Insights From Wapiti

The following item was written by Babak Imanoel, DO and describes his first experience with working locum tenens – and his first introduction to Wapiti Medical Staffing. Dr. Imanoel has worked with Wapiti for a number of years and helps staff several of our Minnesota facilities.

When people ask me how I got involved with Wapiti, my answer is – how much time do you have, as it is a rather long but interesting story.

I finished my residency in January 2000. I wanted to stay in Baltimore, but the job market for internists at that time was quite tight. While looking for a “real” job, I started moonlighting at the hospital where I completed my residency. Back then, the word “hospitalist” had not made it into the dictionary. I was working as a “house officer.” Essentially, I was going around the hospital and putting out fires.

One very slow Sunday afternoon, I was in the call room reading some of my throw away journals. I reached the end of a journal and decided to look at the classified ads. One tiny 3-line advertisement grabbed my attention. It was an ad for Wapiti Medical Staffing looking for ER physicians, and it stated that ER experience was not required. I thought to myself, what kind of an ER would hire a physician with no ER experience?

Being bored and not having anything else to do, I picked up the phone and dialed the phone number. The person who picked up the phone was Dr. Brad McDonald, the CEO of Wapiti at the time. We talked for over 90 minutes. We discussed religion, politics, ice fishing, living in Iran, where I came from, my residency and whatever else we could think about.

At some point, I told him that I’m an internist and I have had minimal to no training in Peds, OB, GYN, trauma and Orthopedic surgery. I asked him if he thought I could really run an ER all by myself, especially an ER in the middle of nowhere where I would be expected to take care of anything and everything. He explained that I would be starting in a tiny two bed ER and would be expected to see about 20 patients in a 60-hour shift. He essentially said that I could call him for any questions, and he would guide me in managing the patients when needed. In addition, I would be able to send any case that I would not be comfortable with to a tertiary hospital.

To say the least, I was not sold on this and told him that I would think about it. Apparently, he was expecting that response and was not willing to take no for an answer. He went on to say that he would pay for my license if I committed to working one shift – and if I didn’t like it, I could stop. I reluctantly accepted.

My first shift with Wapiti was the 4th of July weekend 2001. I was scheduled to work in an ER in northern Minnesota from 5pm Friday until 8am Monday. Remember, I was told to expect 20 patients. I got on a flight and flew to Minneapolis, got a rental car, and drove to the facility. All along, I was thinking to myself that I was the biggest fool for agreeing to do this.

As it happened, that weekend was the busiest weekend that ER had ever had in decades. I saw over 60 patients and miraculously all went well. I was welcomed to the hospital and the community with open arms. It was amazing to see how the hospital staff truly appreciated my work and my dedication. I had never seen that level of appreciation for the work that I did. Looking back, after that shift, I was hooked to the job the same way an addict is hooked to heroin. From that moment on, I wished that I could move there with my family and live there forever.

As it turns out, moving to such a remote location with family is easier said than done. Despite my best efforts, I could not convince my family to move to Northern Minnesota. Instead, I decided that I would work full-time with Wapiti while my family was in Maryland. I could easily work two weeks a month with Wapiti and spend the other two weeks with my family in Maryland. That’s exactly what I did for about two years.

Once we had our first child, that arrangement turned out to be very tough on the family. So, in late 2004 I started my own private practice of Internal Medicine in Baltimore. As with any new internist back then, I had to support my practice by taking unassigned patients from the ER. This required my presence in Baltimore, and I had to stop working with Wapiti.

By 2010, most of the large hospitals had developed elaborate hospitalist programs and no longer saw private physicians as an asset. Rather, we were now a liability, as we were competing with their hospitalist program. Hospitals across the country started to push out their private internists, which was the case with my hospital as well. Along with 23 other internists, I was pushed out of Carroll Hospital Center and suddenly my practice was reduced to less than half of what it was. As a result, I called Wapiti once again. By this time, Wapiti had grown from a half dozen physicians to a few hundred physicians. Despite that, Wapiti welcomed me back with open arms.

Shortly after quitting the hospital, I began practicing Addiction Medicine and gradually increased my addiction medicine practice time. By the end of 2012, I had quit practicing internal medicine completely. I am now boarded in Addiction Medicine and own and run two methadone clinics in Baltimore. However, I have made a commitment to travel to Northern Minnesota once a month to practice Emergency Medicine.

Yes, I’m hooked on the practice of Emergency Medicine in Northern Minnesota. I’m now one of over 500 physicians working with Wapiti. However, when I call Wapiti, I’m treated as though I’m their only child. I have not learned to say No to Wapiti.