Pulse
The Pinch Hitter
Working locum tenens enables John Salchert to do what he loves—connect with patients—and avoid the hassles of running a practice.
John Salchert, M.D., knows about retirement. That’s because he has done it three times during his medical career.
Salchert, a family physician who now lives in Shoreview, retired 10 years ago at age 60 from the Veterans Affairs Hospital in St. Cloud, where he worked as a primary care physician in the chemical dependency unit. In 2000, he retired again, this time from the Minnesota Army National Guard, where he served for 20 years and commanded medical forces as the state surgeon. Then in 2004, he did it yet again—from a hospice in St. Cloud, where he was medical director for six years.
But Salchert still wasn’t ready to give up practicing medicine altogether. Since then, he has been doing locum tenens work during the summers. Gigs have taken him to clinics in St. Paul, Elk River, Monticello, Hutchinson, Caledonia, Hinckley, Moose Lake, Sandstone, and Arlington, Minnesota, and an Indian reservation in Gallup, New Mexico. “The best explanation I can give is that I really enjoy practicing medicine, and my wife tells me that when I practice medicine and come home, there’s a sparkle in my eyes,” he says of his reason for continuing his work.
In late June, Salchert, who turns 70 this month, was spending Tuesdays and Fridays at the Gateway Family Health Clinic in Hinckley, an area with a shortage of physicians. He explains how the experience takes him back to the days when he ran a solo family practice in north Minneapolis—a practice he sold in 1986. “The HMOs made it too difficult for me,” he explains.
“When I was practicing medicine by myself, I always thought when I got older I would have a small office and a nurse who had been with me forever. I’d see some of the old patients, check their blood pressure, send them to the hospital if they were very sick, talk about the children I delivered, and grow old. You can’t do that any more. But this is a substitute. It’s the nearest thing you can get to that,” he says, explaining that with locum tenens work he doesn’t have to deal with the bureaucracy that goes along with owning or being part of a practice.
Treating Body and Soul
A gregarious man who still has the easy way that won him a seat representing north Minneapolis as a Democrat in the Minnesota House of Representatives from 1966 to 1974 (another career from which he retired), Salchert says he likes the fact that locum tenens work gives him a chance to develop relationships with patients, even if it’s just for a short time. (Salchert also does pre-employment physicals for Japs-Olson Company, a St. Louis Park printer.)
And the physicians he works with, even on a temporary basis, appreciate the experience he brings. “He deals well with patients on what I call a realistic basis,” says John Vener, M.D., a family physician who practices at Sibley Medical Center in Arlington, where Salchert has pinch hit for the last two years. “Other locums we’ve had haven’t related well with patients or sometimes lack experience and feel they have to address every symptom with a lab test or pharmaceutical. John is smart enough to sit back and think.”
In addition to addressing patients’ physical concerns, Salchert can also address their spiritual and emotional needs. An ordained deacon in the Catholic Church, Salchert received a Bush Fellowship in 1994 and spent four months at McGill University’s Royal Victoria Hospital in Montreal learning about the medical side of hospice care, then took clinical pastoral training through the VA Hospital in St. Cloud. “It allows you to get in touch with where you are in a relationship with a patient and your feelings about how to be a caregiver rather than a caretaker,” he says of what he learned during the training.
Those lessons served Salchert well at the St. Cloud hospice and still come in handy in his locum tenens work. He tells about a recent experience with a 22-year-old man who came to the Gateway Clinic for a physical at the suggestion of his mother. “When we got down to the real issue, I found out his mother and father were divorced … and his 19-year-old brother was dying of cancer, and his grandfather, whom he loved, died the week before. We did the physical but spent most of the time dealing with how he was handling his grief,” he says.
“You have to ask the questions to know what’s going on. That’s why I enjoy it,” he says of continuing to practice medicine. “That’s why I get a sparkle in my eye.”—K. Kiser