As I wrap up my recent assignment in Montana, I’m excited to begin a new locum role closer to home on the East Coast—working a Monday through Wednesday schedule, with weekends off and time to recharge. It’s a thoughtful balance that supports the type of sustainable, high-quality care I aim to deliver, and I’m fortunate that this new opportunity also comes with a better incentive package that reflects that alignment and growth.
Though this was my first official locum assignment, I’ve long worked as a speaker, peer reviewer, and national educator. This experience allowed me to apply that broader lens in a real-world setting and reflect on the contrasts between urban academic medicine and rural oncology delivery. There’s so much to learn—not just from the patients, but from the systems themselves.
The Power and Challenge of Rural Practice
Montana is a beautiful place, filled with incredible patients who often travel hundreds of miles to access care. God’s country. Most of the clinical staff were generous and committed. Yet, as with any system, there were moments that prompted pause—things I might explore in future posts: questions about staffing dynamics, quality assurance, and how smaller communities manage complex care needs under resource constraints.
Some of these reflections have been influenced by prior observations—not just in one clinic, but across the region. I’ve learned that what happens in one place can cast long shadows. I remain thoughtful about how those shadows impact the broader perception of oncology care in rural America.
A Word of Thanks to Hayes Locums—and an Eye on the Future
Throughout this process, Hayes Locums has been a steady presence, providing logistical support and communication. In a profession where the relationship between locum agency, clinician, and facility must be built on trust and responsiveness, I’ve appreciated their help. As with any evolving collaboration, there are always small matters that benefit from open dialogue and thoughtful resolution. I remain optimistic that everything will continue to be handled professionally and with mutual respect.
That said, transitioning now to a new assignment with Weatherby Locums has highlighted the wide range of experiences available across the locums landscape. Weatherby has been outstanding in their communication, flexibility, and commitment to a smooth onboarding process. It’s been a refreshing change, and I look forward to exploring that dynamic more deeply in future comparisons.
I’ve also had conversations with other locum firms whose professionalism and physician-first mindset make me optimistic about the future of flexible oncology staffing. The role of the agency, especially when issues arise, is pivotal—and I’ll continue to reflect on that publicly, as part of my broader writing and professional advocacy.
A Few Final Thoughts
This assignment reminded me of the tension between growth and comfort. There were moments of great reward—and others that required reflection. I’m walking away from it more aware of the challenges facing rural care delivery, and also more committed to advocating for thoughtful solutions, both inside and outside the clinic. In fact, the contrast between urban and rural oncology models has sparked ideas for a future post—one that explores how geography, infrastructure, and systemic support shape care delivery in vastly different ways. Sometimes stories end quietly. Sometimes they become something more. I’m hopeful that this one simply closes with mutual understanding—and that those involved recognize the value in doing so.
Interestingly, I’ll be returning to Montana briefly this coming week—not for work, but to give a paid dinner talk to local physicians. I’m honored to have been invited to speak, and it’s a reminder that even in the face of small challenges, meaningful connections remain. I’ll also use the visit to gather a few belongings and then head back to Florida—just in time for several family celebrations. Life has a way of sorting itself out. I’m reminded again that sometimes things work out exactly as they’re meant to.
Until Next Time
To my colleagues—thank you for the lessons. To my patients—thank you for the privilege. And to my peers exploring locum work: there’s so much value in being mobile, reflective, and well-supported.