Hiring and firing staff. Paying rent. Vacations few and far between. Bills, bills and more bills… Let’s face it: operating a practice can be a real bummer sometimes.

There’s another option. You can become a locum. Doing locum work is especially popular among new doctors who haven’t yet decided where they want to settle down, but some established doctors, looking for a change and more freedom in their work schedules, are also taking on locum work.

The flexibility of locum work can appeal to physicians of any age. Maybe you want to take summers off to go fishing at your cottage on the lake. Maybe you want to volunteer overseas a few months every year, or spend more time with your grandchildren, or go back to school. Whatever timeframe you have available, you can easily fill it with locum gigs.

It’s usually not hard for locums to find work. In most jurisdictions, you can register your availabilities with a provincial locum program. There are also online booking agencies. Much of the work, however, is set up by word-of-mouth recommendations and personal contacts. Many locums quickly end up in high demand, fully booked months in advance, and have to turn down offers.

A flexible schedule, of course, isn’t the only reason to consider becoming a locum. In this time of steeply rising overhead costs, practicing without a practice is becoming more attractive. There are two kinds of locum work available to general practitioners and family physicians, both of them potentially profitable: in private practices or in emergency rooms. In ERs, the locum typically pays little or no overhead costs and merely has to hire someone part-time to finalize his or her billing. In private practices, the financial situation is a bit more complex and variegated. There are three common types of arrangements: a split, a minimum daily amount, or a combination of the two. A split means the locum agrees to pay something like 35-50% of his or her fees back to the practice to cover overhead. A minimum daily amount — perhaps a few hundred dollars per day — provides a locum with insurance against the possibility that lots of patients refuse to come in until their regular doctor returns. The minimum amount can be combined with a split.

A slightly different contract is recommended by Dr. Lana Lovo, a Calgary FP who worked as a locum full-time for a few years and now still does part-time locums in rural Alberta. She calls it a “split to a maximum,” which means that she takes a 65/35 or 60/40 split, but after the practice gets enough to cover its overhead, she gets 100% of the rest. “It’s a good balance,” she says. “It’s not appropriate for doctors to be making money off their colleagues.” Whatever arrangement you agree to, it would be prudent to put it in writing — just in case.