March, 2008 Archive

Musings of a Physician -- Roots

sembury — Sun, 02 Mar 2008 23:00:00 -0700

The bush pilot gunned the engine of the DeHaviland Beaver float plane as it glided across the bay. We gently lifted off from Ketchikan, Alaska, on the final leg of a journey taking me to a five-week locum tenens job in Klawock, Alaska. During the 45-minute flight, I surveyed the stunning scenery of the vast Southeast Alaska wilderness, which spread out in all directions.

Klawock is located on the Prince of Wales Island, which is the third largest island in the US. The island is accessible only via float plane or a once daily three-hour ferry ride from Ketchikan. During the winter months there are many days when the float planes can’t fly due to weather. The island gets 120” of rain yearly, and it has rained nearly every day. The temperature however, is in the low 40s, and we haven’t had any snow yet.

After my first few days of work at the Alisha Roberts Medical Clinic, I discovered that the pace of life in Alaska is much slower than I had anticipated. My wife Lynn came for a visit during my third week. She enjoyed the slower pace which gave her time to reflect after her father’s recent death.

On Saturday, we travelled 30 miles on gravel roads to the village of Kasaan to see the totem park. We hiked through the rainy woods to the park where we encountered more than a dozen antique totem poles, and an old clan house. It was a marvelous experience!

The next day, we went hiking on Cemetery Island. Southeast Alaska is a rain forest so the forest is very damp, and everything is covered with lichen and moss. Along the trail we encountered several large trees that had been toppled. I was struck by the lack of deep roots, which is due to the abundant rainfall, making it unnecessary for the trees to sink deeper roots. The huge uprooted trunks were lying at crazy angles with their flat roots ripped from the earth. It was so striking that I took several pictures of the trees.

During the ensuing week, the sight of those fallen trees kept coming back to me. They could be used as a metaphor of human life. When I was born, my only “root” was the umbilical cord. Then during my childhood and early life my parents and wonderful grandmother Amanda helped me to form some first tentative roots. Then teachers, neighbors, pastors, Sunday school teachers, and other numerous mentors helped those roots to multiply, and sink deeper. These roots gave me a strong foundation to begin medical school where other positive influences continued to strengthen them.

After medical school and internship, my roots continued to be nourished by my lovely wife Lynn, practice partners, colleagues, and other friends and family. Now unlike those toppled trees in the forest, I feel “firmly rooted”, and hopefully I can withstand almost any wind of adversity. Our deep roots make us truly blessed.

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Note: Stuart Embury, MD, has been writing columns for the Cornhusker Family Physician for nearly 20 years. To read more of his work, visit www.nebrafp.org/online/ne/home/publications.html. This article is scheduled to appear in the Spring 2008 issue.

A potential bright spot on the licensing horizon

rsutton — Mon, 10 Mar 2008 07:51:33 -0700

Forget travel, forget rental cars, forget apartment keys under the mat at midnight...Getting licenses in new states can actually be one of the most challenging aspects of locum tenens practice—or medical practice in general for that matter. But there is a glimmer of “standardize this process for the betterment of humankind” hope on the horizon.

A new, on-line application process called the CLAF, Common License Application Form, has been launched. Ohio was the first board in the country to implement it in 2007, followed by Kentucky and New Hampshire. The new on-line system application is linked from each board’s web site to the Federation of State Medical Boards. Physicians do need to have an FCVS Profile or apply for one to use the CLAF system.

As other licensing boards implement use of this system, physicians will be able complete one application using the CLAF. The common information that all boards require is integrated into the form used by the state board, leaving only state specific data requirements to complete.

This process will save physicians the tedium and time of entering the same information on different applications every time they apply for a license in a new state. I can’t imagine anyone appreciating this more than a seasoned locum tenens physician, or the agency supporting said physician.

Kudos to the Buckeye, Bluegrass, and Granite states for taking this leap into the information age.

Avoiding delays when applying for locums and permanent licenses

rsutton — Mon, 17 Mar 2008 00:00:00 -0700

At VISTA we help physicians apply for licenses in anticipation of locum tenens assignments, and for new permanent positions through our Physician Licensing Resources Division. One of our medical directors has had up to 19 active state medical licenses at one time, so don’t let the prospect intimidate you. Concentrate on the steps that follow, and VISTA will make the process as simple as possible.

• Keep very thorough records of practice experience dates, locations and addresses, especially when on locums assignments.
• Maintain a file of certificate and document copies. If any of these have been lost, obtain an official copy from the institution issuing the certificate.
• Be prepared to provide a detailed and thorough explanation for any or all disciplinary actions or malpractice cases.
• Do not discard court documents, even if very old, or letters from attorneys or from medical boards. Do not depend on attorneys to maintain your documents.
• Thoroughly read and understand every question asked of you on a medical application, especially those concerning malpractice, discipline, arrest/conviction history, substance abuse, and mental health. Be sure to answer correctly and provide a full explanation for each circumstance.

For more information about licensure in conjunction with a locum tenens position talk with your VISTA recruiter or scheduler. If you are interested in help obtaining a new state license independent of locum tenens work, contact our Physician Licensing Resources Division at 800-366-1884. Adventure awaits. We can get you there!

How long does it take to get a new locum tenens or permanent license?

rsutton — Mon, 31 Mar 2008 00:00:00 -0700

Tricky question. It’s tough to pin down processing time for a new state medical license because, although the requirements are the same for each applicant, a physician’s unique history and situation impact processing time.

For example, an American medical graduate with no malpractice claims or disciplinary issues, who has practiced in one location for the 10 years since completing training, will take much less time than an American medical graduate with the same length of time in practice, but who worked in five locations and had a significant malpractice settlement.

In VISTA’s experience the wait for a locums license has varied from three weeks in New Hampshire to two months in North Dakota. Temporary licenses, requested in conjunction with an application for a permanent license, can be issued in a month in Hawaii. It may take up to three months to get the same license in South Carolina. Full, permanent licensure can be processed in two months in Hawaii, but may take as long as one year in Texas.

There are also a host of variables that are essentially out of our hands—and yours. VISTA’s licensing specialists are very knowledgeable about most of these processes and calculate an expected delay into the overall time frame when discussing licenses with you. California, for example, has a 45-day waiting period once an application is at the board before any action is taken on an application. North Carolina has specific deadlines for application completion so an application can be reviewed at a scheduled board meeting. The deadline is usually six to eight weeks in advance of the meeting.

All medical boards experience heavy application volume from March through August because physicians are completing their post-graduate training programs and preparing for practice. We plan for an additional one-to- two week delay during this time.