Returning to locuming after practice ownership

When I started as a locum, I wish I had known that…

It’s a case of being flexible and adaptable. Those are the two big things.

I had locumed for a couple of years, briefly, before I got my own practice. When you’re young, you want to go out there. You’re told you’re going to get paid more, and the idea of being a young person earning more money is a great thing. So, the thought process wasn’t there. It was just a case of, “let’s dive in and see what happens.”

I had locums in my practice, and we found flexibility was not something that people came prepared with. If you’re working for an independent or you’re working for a multiple, they are two very different experiences. The challenge is to be prepared for that.

Because I had that background, when I went back into locuming 12 years ago, after selling the practice, I had a little bit more grounding. So, I think I was relatively prepared.

I realised this when…

After I had my practice and went back into locuming. At that point, I was prepared for what I needed to be doing. Your personality needs to be such that you are adaptable, you are flexible, you are teachable.

When I locumed initially, I was freshly qualified. You have a lot of ideas and expectations that don’t always turn out the way you expect. You have to be able to meet the expectations of the people you’re working for. Having had a little bit of an idea from previous experience, I think it was easier to go into it.

One of the things I want to do as AOP Councillor for locums is...

Create spaces for people who want to go into locuming, who need a little bit of a hand-holding or a safe space to discuss the challenges they’re experiencing. The fact that I had had a practice made it a bit easier, because I knew what was expected of me and I knew what I wanted to do. It was easy for me to adapt to wherever I went. But there was no mentor per se. You get thrown into it.

My biggest challenge as a locum is...

You’re thrown into scenarios, teams, and working environments that you have no idea of. That is one of the challenges. As a locum, you present yourself at 9am, and you’re expected to start straightaway with your clinic. You’ve had no initiation into the systems, into the equipment, into the work process.

I generally find that if you’re going to work for multiples, it is almost the same model. But when you go from one independent to another, it’s a very different scenario. I’ve come across managers who have been fantastic, who will give you time to get yourself familiarised, but the biggest challenge is [when] you go into practices and are expected to just pick up and go. That comes with practice. It’s a case of saying: “right. It’s what I've got to do. It’s the life I've chosen. Just go into it.”

Also, working with new teams. When you go into a practice and you’re meeting new people, to be accepted as part of the team is a big thing, because if the dynamics are not right, you’re not going to perform to your best. Unless you’ve got a manager who’s quite flexible and realises that you’re new to the practice, that can be a challenge.

Practices can make life easier for locums by…

Giving locums a 15-minute initiation, so they can familiarise themselves with the equipment. One OCT is not the same as the next OCT. The biggest thing is the time element at the beginning of the clinic.

Also staff, and the support element – we are part of the team, even though we’re not there on a regular basis. If you’re not being accepted as part of the team, it is a big thing.

One change I’ve seen whilst working as a locum is…

Expectations are far greater as to how much a locum is doing. Someone who is employed has a different level of support than a locum would. Previously, it’s something that you accepted: you went in, did your bit, and left. Now, the expectations are greater, but the support is not quite there.

Independent practices tend to be better in that respect. I’ve got an injury at the moment, so I need longer testing times. I’ll speak to the managers and most will accommodate or will work with me. But unless you’ve got the support, the challenge is that you’re expected to do your OCTs; you’re supposed to do all your pre-screening. There are a lot more expectations on an optometrist in general, but even more so on a locum, because you're going into uncharted or unfamiliar territories. It's a much bigger challenge.

There are a lot more expectations on an optometrist in general, but even more so on a locum, because you're going into uncharted or unfamiliar territories

My favourite thing about being a locum is…

The flexibility. I get bored very quickly. I love being in different environments, because you meet different types of people. I've gone into so many different practices. You pick up so much along the way. I think your skill set increases, because of the expectations: you're expected to know a lot more.

I've made a lot of friends in the past 12 years, who I keep in touch with even if I haven’t gone back to the practice. You form a relationship, and, especially if you're there for a short block, you form friendships.

There are no practice politics to be involved with. If you’re an employee, there are always dynamics like that. That is one of the nicer things. If you don’t like it, you can escape, and that’s you done; you don’t go back. It’s nice to be able to say: ‘I enjoyed that. But that’s it. I don’t need to do it again.’

My advice for new locums is...

Communication is really important. In a lot of locum forums, the complaints are, ‘I was expected to do X, Y and Z, and there was no indication of what was going on.’ Or, ‘I was thrown into it and I was expected to do a teach, and I didn’t have time to do that.’

The first thing is communication. If you know that you’re going to a new practice, if the practice is not willing to give you the extra 20 minutes into their clinic time, see if a staff member can arrive 10 or 15 minutes earlier so you can familiarise yourself with the surroundings, the team and the equipment. That’s the big, big hurdle.

See if a staff member can arrive 10 or 15 minutes earlier so you can familiarise yourself with the surroundings, the team and the equipment

Also, speak to people. When I first started locuming I thought, ‘It’s me, myself and I. I have got to go do whatever it is.’ Over the past 10 years, I’ve taken the initiative to call practices, and ask them what they expect. A number of managers have been really pleased about that. It’s, ‘Oh my god, we’ve never had a locum give us a call to see what our schedules are or how we work.’

Multiples might be slightly different, because they generally have a very similar work style. But if you’re working for practices that are franchises or independents, I think the key is to give them a call a week in advance, ask them about their surroundings, and get yourself mentally prepared for what you’re going in for. You need to be adaptable and able to go in and work with what you’re given, or be prepared and take your bits with you.

My last word on locuming is...

One of the big reasons I decided to join the AOP as a Councillor is because I think the resources we have at hand are under-utilised, including by myself. It’s only over the past five years and through COVID-19 that I’ve started becoming more familiar with all the integral parts of the service the AOP provides.

When you’re employed, you get given your health, your insurance, and everything else. As a locum, you’re pretty much responsible for everything. On insurance, get everything in place. When you’re young you think you’re going to live forever and you’re going to be in great health. But it’s really important to make sure you utilise the services that the AOP has, because it’s one of the resources that I feel I didn’t utilise up until recently.