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Nick Chalfa, MDNick Chalfa, MD
Board Certified Family Physician
Locum Tenens
Dr. Nick Chalfa is a locum tenens physician practicing in a temporary assignment in Northern New Mexico. In his previous life, he was medical director of two full-time urgent care / occupational medicine clinics in High Point, NC. Last year he decided to retire.
When the nation's financial picture changed, he says, "I went back to work because of the economy; I wanted to work a bit but not all the time so locum tenens work is good. My wife and I love to travel so we added the travel component."
His wife Dee is a nationally known painter, a plein air, or "on location" artist, who often takes trips from their home in Davidson, North Carolina to set up her easel and paint in various scenic locales.
Asked how he chose an assignment in New Mexico, he chuckles, backtracking to tell how it all began. When he decided to retire and then take up locum tenens work, he got in touch with VISTA Staffing Solutions, where he says he found great people. He says, "I have been so impressed with the personnel at VISTA; it's almost like I've joined their family. I have never experienced a more organized, friendly company. I really love them." But how did he end up in Taos? "My wife and Laurie Peterson [of VISTA] basically decided where I would go.” He laughs. "The two of them are in collusion!"
Through locum tenens work, Nick and Dee set up house in Taos and she paints while he works in nearby communities five days a week. He says, "I'm a family practice physician here and VISTA got me credentialed with the V.A. so I'm seeing V.A. patients as well." His biggest adjustment challenge: A different computer system at the V.A. He practices in Taos's outlying towns, 23 to 47 miles away but he enjoys the drive through New Mexico's gorgeous landscape. He sees patients after driving through the breathtaking Rio Grande gorge with the river on one side and the spectacular mountains on the other. He says, "It's inspirational going to and from work every day."
That amazing countryside is part of why Taos has an extensive art history. Nick says, "A lot of artists are based here - it's been a wonderful experience for my wife. She's a workaholic type of artist; she's very prolific. It's basically her whole life."
Nick calls himself Dee's art slave. That entails helping her with the workshops she leads, the marketing of her paintings, her web site, e-mails, and so forth. He also has a hand in getting her paintings ready for galleries, photographing the artwork, and of course being the number one fan of her considerable talent. Her beautiful works can be seen at www.deebearddean.com.
When asked if Dee is as supportive of his career as he is of hers, Nick says, "Yeah, she really is, but she doesn't help too much with the medicine!"
Nick and Dee have been in Taos about three months. He says, "We love Taos; it's perfect for painting." But they will probably try some other places. He's been offered locums work in Alaska and Hawaii as well as international locum tenens assignments. Their blended family consists of five grown kids as well as some grandkids, all in the Southeast, so they still keep their home base in North Carolina. But for two skilled professionals with portable careers, this couple is finding that they can sample wonderful locations whenever they choose, just by pulling new ideas out of plain air.
Gretchen Neumann Stone, MD
Board Certified Family Medicine Physician
Locum Tenens
Gretchen Neumann Stone, M.D., has dedicated more than 21 years to the field of family medicine, which she chose because she likes to "do a little bit of everything." However, Dr. Stone is not your typical family doctor. Throughout her career, her desire to provide a better quality of medicine has taken her to the far reaches of the earth; sometimes to areas so isolated they don't appear on most maps.
Recently, Dr. Stone journeyed to another remote part of the world when she accepted one of VISTA Staffing Solutions' first locum tenens placements in Tasmania, Australia. And this time, her husband and three children went along!
Not your typical locum tenens physician, Dr. Stone is taking a sabbatical from her group practice in Ohio, and from her clinical faculty position at the University of Cincinnati. She has been in practice since 1984, when she completed a three–year residency at the Natividad Medical Center in Salinas.
As noted, Dr. Stone's career path has been anything but typical. In February 2004, she took time away from her practice to go to Keew, an isolated area of Sudan, Africa. There, she helped the International Medical Relief Fund in its effort to treat patients from the Nuer and Dinka tribes who suffer from tuberculosis, leprosy and a parasitic disease called kala azar. Since 1982, she has served the organization in a variety of capacities, including founding trustee, interim director, organizer/fundraiser and volunteer for medical missions to El Salvador and Africa. She began her service in 1984 by conducting research into, and educating Nicaraguans about, pesticide toxicity in their country.
Gratifying experiences during her medical relief trips to Central America and Sudan came to mind when Dr. Stone received a postcard from VISTA that described locum tenens opportunities in other countries. She and her husband, Phil, have three children. As parents, they want their kids to experience the diversity and richness of other cultures and decided that a locum tenens assignment provided a perfect opportunity for an overseas adventure.
Dr. Stone contacted VISTA and asked about placements. The discussion quickly turned to the wonders of Australia. After consulting with her family, Dr. Stone accepted a one–year placement at the Scottsdale Doctors' Surgery, a rural family clinic serving the town's population of about 2,000. Scottsdale is located in Tasmania, or Tassie as the Aussies affectionately call it. Tassie is an island across the Bass Strait just south of Australia's mainland. Fertile farming land and tourism define the culture and economy of the approximately 470,000 people who call the island home.
