LocumLife - January 2009 - (Page 28) RESOURCES Dynamics Professional transitions Doc, you should write a book How locum tenens practice helped this physician/writer realize a dream. Douglas Butler, MD 22-mile dayhike; a 5-day backpack and steep ice climb are needed to reach Wyoming’s Gannett Peak; and Mt. McKinley (Denali), Alaska’s and America’s loftiest summit at 20,320 feet demands a 3-weeklong expedition, traversing ice and snow. To realize another long-held dream— and to keep my medical skills sharp during my sabbatical—I planned to assist Native American communities through a series of short-term engagements on American Indian reservations. Project USA, a program administered through the American Medical Association (but unfortunately discontinued in 2008) facilitated opportunities for me at three locations, two in the northern Plains and one in the Southwest. DOUGLAS BUTLER, MD, prepares to ascend the final wall of Granite Peak in Montana. me also. The idealism that led to my medical career resurfaced; I began seriously considering how locum tenens practice could assist disadvantaged populations. GETTING IT DOWN ON PAPER For years, friends, family, and patients had urged me to compile my adventures and award-winning photography into a book. The locum tenens lifestyle allowed me to pursue that opportunity. I continued with Project USA after summiting Mt. McKinley, my 50th state peak. Every other month, I traveled to one of the half-dozen Indian reservations from North Dakota to New Mexico that I intermittently staffed. Since all were federal facilities, only a single state license was required. On the “rez,” I would rise at 4:00 a.m. and write for 3 to 4 hours before staffing the urgent care clinic or ED. Most sites consisted of outpatient clinics with limited call, while free weekends allowed me to hike and tour the surrounding region. As patients came to know me, I was made to feel part of the community, receiving invitations to Native festivals and ceremonies. Writing a book is a major project, more intense and time-consuming than I ever imagined. For 3 years, I wrote and www.LocumLife.com THE CHALLENGE Since college days, I had longed to tour our nation, see its varied geography, meet its people, and learn more about our history. Throughout my emergency medicine career, I traveled internationally—visiting the Amazon, Asia, the Arctic, and Africa—but as the hospital neared insolvency, I planned a personal journey of discovery through our country. And I added another challenge—to reach the highest geographical point in each of the 50 United States. Some state summits are easy. “The scheduling flexibility has permitted me to travel, climb, and publish a book, as well as practice medicine.” —Douglas Butler, MD Twelve months of travel and climbing were exhilarating. Florida’s highest point is atop a sand dune near Tallahassee; Delaware’s “summit” is a suburban street intersection; and Connecticut’s loftiest point isn’t even a hilltop, just a mountainside bisected by the Massachusetts state line. Other peaks, however, demand physical stamina and/or mountaineering skills. Mt. Whitney (14,494 feet), California’s highest peak, requires a 28 LocumLife JANUARY 2009 During a series of month-long trips, I crisscrossed our country, driving 25,000 miles—nearly all on secondary roads— touring our nation, and reaching state summits as weather and climbing conditions permitted. But helping the Native Americans, an underserved yet appreciative and welcoming people, deeply affected Douglas Butler I am a refugee from private practice. Years of education taught me the art and science of medicine but did little to prepare me for the “business side” of practice, the challenges of hospital politics, or the frustration of dealing with third-party payers. After 12 years, I closed my rural family practice and entered emergency medicine, finding renewed purpose. But 8 years later, the emergency department (ED) closed, and I made what in 2000 was considered a risky mid-career choice: I took a year-long sabbatical to travel, photograph, mountain climb, and accept a handful of short-term locum tenens opportunities at Indian Health Service facilities. http://www.LocumLife.com
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