Dr. Molly Hutsinpiller says she has the best job in medicine.
Her work for a physician staffing agency has taken her from the South Pole to Alaska. She can pick and choose the assignments, or not work at all. She doesn't have to support an office or staff, and her agency covers expenses for airfare, rental cars, lodging and malpractice insurance — "everything except gas and food."
She's a doctor for hire who practices medicine and nothing more.
"You have power over your schedule," said the 48-year-old emergency physician from her Snowbird resort time-share, resting after 3 1/2 months at the South Pole, where she worked for National Science Foundation contractor Raytheon Co. and dealt mostly with altitude sickness at the 9,000-foot base.
A business started 25 years ago this fall by a University of Utah medical student — hiring doctors like smokejumpers for temporary assignments, often to remote places — has provided thousands of physicians like Hutsinpiller with reliable work and ballooned into a $2 billion industry.
"They're needed and appreciated, and they don't get sucked into professional politics. It's pure medicine, without all the hassles," said Dr. Therus Kolff, who started the physician-for-hire business known by the industry name locum tenens — Latin for "holding a place."
Kolff, an entrepreneur who started four companies, now sits on the board of Salt Lake-based VISTA Staffing Solutions, which can draw on a pool of more than 1,200 physicians, including Hutsinpiller. Their wages range from $50 an hour for basic emergency care to as much as $2,000 a day for neurosurgeons, depending on the assignment.
"If they don't want to go to North Dakota in February, they don't have to," said VISTA chief executive Mark Brouse, who can resort to horse-trading to find doctors willing to take less-desirable postings: "We'll send you to Hawaii in March."
Physicians work anywhere from a week or less on U.S. assignments to as much as six months overseas, typically earning $400 a day for family practice or about $1,200 for specialists.
VISTA, which screens and certifies doctors, covers their malpractice insurance with a $1 million annual premium, Brouse said. The company has as many as 200 physicians under contract any given day.
The demand for these footloose doctors is expected to steadily increase as the U.S. population grows and gets proportionally older, while U.S. medical schools are limited in the number of new doctors they can graduate, Kolff said.
Regional disparities in the supply of doctors, who tend to gravitate to metropolitan areas, gave rise to shortages in the first place.
Kolff was a medical student when he landed a federal grant to supply medical help to rural areas and Indian reservations across the West where doctors are scarce.
In 1979 he founded Comprehensive Health Systems, selling that company in the early 1990s. Through a series of mergers it's now called CompHealth Group, one of seven big players in the medical staffing industry. VISTA is the fifth largest and fastest growing player, supplying doctors only. Others deploy nurses as well. The roll call of agencies includes another 60 mom-and-pop operations.
Kolff, 55, comes from a family of doctors including his father, grandfather, two uncles and three brothers. Another brother is a medical architect who designs hospitals and clinics.
Their 93-year-old Dutch immigrant father, Willem J. Kolff, invented the kidney dialysis machine and headed the Division of Artificial Organs at the University of Utah until 1999.
Therus (pronounced "Terrus") Kolff says many doctors are fed up with pushing paper, fighting insurers, keeping long hours and paying exorbitant malpractice rates.
When the economy and stock market rebound, he predicts, many older physicians will cash out their retirement portfolios and retire, aggravating the doctor shortage and giving companies like VISTA and its contractor-physicians more business.
Hutsinpiller has worked for VISTA and other staffing agencies off and on since 1998. An engineer, she decided at 32 to pursue a medical degree at the University of Utah. She completed a residency in Denver, then worked for the Colorado Outward Bound School for nine years while spending winters skiing.
"Financially single" but married, she visits her husband and his daughter in Spokane, Wash., between assignments and spends Augusts at Priest Lake in northern Idaho. She still owns a house in Salt Lake City, which she rents out.
Hutsinpiller has spent parts of the past few weeks pulling 24-hour shifts at one hospital in Ketchikan, Alaska, and overnight shifts at another hospital in Anchorage. She could make more money being a regular doctor with fixed hours but "my needs are not huge."
"Life is so short, you have to enjoy it," she said.