Regarding “Per diem work” (March): Physicians want to be per diem so they obviate the need for having a boss. Also, they aren’t pressured to pick up extra shifts at a low rate. Just like in emergency medicine, per diem is here to stay. I would take it a step further and recommend renting instead of buying a home as a career advantage if you work as a locum physician or even an employed hospitalist. That way, it’s easier to move for better opportunities or to leave your program when the outsourced company you have now changes to a new one or is taken in-house by the hospital.
S. Bhatia, MD, CDIP
Bristol, Pa.
As the physician shortage increases and the patient population grows older, the demand for (and luxury of) per diem/locum hospitalist work will continue to rise. I see this as a great opening for those of us who never intended to make medicine our entire life, but rather a means to living a good life. Instead of being overwhelmed with hospital politics, dealing with conflicts within and among hospitalist groups, and feeling like pawns in the hands of administration, we can now focus on the most important people in the hospital: the patients. I also see locum work as a means of employment that allows us to pursue endeavors outside of medicine. I am happy that my fellow physicians and I have chosen this liberating line of work.
Akua Ampadu, MD
Union, N.J.
This thought comes to mind: the lack of engagement and ownership in an organization’s mission and values are often seen in professionals “just passing through.”
Deb Stargardt, MBA, LFACHE, CPXP
Atlanta
I agree that physicians are seeking ways to regain their autonomy and independence. Hospital administrators and other corporate sources have overplayed their hand, and the pendulum will be swinging back to independent physician practices. As much as I appreciate the assistance and support of my advanced practice provider friends, there is no future without physician leadership. The “gig” per diem economy will grow to include physicians finding ways to work in a more simple, independent fashion within their own long-term community and health care systems.
Brian Cunningham, MD
Monroe City, Ind.
More on the gender gap in pay
Re: “The gender gap in pay” (March): While this may not be universal, the men in my group can take more shifts because they are either single or have stay-at-home spouses. The women are all married with children, and some spouses travel for work. We get the same contract and hourly rate. So all else being equal, the presence of in-home, reliable childcare is probably the biggest factor in our pay gap. Our highest earner is a female nocturnist whose children are in high school.
Marnie Abesamis Chan, MD
Ossining, N.Y.
