Saying no, and not getting my first choice.

I think I’ll take off for a week.

Perhaps a large elk I will seek.

Or I’ll take me a drive

For ten days or five

To the Front Range, out near Pike’s Peak.


SYNOPSIS:  I’m a family physician from Sioux City, Iowa.  In 2010, I danced back from the brink of burnout, and, honoring a 1-year non-compete clause, worked in out-of-the-way places from New Zealand to Barrow, Alaska.  Now I work part-time at a Community Health Center, on average 54 hours a week.  Just back from a two-week working vacation in Petersburg, Alaska, and a week Continuing Medical Education in San Diego.


Usually I plan ahead better than this.

About three weeks ago I decided I wanted to go elk hunting during the first week of November, I contacted an outfitter, and, at the same time, requested to be off the schedule for that time period.  Few outfitters would consider such short notice hunts, but I know one who would.  Three days into the negotiations I read his Facebook post that he’d gone lion hunting, planning a return in two weeks.  I performed a basic game theory analysis and decided I’d better make alternate plans, especially because I’ve learned the importance of time off.  I started thinking about taking some Continuing Medical Education time (I have 48 hours left in my account), and I went looking for a course in a place where I have family and friends and came up with a 5 day Board Review course in Denver.

I haven’t actually paid for the course.  Imagine my surprise when a locums recruiter contacted me at the beginning of last week to see if I wanted to work for one week in Alaska.

I thought about it for a day and a half and replied that I wanted details.

The only reason I can pronounce the name of the place is because I already speak one Athabascan language.  I went to Wikipedia and found some really interesting history; the clinic serves the Native population.  The village has air and water access but no road leads there.

I considered it enough that I asked that key business question, How much?

The figure came out so low that it shocked me.  When I do locums work, I frequently say that it’s not about the money.  Such a price could pass for an insult.  But I inhaled and asked if the situation carried profound humanitarian implications.  I would work below industry minimum if a colleague had a life cycle event or faced a crisis.

I casually went back to my email while I awaited the call.

The clinic staffs exclusively with locums, and had a one week coverage hiatus.  The recruiter gave me a counter offer below my bottom line, saying that the firm didn’t want to lose money on the deal.  I replied that I didn’t either, and asked her to keep me in mind for future assignments.

My first choice would have been the elk hunt, but experience has shown me I rarely get my first choice, and I generally finish happier when I don’t.


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