I find it works best to have a trusted colleague or two to cover. (1) Paying for a locums is extremely expensive, probably twice what I make in the office. (2) You never know who you are going to get... at best there will be significant differences in how you practice, and at worst the locums might not be that competent. Finally (3) even the best locums will barely have figured out what drawer you keep the pencils in by the time you get back. He or she will be trying to just keep things patched together until you get back. Better with someone who knows your community and has an idea of your referral sources.
This is all independent of the phone/EMR issue. I find I can just make it clear that I am REALLY out of reach and things sort themselves out. Everyone knows even doctors get a break. After all, if you dropped dead, the patients will shed a short tear and the world will go on.
