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Consumer Reports

Temping is latest trend for docs who want to leave cares behind | (KRT) Some get fed up with soaring malpractice insurance premiums.

Others hate all the paperwork and hassles that come with managed care. Still others are looking for a new place to live, or semi-retirement, or freedom to work when they feel like it.

And so they become traveling docs, picking and choosing their assignments from CompHealth, a Salt Lake City company with a huge Fort Lauderdale operation.

If they were secretaries, they would be called temps, but since they're physicians, they're known as locum tenens - Latin for "one holding a place,'' or filling a vacancy.

No one is certain how many there are. Jamey Morgan, president of the National Association of Locums Tenens Organizations, estimates that about 8 percent of doctors are travelers - meaning more than 50,000 nationwide. Other sources place it closer to 25,000.

Whatever the size, the field is booming. Modern Healthcare, an industry publication, reports that locum tenens operations have been growing 20 percent a year since 1997.

One traveling doc is Michael Atherton, 61, an anesthesiologist from the Fort Myers, Fla., area who has spent the past three months in Albuquerque, N.M.

"It's very pleasant,'' he said. "I can accept or reject any job, and I get offers at least twice a week, almost all at high-quality facilities.''

The Stanford-trained specialist had been an employee of a group practice in Naples, Fla., but five years went by without a raise. The reason, he suspected, was that the group's money was going to pay ever-increasing malpractice premiums, but to him the raise wasn't as important as a desire to slow down.

With CompHealth, he found that he could work eight months a year for what he earned in 11 months in Naples, meaning he can set aside four months for vacations rather than one.

Over the past year, Atherton has done stints at hospitals connected with the University of Massachusetts and the University of Florida, as well as a Veterans Administration facility in West Virginia and, now, the Lovelace Clinic Hospital in Albuquerque.

He and his wife live in an upscale apartment that they don't pay for and they enjoy the excitement of new places.

"There's that honeymoon phase, new restaurants to try, new people to meet,'' he said. After six or 12 months "you just fall into a routine.''

He particularly enjoys not having the headaches that come with running a private practice - no worries about billing, slow-paying insurers or hospitals' "office politics.''

His plans after Albuquerque: "Three months in Nova Scotia,'' where he has a vacation home. "Then I'll decide what's next. ... It's great.''

Plenty of firms are getting into the traveling doc field. The National Association of Locum Tenens Organizations, based in Altamonte Springs, Fla., has 20-some members providing doctors, "but certainly CompHealth is the big guy out there,'' says Bill Kautter of the National Association of Physician Recruiters, a sister group. "They dominate.''

Even so, CompHealth has plenty of competition. Scott Beck, head of CompHealth's physician staffing division, says NALTO estimates that the field has annual revenue of about $900 million. Beck says CompHealth has about 15 percent of that.

Last year, the privately held firm, which doesn't reveal its revenue, reports it provided work for about 2,000 traveling doctors and about 2,700 workers in the allied healthcare field, which includes X-ray technicians and pharmacists.

Started in 1979 with a federal grant to find temporary doctors for remote Western towns that had no permanent physicians, CompHealth now has more than 800 employees nationwide.

More than 220 employees work in Broward County, Fla., handling doctors and allied employees all over the United States. The firm recently consolidated operations of three downtown Fort Lauderdale offices.

Beck says the firm is getting job inquiries from Broward surgeons who are finding it difficult, it not impossible, to buy malpractice insurance.

"Some are leaving the county and the state altogether,'' he says.

At one time, hospitals and clinics suspected that many doctors traveled because they had problems in their past. But employers are free to turn down any CompHealth staffer, says Beck, and background checks are so thorough that it's difficult for anyone with a bad past to slip by.

Atherton, the Naples anesthesiologist, for example, has a clean disciplinary and lawsuit record with the Florida Board of Medicine.

Many traveling doctors are near the end of their careers and do not have to worry about moving children. Others are at the beginning of their careers, perhaps seeking a place to settle permanently.

A CompHealth survey found that almost two in five traveling docs - 38 percent - are over 60. One in five is under 40.

Most say they like practicing part time or the flexibility of the work schedule. More than half are looking for assignments of less than a month.

Almost a third of the travelers are family physicians. They mostly work for clinics or established group practices. Another third specialize in radiology or emergency room care - hospital work in which there's no need to build a practice.

Some are looking for a transition - using CompHealth to try different areas of the country and see what they like best.

More than two-thirds of those surveyed said they were more satisfied than when they worked out of one place. Only one in 10 said the traveling life made them less satisfied.

Psychiatrist David Weiss 39, is far more satisfied. He was part of a group practice in Denver, but it was tough because managed-care plans have clamped down hard on talk therapy, limiting the fees and numbers of sessions.

"We were having to work harder to make less money,'' says Weiss. "The overhead and the infrastructure was just getting ridiculous.''

The group broke up. Weiss went with CompHealth. The Denver area is large enough so that he finds temporary assignments within driving distance, either in acute-care hospitals or in out-patient clinics.

"I'm really enjoying medicine again, which I hadn't for a very long time,'' says Weiss. "It's allowed me again to focus on treating patients.''<

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© 2003, Distributed by Knight Ridder/Tribune Information Services