from locuming and have a more predictable practice schedule now, I’ve found that entrepreneurship has provided me with the variety I used to gain from locuming. I’ve also been lucky enough to receive an increasing number of invitations to present at medical conferences—and, lately, in corporate settings. This has ignited a whole new area of passion I didn’t even know I had, and I’m excited to pursue it further. I often think back to residency – where your clinical schedule is assigned and you have no control over it – and recognize how lucky I’ve been to be able to experiment and find the schedule that works best for me.
I look back now and wonder: how did I get here? The answer is pretty simple: I made decisions based on what I wanted for myself and my family, not what others expected of me. And in doing so I discovered my own perspective on work-life balance: it’s a complete myth. You are never going to find a perfect balance. So, knowing you’ll err on one side or the other, choose which side you plan to err on, and then schedule your life around that. The best way to do that is to imagine what your ideal week would look like as a pie chart: how would you divide it between work, family time, hobbies, and everything else that is important to you? Once you’ve sketched that out, start doing what it takes to achieve it; for me, this was easiest as a locum, but now that I’ve settled into more permanent roles, I have intentionally prioritized a high degree of flexibility.
Six years after residency, I feel my transition into practice has finally settled into a comfortable groove. I’ve learned and applied many lessons from my years of locuming and discovered that my ideal week looks very different than I thought it would when I finished residency. And while I may never find the perfect balance between work and life, I’ve accepted and embraced that, and, in doing so, am enjoying both work and life so much more than ever before.