Exploring Locum Tenens: A Comprehensive Guide for Medical Professionals

Locum tenens has moved from a niche option to a mainstream pathway in modern healthcare careers. For many physicians, NPs, and PAs, it offers a way to reclaim work-life balance, explore different practice settings, and maintain career flexibility at a time when burnout and administrative burden are high.

If you’re finishing residency, feeling stuck in a traditional job, or simply curious about new ways to structure your medical profession, understanding the pros and cons of locum tenens is essential. This guide walks through what locum tenens really looks like day to day, who tends to thrive in it, and the key factors to weigh before making the jump.

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Understanding Locum Tenens in Today’s Healthcare Landscape

What Does “Locum Tenens” Really Mean?

“Locum tenens” is Latin for “to hold the place.” In healthcare, it refers to clinicians who temporarily fill in for other providers or cover staffing gaps in:

• Hospitals and health systems
• Community clinics and FQHCs
• Private practices and group practices
• Academic medical centers
• Rural or underserved facilities

Assignments may last:

• A few shifts or a single weekend
• Several weeks or months
• Ongoing “per diem” coverage a few times a month

You typically work through a locum tenens agency (though some clinicians work directly with facilities), and you are usually paid as an independent contractor for the duration of the assignment.

Who Commonly Works Locum Tenens?

Locum tenens can fit many points in the medical career timeline:

• New graduates and early-career physicians/APPs

  • Test different practice models before signing a long-term contract
  • Pay down student loans more aggressively
  • Bridge time between training and a permanent position

• Mid-career clinicians

  • Manage burnout by regaining schedule control
  • Transition between jobs or geographic moves
  • Explore a new region or specialty niche before committing

• Late-career and semi-retired physicians

  • Gradually reduce clinical hours
  • Work seasonally or part-time while maintaining skills
  • Continue contributing clinically without long-term obligations

Locum tenens can be full-time, part-time, or occasional “extra” shifts—making it one of the most flexible models in healthcare careers today.

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Key Advantages of Locum Tenens Work

For many clinicians, the appeal of locum tenens starts with flexibility—but that’s only one of several major benefits.

1. Flexibility and Genuine Work-Life Balance

Traditional employed positions often come with rigid schedules, call obligations, and long-term contracts. Locum tenens flips that dynamic: you choose which assignments to accept.

How locums can improve work-life balance:

• Control over schedule

  • Accept or decline assignments based on your availability
  • Plan blocks of time off for family, travel, research, or board prep
  • Choose between day, night, or weekend shifts depending on your preferences

• Ability to design your year
  Example: Work intensely for 3 months at a high-paying rural site, then take 4–6 weeks off. Repeat throughout the year. This can be especially attractive after residency, when you may want to catch your breath while still earning meaningful income.

• Geographic flexibility

  • Work close to home or accept travel-based assignments
  • Try out different cities or states before relocating
  • Spend part of the year near aging parents or in a preferred climate

For clinicians prioritizing work-life balance and autonomy, this level of control can be transformative.

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2. Diverse Clinical Experience Across Settings

Locum tenens often accelerates professional growth by exposing you to a wide range of practice environments.

Benefits of this diversity include:

• Exposure to different practice models

  • Large academic centers vs. small community hospitals
  • Private practice vs. integrated health systems
  • Urban trauma centers vs. rural critical access hospitals

• Enhanced adaptability and clinical confidence

  • Quickly learning new EMRs and workflows
  • Managing different patient populations and case mixes
  • Handling variable resource availability (e.g., limited specialty backup in rural sites)

• Clarifying long-term career preferences
  Unsure whether you prefer academic medicine, community practice, or telehealth-heavy models? Locum tenens lets you “audition” environments without long-term commitment.

This breadth of experience can be especially valuable early in your medical profession, when you’re still refining your ideal practice style.

3. Strong Financial Potential and Income Flexibility

From a financial standpoint, locum tenens can be very competitive—and sometimes superior—to traditional employment, depending on specialty and region.

Common financial advantages:

• Higher base hourly or daily rates
  Facilities often pay a premium for temporary coverage, especially in high-demand specialties like emergency medicine, anesthesia, hospital medicine, psychiatry, and certain surgical subspecialties.

• Covered travel and housing
  Many locum tenens agencies or facilities provide:

  • Round-trip transportation (airfare, mileage, rental car)
  • Furnished housing or housing stipends
  • Meal per diems or incidentals in some contracts

  These benefits can significantly reduce your living expenses during assignments, effectively increasing your net income.

