BMJ Career Focus 2002;325:94 (21 September), doi:10.1136/bmj.325.7365.S94
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Profile
Robbie Coull
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Introduction |
This GP locum was once told that doing locum
work would ruin his career. Rhona MacDonald discovers what
happened next
Medicine almost lost the young Robbie Coull to computer science. Fortunately, he thought the open day at the university was so boring that he went along with his best friend (who had always wanted to be a doctor) to the medicine open day at Glasgow University. He was immediately taken with what was on offer, opted to do medicine instead, and later gained a place at St Andrew's University.
But an interest in information technology has stayed with Robbie throughout his medical career. In fact, an innovative computer software program he wrote has recently given him his 15 minutes of fame in the Scottish media. More importantly, it is helping general practitioner (GP) locums and practices across Scotland and beyond.
"Practices are really struggling to get locums and rely mostly on word of mouth," Robbie explains. Now he is based in Inverness, and it took him over eight hours of phoning round to try toget a locum to cover for him one day when he had to be a witness in court. This is where his innovative locum123.com website comes in. He explains how it works: "Locums fill out an electronic form online (www.locum123.com) to state what types of work they are willing to do and where. Likewise, practices and hospitals state the dates they need locums for. The software automatically matches them and sends emails and text messages to the locums who can then contact the practice directly." The system runs itself, although Robbie keeps a watchful eye on it. The clever software program even sends him a text message if there are any problems.
This simple concept has been a huge success. It was first launched in the Highlands of Scotland at the beginning of the year and then in Glasgow a few months later. It has now also reachedLondon. Over 500 locums are currently on the list, and over 10 000 text messages are sent out each month. According to Robbie, over 80% of the Glasgow requests are met in the first five minutes.
Robbie knows all about the hassles and difficulties facing GP locums as he has worked for many years as one himself, throughout Scotland and also in north Canada. But it is not all in thepast tense. Robbie still works as a locum as he believes there is no better way to work.
He first "saw the light" during his house job in Manchester. He admits: "I really enjoyed the clinical work, but I thought the NHS was the worst employer I had ever seen. A colleague was doing locums to pay for his new car, and I thought it sounded like a great lifestyle. My medical consultant was a real role model for me, and he was very supportive—he even gave me a leather bound AA road map of the UK to start me off." Other consultants, however, warned him that locum work would ruin his career.
He initially wanted to work in emergency medicine but was put off by what he witnessed in the consultants. He recalls: "They were unhappy, overworked, and stressed. The few who seemed happy were those who had done other things or had other interests."
In 1995 he went to Stornoway (in the remote Western Isles) to do a locum job in emergency medicine for three weeks but ended up staying for three years. "I loved the lifestyle there," he explains. He did a couple of the senior house officer rotations between locums to make up his two years and then he did his GP registrar year in a practice in Stornoway. Housecalls in the Western Isles take on a whole new meaning as the mileage is extreme.
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We spend a few pleasant minutes reminiscing about various remote locations in the Western Isles (one of my most favourite places in the world), and Robbie shares with me that he did think about settling there. He applied for partnership but didn't get it: "I really liked the team, and I still keep in touch with them, but I think they knew I would get itchy feet before too long, and they really wanted a long term female partner as they only had a half time female partner in a five partner practice."
Undeterred he launched himself into full time locum work, initially based in Glasgow. He confesses: "I don't want to get too specialised in one particular area of locum work because if the work dries up you are completely stuck." He has an impressive array of letters after his name and thinks that all locums working in rural areas should have BASICS (British Association of Immediate Care) training. "There have been occasional problems with locums coming to the Highlands who have not expected to be so "hands on," he explains. "Locums should have at least some training in emergency medicine to be able to deal with road accidents, heart attacks, stitching lacerations, etc."
Of course there is an ambulance service in the Highlands but because of the huge distances involved, it can take them a long time to get to a particular location. This can also add to the time taken for callouts. Robbie tells me about his longest single callout. He was called to see a patient in a very remote area of the West Highlands. After he had tended to the patient, waited for the ambulance to come, and then travelled with them to Inverness, it was seven hours before he was back home.
Last year Robbie went to remote north Canada for a few months, to see how they do things there. Apart from the nightmare of administrative red tape he had to negotiate to get there, he has mixed feelings about the experience. "It was a real eye opener, and I began to realise how great the ideals of the NHS are," he admits. "The facilities were much better there, but the system was so fragmented—I didn't even know when my patients were being treated by hospital specialists, and those specialists that did let me know mostly sent handwritten letters." The morale is much better, however, and GPs are paid almost twice as much as in the United Kingdom. He also explains that GPs are flown in and out of remote Canadian areas, work a week, and then are flown home for a week. This might be why he was able to write the software for his locum123.com scheme while he was in Canada.
Robbie is now so busy working as a locum in the Scottish Highlands that, despite being a keen mountain biker, he can admire the amazing scenery only from his car window. But at least he still enjoys what he does.
When I ask him what his advice he would give to others he laughs and says: "Never listen to other people's advice. Do what you want to do—what is best for you. Don't do something because you think it will be good for your career. Do something because you enjoy it." He continues: "It's not the arriving that is important, it's the journey. If you don't enjoy the journey,what's the point?"
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Further information
Locum123.com—https://www.locum123.com BASICS—www.basics.org.uk/ National Association of Non Principals—www.nanp.org.uk Locum work in general Locum work in Canada Rhona MacDonald, editor of Career focus
Article re-published on this website with the permission of the British Medical Journal.
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