Dr. Stone reports that the whole process of getting to Tasmania went amazingly well. VISTA took care of most of the logistical details, including coordinating arrangements for a temporary work visa and Dr. Stone's medical registration. She was particularly impressed by the fact that VISTA "understands what physicians want in a practice" and appreciates the company's efforts to make "a good match" for her and her family.
Dr. Stone joined four family practitioners, a practice manager, two part–time nurses, two full–time and four part–time staff at the Scottsdale Doctors' Surgery. This medical team also staffs the North–Eastern Soldiers' Memorial Hospital (NESMH), a public hospital with 23 beds. Just as in the United States, rural areas in Australia often have trouble recruiting and retaining doctors. However, scenic spots such as Tasmania are attractive to locum tenens physicians who are more than willing to fill the gap and view their temporary assignment as a "working holiday."
Every weekday morning, Dr. Stone enjoys a 15–minute stroll to the NESMH, where she joins the other doctors to do patient rounds. Her first locum tenens assignment is providing an opportunity to do what she loves best: utilize a wide–range of medical skills. She has seen patients with everything from brain tumors to broken noses and legs, which are inexplicably referred to as "ham and eggs" in Australia. Patients experience problems similar to those in the United States, including diabetes and high blood pressure.
Dr. Stone enjoys making house calls to patients, which is still considered the norm in Australia. During her first Saturday on call, she was asked to visit a patient living in a retirement community, who was too short of breath to come to the doctor's office. Dr. Stone decided that he needed to be admitted to the hospital. A neighbor helped him pack his bag and then the patient climbed onto his electric scooter and "drove on down" to the hospital, with his neighbor and the suitcase trailing behind.
There are some notable differences to practicing medicine in Australia. A Medicare program covers permanent residents and the country does not have a litigious society, both of which contribute to an easier, less complicated medical system. Dr. Stone notes, "Patients are not shuttled in and out of the hospital because of insurance restrictions." In addition, there are fewer administrative duties and physicians at the NESMH are not required to bill for every procedure or process. As a result, Dr. Stone spends more time with her patients and is refreshed by the opportunity to practice high–quality medicine in what she calls a "straightforward system." She says, "Practicing here changes your perspective, professionally and personally."
Natalie Burch, M.D., a partner at the Scottsdale Doctors' Surgery, reports that Dr. Stone's contributions to the surgery and its patients are definitely high quality, invaluable and timely. "Dr. Stone is a godsend! She is competent and diligent, but above all, she is friendly, thoughtful and has a great sense of humor," says Dr. Birch. "Her presence has eased our staffing burden considerably."
The locum tenens assignment in Australia is also providing an exciting opportunity to lead the "good life" in another country for the Stone family, who arrived in mid–February 2005. Moving from a spacious farm in Ohio to a compact, three–bedroom house in the small town of Scottsdale required a bit of adjustment, but they can now walk to school and shopping. Their backyard, like those of their neighbors, boasts a clothesline that can dry several tubs of laundry at once, and a woodpile that will heat the house all winter.
During their leisure time, the Stone family plays a lot of board games, particularly Scrabble™. According to Dr. Stone, "Living in Scottsdale feels like we've gone back in time about 40 years." Her oldest son is quick to point out that although he agrees in general, there is one exception. He says, "Everyone has cell phones–except my family!"
Of course for Dr. Stone's children, living in Australia also means attending different schools. They were able to join their new classmates two days after arriving in Scottsdale and now take a short, seven–minute walk to school every morning. She says that they are also acquiring valuable skills beyond academics. Required classes for seventh–graders include personal computing, design graphics, cooking, woodshop and gardening.
The oldest two children are on the high school debate team, which has become the center of the kids' social life. Dr. Stone's 10–year old son has been recruited as a timekeeper during the debate matches, and recently wound up being scheduled as a team captain. In order to attend debates and hang out with the kids after school and during holidays, her husband Phil is working part–time, manning a boat for a local abalone diver.
An island separated from the Australian mainland by the Bass Strait, Tasmania is quite similar to coastal California. The Stone family is enjoying easy access to white sand beaches, which are only 20 minutes away from home. The family plans to surf, beach camp and scuba dive together. Hills and mountains surround the area and the family plans to camp and backpack in several Australian national parks. "We thought we would try to go to the mainland during school holidays, but we are nowhere near finished experiencing all we want to do in Tasmania," comments Dr. Stone.
The Stone's have discovered that Tassies love to play sports, everything from footie (Australian rules football) and hockey to basketball, netball and swimming. Dr. Stone and her daughter are one of three mother-daughter combos on the Frogs, a local hockey team, and her sons play on two footie teams. "Australians have a passion for footie that no American sport could begin to elicit," explains Dr. Stone. She tells of a patient who recently called her to report suicidal feelings, but he said that he couldn't come into the hospital to see her because his coach wouldn't let him play if he'd been to see the doctor!
