Key Points
- Dr. Climo provided temporary psychiatric coverage at a challenging juncture in his career.
- Locum tenens practice renewed his zeal for healthcare.
- He authored a book about his experiences.
"As I set forth upon temporary engagements, I not only worked myself out of a funk, but also found myself unexpectedly eager
to continue in this itinerant practice."
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In step with so many of my generation, I had been trained as a psychoanalytic psychotherapist and then morphed into a psychopharmacologist.
I eventually gave up my academic teaching appointment to focus on clinical work. Later, I closed my part-time private office
to become medical director of a struggling community clinic. During those 15 years, my focus remained on patient care while
I maintained a full clinic caseload. Needless to say, I was shocked when I received a 2-week notice after 18 years of service.
In retrospect, I should not have been surprised. I knew that the clinic was in financial trouble. Moreover, other full-time
psychiatrists were gradually leaving and being replaced by part-time nurse practitioners. I knew it had to do with the bottom
line. I had just hoped it was someone else's bottom line, not that of my clinic.
CHANGE IN PLANS
Psychiatrist on the road
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So what do you do when the élan of caregiving has all but been eroded away from years of battering by marketplace realities?
For me, three things were certain: After over 35 years of service, I was suddenly feeling burned out; I was not ready to
retire; and I needed to get away. Thus, it was at this juncture that I ventured into locum tenens.
To my surprise, and totally against the grain of lifelong professional instincts, I embraced this practice alternative. As
I set forth upon temporary engagements, filling in at facilities in need of psychiatric coverage, I had much to think about
(and much to try not to think about). It was during this initial adjustment period that I seemed to have not only worked myself
out of a funk, but also found myself unexpectedly eager to continue in this itinerant practice.
In the fall of 2003, I took my first foray into locum tenens with Staff Care, based in Irving, Texas. The opportunity was
located at a community hospital in a small New England town. I enjoyed the lifestyle so much that I accepted six other engagements
that included inpatient and outpatient care, emergency services, admitting unit coverage, and consultation/liaison services
at Veteran Administration and Indian Health facilities.
BROADENING PERSPECTIVES
To this day, I do not know where to place the credit for that invigorating renewal and change in career. How much, for example,
ought I attribute to our visit to the Indian Nations of the Southwest, where we listened to their drumbeats, and also to the
profound silence of the desert? How much to the single prayer feather we hung in our living room bay window, around the time
my wife, Diane, began her weaving lessons with a Navajo artisan? Or to the horseback ride that we took into Canyon de Chelly
to view the Anasazi ruins and rethink old perspectives? Perhaps it was when the train shook our cabin in the hollow at Old
Fort in Appalachia as it was literally "comin' 'round the mountain" only a few feet away from our door. Or was it the shaking
feet of folks clogging to live Mountain music every Friday night? Then, again, maybe I was invigorated because my practice
was, at last, only about seeing patients.
In any event, what I experienced and learned on these temporary opportunities over those years opened my eyes to my patients,
America, and myself, as well as to our evolving healthcare landscape. It seemed my learning curve crossed both personal and
professional boundaries. More than once, this involved not only bending some rules and thinking outside the box, but also
encountering some extraordinary mysteries.
COMPLETING THE CIRCLE
Although I am now retired, those five memorable transition years that I spent as a locum tenens psychiatrist filled me with
energy, lessons, and insights, and helped me determine what I wanted from my retirement. But more meaningful and fulfilling,
they left me with the truly satisfying memory of having finished my career in the spirit in which I began it, as a physician,
not a businessman; as a healer, not a productivity manager.
And now, in my retirement, it seems, I have become an author. There are stories I want to tell. My first book, Psychiatrist on the Road: Encounters in Healing and Healthcare, will be out in the spring. I have come full circle, and it feels good.
