Locum tenens allows physicians to make a meaningful impact in underserved communities, and Dr. Marc Atzenhoefer is a great example. As a locums cardiologist, he’s practiced in some of the most rural communities in America, providing cardiology care for patients who might not otherwise have access.
“Practicing cardiology with Hayes Locums will remain one of the highlights of my life,” said Dr. Atzenhoefer of his experience as a locums cardiologist. Here’s what he had to say about how locum tenens helped him exercise his unique skill set in communities that needed it, and broaden his perspective and his practice.
Can you share a bit about your background and what drew you to cardiology?
I feel like cardiology chose me. During my residency, I went through rotations in different specialties and subspecialties, and through every rotation, I thought, nope, not that one. Then finally cardiology came along and I just thought it was fun.
The big thing that drew me to cardiology was the ability to care for more than just one organ system. Because who doesn’t like to dabble in multiple organ systems? [As a cardiologist], you work with the entire cardiovascular system, so one of the main organs I work with on a daily basis is not just the heart, but the kidneys, which is another area that really interested me. And I thought, nephrologists don’t get to play with heart medicines, but heart doctors get to play with theirs! [laughs].
It’s a big responsibility because I have patients who I care for at length. I manage their diabetes, their high blood pressure, and then more complex cardiac conditions like valvular heart disease, or cardiomyopathies. Being a cardiologist is kind of like being a primary care doctor on steroids.
Why did you decide to try locums?
I was curious to see if there was a job that would be the right fit for my unique skill set in interventional imaging support for structural heart procedures. It’s a very niche thing, and I wanted to see if there would be a locums opportunity for those skills.
At first, all of my mentors cautioned me about locums because there was a stigma around it––they thought if I did locums once, anyone who hired me would just think I was going to quit and go back to locums.
I chose not to believe all of that, and I’m so glad I did. Sarah, my [Hayes Locums consultant] streamlined the entire process, and none of the horror stories I’d heard came to fruition.
One of the best things that happened to me was at the end of my first day on a locums assignment. The interventional cardiologist said, “Wow, you really are as good as they say.”
It just felt meant to be.
How has locum tenens broadened your practice and your skill set?
All Cardiologists have a similar foundation of knowledge, but it is really interesting to see the variability in how that knowledge is leveraged to care for patients with the same conditions.
I had two assignments in rural locations in the Midwest, and I figured since they’re both in the Midwest and we all use the same textbooks and take the same boards, the practice would probably be the same— but it was wildly different, in some good ways and some not-so-good ways.
I’ve learned that if you go out and learn how other people are practicing, you can take the good things that you learn, leave any bad traits behind, and create something that’s better for everybody.
I was able to practice different clinical and procedural skills by seeing how other practices were doing things differently. And I learned so much from working with other people. I saw how good of a leader the interventional cardiologist at one of my assignments was. He was the captain of the ship, but he was also inclusive: he asked for other people’s opinions and made them feel welcome. Watching him taught me how to be the same kind of leader.
What advice do you have for cardiologists who might be considering locum tenens?
Be open-minded and adaptable. If those aren’t traits that you feel confident in, and you want to challenge yourself to grow in those areas, locums is a fantastic modality for doing that.
Locums gives you the opportunity to grow your perspective. And you don’t have to do it on your own, which is the best part. You’ve got backup: you’ve got Sarah or your own version of Sarah. If you’ve got a problem, ask for help and they’ll be there.
My advice for any cardiologist considering locums is to jump in head first.
What impact did locums have on your work-life balance?
It really improved my work-life balance, which I thought was wild, because I didn’t feel an impact on my bank account [going from full-time employment to locums]. I went from working five days a week on call, bringing charts home and reading scans at home, to a locums assignment where there was minimal call. And once you’re done, you’re done. You don’t have an inbox that’s 3,000 messages deep, and you’re not up to your eyeballs with work when you get home.
It makes a big difference because now I get to spend a lot more time with my loved ones. Locums has given me five times as much free time to do the things that I want, without taking a hit financially.
What have been some of the other benefits of locums for you?
It gives you the opportunity to challenge yourself and to make a difference.
The clinic I supported in South Dakota happened to be a critical access facility, which means it would require a flight or a 3-4 hour drive to get to another hospital that offers specialist care, and that’s just not feasible for a lot of these patients.
Before locums, I had never flown in a private jet. That changed with my South Dakota assignment, where I started landing in cornfields to get to my patients. Once, when it was foggy, we had to fly past our small town and land in another because our intended destination didn’t have radar to support the landing. A grateful patient who’d had a bypass the previous year picked us up in his truck. He drove our whole team to the clinic, where twenty patients were eagerly waiting—some hadn’t seen a heart doctor in fifteen years. It was really touching.
For the first time since graduation, I felt the value of the physical exam and my stethoscope. It helped me rediscover the art of the physical examination, which is a dying art. The people who trained me and are retired now always reinforced the need for it, and I was always thinking, why, I’ll just order an echo?
But in South Dakota, I didn’t have an echo, so I had to rely on the physical exam. I caught a critical aortic stenosis just by using my ears. That’s not something I knew I could do until I had the opportunity.
Having a locums cardiologist in these communities makes a huge difference. Because we know what happens when somebody has critical aortic stenosis. We know their mortality rate is 50% within one year. By year three, they’re all gone. So if there’s no one in these critical access areas listening to hearts and picking up on that murmur, identifying what it is, and getting them the care they need, then they are looking at two years of life, tops.
[But I was able to catch it], and I had the opportunity to give that patient a new heart valve. It was amazing.