For Dr. Stone, the locum tenens lifestyle is a "family adventure type of thing;" she eventually plans to return to her practice in Ohio. VISTA hopes that her experience as a temporary physician in Australia will convince her and her family to consider another of our international placements.
Larry Johnson, MD
Board Certified Family Medicine
Locum Tenens
Larry Johnson, M.D., gave 30 years to the United States Navy Medical Corps, from which he retired as a captain and the director of two Navy family medicine residencies. During that time, he also devoted 19 years to national leadership positions for the American Academy of Family Physicians. He has been married to his wife Rita for 36 years and has played the baritone horn in the Home Town Band for 15. As these "statistics" show, Dr. Johnson sticks with what he values. VISTA Staffing Solutions is helping him continue one of his primary allegiances, practice as a family physician.
Dr. Johnson started his career as a resident at the Naval Medical Center in Charleston, South Carolina and ultimately, treated patients at Naval hospitals and family medicine clinics across the country, including Camp Pendleton and San Diego, Calif., and Bremerton, Wash. During his full–time military practice, Dr. Johnson also developed, staffed and directed the first and second Navy primary care/family medicine clinics in San Diego and Coronado, Calif.
As to why he became a Navy "lifer," Dr. Johnson says, "I kept getting fun jobs that I liked. I signed up for two years and ended up staying for 30."
Although he decided to hang up his Naval uniform in 1999, Dr. Johnson wanted to continue treating patients. However, he had no desire to work full–time or start a private practice. Looking for a solution, Dr. Johnson interviewed several professional staffing groups at a medical conference in 1998. Dr. Johnson and Rita were most impressed by VISTA's style and presentation. "Other staffing companies sent representatives who were not well versed about their company's services," remembers Rita. "We felt like we were talking to used car salesmen. VISTA, on the other hand, really knew their stuff."
Shortly thereafter, Dr. Johnson sensed a commitment to VISTA was imminent, but asked the company's recruiters not to "bug him" until he was ready to sign up. They honored his request and on April 1, 1999, Dr. Johnson extended his career by becoming a locum tenens physician. Today, his affiliation with VISTA, one of the largest temporary physician staffing firms in the country, allows Dr. Johnson to practice on a part–time basis while he travels from state to state with Rita. To date, they have toured the country and enjoyed locum tenens assignments in hospitals, clinics and a private practice in Ohio, New Mexico, Washington, South Dakota, Arizona, and Washington, D.C.
Now attuned to his style, VISTA regularly contacts Dr. Johnson about new assignments. The company makes it easy for him to continue practicing medicine by making all the arrangements associated with a temporary placement, including providing malpractice insurance. Once he accepts a new assignment, VISTA helps him secure new licenses, complete the credentialing process and apply for hospital privileges. He says the company's professional staff appreciates the depth of his family medicine experience. "They work hard to find places that are comfortable for me to work," he says. "And, they keep inviting me back even when I say no, which happens more often than not."
For Dr. Johnson, the transition from military to civilian practice required no major adjustment. The main difference was obvious, since clothing in a military facility is pretty "uniform." "Otherwise," says Dr. Johnson, "most things remain pretty much the same–– types of patients, their illnesses, the medical routines and procedures." Dr. Johnson has observed, however, that some civilian practices are more streamlined than military facilities. As a stickler for quality, he says he would like to see more use of technology to help improve patient care.
Dr. Johnson prefers assignments that last a couple of months. However brief his stay, he focuses on trying to make a difference for the patients and the medical staff. He believes that "a locum tenens physician can sometimes see something that has been missed by long–term care providers, perhaps a procedure that could be improved." He also says that, like full–time colleagues, temporary physicians have to keep their wits about them in a really busy facility to ensure the safety and quality of patient care.
Dr. Johnson's professional reputation precedes and follows him, so it is no surprise that he is often asked to stay at an assignment and work full time. But he has developed a passion for working part time as a locum tenens physician and plans to continue. He and his wife take great pleasure in traveling by car from one assignment to the next, with an occasional stop at home in Bremerton.
Beyond the pure joy of travel, the locum tenens lifestyle lets Dr. Johnson and Rita catch up with friends all over the United States, some of who have also retired from the military. Often, as he settles into a new temporary assignment, Rita volunteers at community centers. And when they are not on the road, Dr. Johnson volunteers one day a week as a Red Cross physician at the Bremerton Naval Hospital.
No one knows how many more years Dr. Johnson will continue traveling to different cities helping healthcare facilities ensure the quality and continuity of patient care. When they entered the locum tenens lifestyle six years ago, the good doctor and his wife made an agreement. Whenever one of them says it's time to quit, they will retire. Until then, VISTA will keep inviting him back.
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