Locum life: expectations vs reality

An optometrist may anxiously imagine days waiting for the phone to ring before starting to work as a locum – then find out they had nothing to worry about as a steady flow of work comes through after making the switch.

Another would-be locum may picture a windfall for their bank balance before shifting to locum work, before the financial reality of working as a locum – accounting for tax, holidays and sick leave – moderates their expectations.

Below OT asks a panel of locum optometrists what they thought this mode of working would hold for them and also how their daily experience compares to the working life they anticipated.

Prioritising balance

Before Shamina Asif became a locum optometrist, her concerns centred around short testing times, unfamiliar equipment and the level of support that her new colleagues would provide her with. She was also uncertain about the level of training optical assistants would have.

She was attracted to the idea of locum work because of the potential for a better work-life balance and the opportunity to explore different cities.

She shared with OT that the work-life balance has been better as a locum optometrist, while her concerns around testing times and training did not eventuate.

“The testing times have been fair wherever I have worked, and most stores have excellent optical assistants who have been trained well,” she said.

While she did face the challenge of becoming familiar with a wide range of equipment, this has become easier as she has learned about different types of visual field machines and other devices.

Asif shared that in some practices it has taken time to “win the staff over.”

“There have been some stores where I ended up picking up extra tests of the residents unfairly,” she said.

In terms of her tips for people starting out as locum optometrists, Asif recommended that newly qualified optometrists gain experience in a resident role first.

“If you are going to a new store, turn up early and make yourself familiar with equipment and staff and procedures – try and research beforehand if you can,” she said.

She also advised new locum optometrists to invest in their own equipment where possible.

“Make sure you do have a good life-work balance, and don’t end up working all the time as that is the biggest advantage of locuming,” she said.

The testing times have been fair wherever I have worked, and most stores have excellent optical assistants who have been trained well

Ample work opportunities

Southampton-based optometrist Rebecca Rushton began working as a locum in 2012 – attracted by the flexibility of the role.

“I thought it would be difficult to get work as a locum, I suspected I'd go through times of 'feast and famine' and be struggling to book work,” Rushton shared.

“It turns out there's plenty of work out there – especially if you're prepared to travel –and if you make a good impression, many employers will ask you back again, so work is a lot steadier than I had envisioned,” Rushton said.

Before Aaminah Khan became a locum, she wondered if there would be challenges around continued patient care and a lack of professional growth opportunities.

However, now she is in the role, she believes that being motivated to make the best of the role can make a difference.

“It really is what you make of it and how involved you want to be,” she said.

Khan shared now she is working as a locum, she has realised that a heightened level of self-awareness is needed in this role.

“As a locum, performance reports or customer feedback are not readily available,” she said.

Khan shared that one element that surprised her about working as a locum was the variability in daily rates between different areas.

“I hadn’t expected financial compensation to be so heavily influenced by geographic location,” she said

Khan shared that her top tip for new locum optometrists is that invoice payments can vary from practice to practice – which can create fluctuations in a locum’s income.

“It would be wise to have a buffer of funds to withstand this,” she said.

Locum finances

When asked about his expectations, Frank Eperjesi said that he thought working as a locum would be challenging because of the need to adapt to different records systems, equipment, practice processes and referral systems each day.

Eperjesi shared that these anticipated challenges were part of the learning curve when he began working as a locum.

“Things became easier as I did more sessions in each practice and became familiar with the equipment and processes,” he said.

Working as a locum delivered on Eperjesi’s expectation that he would have the opportunity to travel and only work at the practices he chose to work at on the days he wanted to work.

Eperjesi highlighted that once he started working as a locum optometrist, he had to adjust to employing an accountant and being aware of the VAT threshold.

For new locum optometrists, he recommends putting a third of their income into a deposit account to pay for income tax.

Eperjesi also advises putting a quarter of what remains into another deposit account to cover sick days and holidays.

Locum optometrist, Francesca Marchetti, shared with OT that she had no idea what working as a locum would be like when she first started this mode of work.

“I had been cosseted working with the same companyas a Saturday girl, then pre-reg and employed optometrist,” Marchetti shared.

“What met my expectations wasthat the patients were the same everywhere – the same pathologies appeared wherever you were working,” Marchetti highlighted.

Like Eperjesi, Marchetti had a period of adjusting to working with different referral pathways, consulting room layouts as well as a range of equipment and computer systems.

“You were working with strangers regularly,” she said.

Locum optometrist, Hassnain Safdar, told OT that he had friends who worked as locums before he made the switch to locum work so knew that he would have to travel to find work.

“I was expecting to travel as Leicester is a saturated area – up to an hour was my limit,” he said.

He shared that adapting to managing his own diary was challenging at the start.

“You have to find work and get your name out there as a trusted, reliable optom,” Safdar observed.

“It takes time to build that rapport,” he added.

Safdar enjoyed the fact that each day was different when he began working as a locum optometrist.

“It was exciting to meet new people and see different towns all the time. I had never driven so many miles before!” he shared.

His advice to new locum optometrists is to be well-prepared ahead of a shift – for example, by checking the best place to park and researching local referral schemes on the local optical committee website.

“Be friendly and prepared to help stores where possible – you have a short space of time to make a lasting impression,” Safdar emphasised.