• Opportunity to boost savings or pay down debt
  Strategically choosing higher-paying assignments can help you:

  • Accelerate student loan repayment
  • Build an emergency fund quickly
  • Save for a home down payment or major life changes

• Negotiation leverage and contract flexibility
  Because assignments are time-limited, you renegotiate relatively frequently. Over time you’ll gain a sense of market rates in your specialty and can push for improved compensation or more favorable terms.

Important: As an independent contractor (common in locums), you are responsible for your own taxes, retirement savings, disability insurance, and often health insurance. This means higher gross pay does not automatically equal higher net pay—you’ll need a plan, which we’ll address below.

4. Expanded Professional Network and Career Opportunities

Working in multiple settings can significantly expand your professional network across the medical profession.

Networking benefits of locum tenens:

• Connections across regions and systems

  • Meet department chairs, medical directors, and practice owners
  • Build relationships with colleagues in multiple specialties
  • Gain references from diverse settings

• Pathways to permanent or hybrid roles
  Many facilities use locum tenens coverage as a “trial period” and may offer:

  • Permanent full-time positions
  • Part-time or job-share roles
  • Flexible contracts with a mix of locums and employed shifts

• Opportunities for leadership and side roles
  Over time, your broadened network may lead to:

  • Medical director positions
  • Quality improvement or committee work
  • Teaching or precepting roles in academic or community programs

For residents and early-career clinicians, this can be especially valuable as you’re still exploring the full range of healthcare careers available.

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Major Drawbacks and Challenges of Locum Tenens

Despite its advantages, locum tenens is not ideal for everyone. Understanding its downsides honestly is crucial before committing.

1. Inherent Lack of Long-Term Job Security

By design, locum tenens assignments are temporary. That flexibility comes with trade-offs:

• No guaranteed continuity of work

  • Assignments can end sooner than expected if staffing changes or volumes drop
  • Seasonal fluctuations may affect demand in certain regions or specialties

• Income variability

  • Periods between assignments may be unpaid if not planned for
  • Rates vary by location, facility, and urgency of need

• Economic and policy sensitivity
  Changes in healthcare policy, reimbursement, or hospital budgets can influence the volume and compensation of locum roles.

Mitigation strategies:

• Maintain an emergency fund covering at least 3–6 months of expenses
• Keep your CV, licenses, and credentialing documents updated for quick placement
• Cultivate relationships with multiple agencies and facilities to diversify opportunities

If you strongly prefer predictable, stable employment and a steady paycheck, this aspect of locum tenens may feel stressful.

2. Constant Need to Adapt to New Environments

Thriving in locum tenens requires a high tolerance for change and strong interpersonal skills.

Common adaptation challenges:

• Learning new systems quickly

  • Different EMRs and documentation standards
  • Variable order sets, formularies, and support services
  • Distinct call systems, communication channels, and workflows

• Navigating local culture and politics

  • Each facility has its own unwritten norms and team dynamics
  • As “the locums doc,” you may initially be viewed as an outsider
  • You’ll need to earn trust quickly with nursing staff, consultants, and administrators

• Personal disruptions

  • Frequent travel can mean time away from family or established social networks
  • Rotating housing and unfamiliar locales can feel isolating for some

Some clinicians find this constant change energizing; others find it draining. Honestly assessing where you fall on that spectrum is key.

3. Limited Traditional Employment Benefits

Locum tenens clinicians often work as 1099 independent contractors rather than W-2 employees, which usually means:

• No employer-sponsored health insurance
• No employer contributions to retirement (401(k), 403(b), pension)
• No paid time off or sick leave
• No guaranteed parental leave

These gaps don’t necessarily make locum tenens less financially attractive—but they do require more planning and personal responsibility.

How to proactively address benefits as a locum:

• Health insurance:

  • Purchase individual or family coverage through the ACA marketplace or private insurers
  • Join a spouse/partner’s plan if available

• Retirement savings:

  • Set up a Solo 401(k) or SEP-IRA for tax-advantaged savings
  • Aim to “pay yourself first” with regular contributions from each assignment

• Disability and life insurance:

  • Purchase own-occupation disability coverage, ideally early in your career
  • Ensure adequate life insurance if you have dependents

• Paid time off strategy:

  • Build time off into your schedule and budget
  • Treat vacation as essential, not optional, and pre-fund it in your savings plan

If you’re willing to take charge of your own benefits, locum tenens can still strongly support long-term financial health and career flexibility.

4. Licensing, Credentialing, and Administrative Burden

One of the most underappreciated challenges of locum tenens is the administrative workload around licensing and credentialing.

Key hurdles:

• Multiple state licenses

  • Each state has its own requirements, timelines, and fees
  • The Interstate Medical Licensure Compact (IMLC) can help if you’re eligible, but not all states participate

• Hospital and facility credentialing

  • Filling out detailed applications for each new site
  • Providing documentation of training, board certification, malpractice history, references, and immunizations
  • Waiting weeks to months for committee approval in some systems

• Malpractice coverage

  • Many agencies provide occurrence-based coverage, but you should verify policy type and limits
  • Some facilities may require separate tail coverage, depending on the arrangement

Tips to streamline this process:

• Maintain an up-to-date digital “credentialing packet” with:

  • CV, diplomas, board certificates, licenses
  • Immunization records, DEA, CME logs
  • Malpractice certificates and claims history

• Consider working with one or two primary agencies that assign a dedicated credentialing specialist

• Plan your schedule with enough lead time for licensing and privileging, especially for new states

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Is Locum Tenens a Good Fit for You? Key Questions to Ask

Choosing locum tenens isn’t just a financial or logistical decision—it’s about aligning your career with your values, personality, and life stage.

1. Clarifying Your Personal Priorities and Life Circumstances

Ask yourself:

• How important is geographic stability right now (e.g., for spouse/partner, children, schooling, or eldercare responsibilities)?
• Am I energized by travel and new environments, or do I prefer a consistent home base?
• Is this a season of my life where I want maximum flexibility, or do I crave predictability and routine?

For example, a single physician early in their career may embrace frequent relocation, while a parent with school-age children may prefer local or regional assignments only.

2. Aligning Locum Tenens With Your Professional Goals

Consider how locum tenens will impact your long-term trajectory in the medical profession:

• Are you trying to:

  • Explore settings before choosing a permanent job?
  • Gain experience in rural or underserved care?
  • Increase procedural volume or specific clinical exposure?
  • Create bandwidth for research, teaching, or entrepreneurial projects?

• How will locum tenens appear on your CV?
  When framed appropriately, locums experience can highlight:

  • Adaptability and resilience
  • Breadth of clinical expertise
  • Commitment to serving high-need areas

You can also combine locums with academic affiliations or telemedicine work to maintain scholarly or niche clinical interests.

3. Financial Readiness and Risk Tolerance

Evaluate your financial situation honestly:

• Do you have an emergency fund or a plan to build one before going fully locums?
• Are you prepared to manage variable income and self-employment taxes?
• Have you thought through health insurance, retirement savings, and disability coverage?

If needed, consider consulting a financial planner familiar with physician 1099 income to help structure your approach.

4. Personality Fit and Work Style

Successful locum tenens clinicians often share certain traits:

• Comfortable with ambiguity and frequent change
• Strong communicators who build rapport quickly
• Organized and proactive with logistics
• Self-directed and disciplined, especially when not tied to a traditional schedule

If you prefer long-term relationships with the same patients and team, or you strongly value institutional loyalty and deep integration in local systems, you might prefer a hybrid model: primarily employed work with occasional locums shifts.

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Practical Steps if You’re Considering Locum Tenens

If locum tenens seems potentially aligned with your goals, here’s how to evaluate and transition thoughtfully.

1. Start With Information-Gathering

• Talk to colleagues who have worked locum tenens—especially in your specialty
• Attend webinars or information sessions hosted by reputable locum agencies
• Review sample contracts to understand standard terms, pay structures, and expectations

2. Try a “Test Run” Before Fully Committing

If possible, start with:

• Occasional weekend or vacation coverage locally
• A short-term assignment between training and a permanent role
• A part-time locum job alongside a reduced FTE permanent role

This approach lets you experience the workflow, travel, and administrative processes without relying entirely on locums income at first.

3. Choose Agencies and Assignments Carefully

• Work with 1–3 reputable agencies rather than many smaller ones

• Ask specific questions:

  • What is covered (travel, housing, malpractice)?
  • How often do assignments extend?
  • What is the average time from interview to start date?
  • What support is available if issues arise on-site?

• When evaluating individual assignments, clarify:

  • Patient volume and acuity
  • Support staff and specialty backup
  • EMR system and onboarding process
  • Call responsibilities and schedule details

4. Protect Your Time, Health, and Boundaries

Locum tenens can tempt high-earning clinicians to overschedule. