When I started doing locum tenens work as an OBGYN in 2020, I had perhaps 25 or 30 jobs to choose from. On my journey to personal and professional freedom and life/work balance, they all sounded exciting. Should I work out west in Maine, where my parents first lived before I was born, and try to recreate some of their trailside adventure photos? Should I work in northern Wisconsin, an area I’d previously explored in the summer but never even considered working in? Should I work in South Carolina, where I visited my grandfather as a child and giggled and shrieked over the alligators we’d see and crabs we’d catch? Or should I head to the mountains and oceans out west and explore the seemingly Jurassic Pacific Northwest? I felt that I had a wealth of options. Now, a mere two years later, those options have tripled, quadrupled, and quintupled. Options have created an opportunity for us as physicians.

 The OBGYN job board for locum tenens positions is a solid 15-second brisk scroll on my phone, seemingly endless. The Great Resignation of the COVID pandemic has hit the physician world with fury and left gaping holes in our healthcare system, hospitals, offices, and communities.

 This great resignation is both tragic and promising. The tragedy is, of course, the reality as to why providers have left the field. Many have retired much earlier than they ever intended during the COVID pandemic, and survey studies are showing up to 1 in 5 physicians intend to leave or decrease their practice further within the next two years. Many were (and continue to be) overworked, overwhelmed, and left with inadequate resources. Physicians are forced to take on more work as colleagues leave, often without pay. One of my friends is an Emergency Medicine physician who was asked to pick up additional unpaid shifts during the COVID pandemic. A good samaritan through and through, she said yes, thinking this would be short-lived. But for months, she picked up additional shifts, all unpaid. Our goodwill only goes so far as to buy groceries, pay for childcare, and cover the mortgage. The locum job board grows …

 The promise is in the opportunity. We know there is a need. In many locations, a desperate need. This gives us a chance, as physicians, to bring our values, needs, and goals to the negotiation table with more confidence. Our work, patient care, surgeries, and presence drive the income and reputation of our clinics and hospitals. We have so much value to bring to our communities, and now we have an opportunity to ask that our values be met.

 If you are a physician looking for a job, take your pick. If you are already in a position, especially one with a significant need, now is your time to negotiate for change from within. I encourage everyone to consider their values and negotiate for these in the contract. Of course, your options may differ by your specialty and whether you are looking at locums versus permanent positions or if there is a specific region you want to stay within that may further narrow the availability. Overall, keep your eyes peeled as the job availability is growing and, with that, the potential for growing creativity in contracts.

 Top 3 points to consider negotiating:

  1. Call schedule: with physicians leaving the workforce, check the language in your contract to ensure you are protected. Does your agreement say call is “shared equally” between physicians, so your original 1:7 is now 1:5 and expected to be 1:3 next year, with no change in your compensation? Aim to negotiate a ceiling to your call schedule with additional calls further compensated.
  1. Vacation time: if your group is losing providers, your workload may be more than it ever was, as patients are double booked on your clinic schedule, and you are required to take additional weekend call coverage. Extra vacation time may help provide you the time and space to recover from the exhausting work schedule, and additional days can often be negotiated into contracts without impacting compensation. Protect yourself to maintain your health. We are our best physician selves when we are our best emotional and physical selves.
  1. Bonuses: as hospitals look to hire new physicians or look to avoid losing current physicians, consider negotiating a solid starting and relocation bonus for your new position to incentivize the transition. If you are already at a facility, raise the idea of a retention bonus so that if you stay for another year or perhaps two or three, you can expect a generous cash incentive on the latter end.

This list could go on for pages. If you want to get creative with your negotiations, contact us at Contract Diagnostics to help review your options and identify some areas you can negotiate to incentivize you to continue to work in medicine. By acknowledging my values and my associated negotiations, I do everything I can to be mentally, physically, and professionally fit and fulfilled to continue providing the best patient care I can. I hope we do not all leave medicine, so there are still enough of you fabulous physicians to one day care for my mom, my brother, our friends, and our communities! Through resignation, let there be a negotiation.

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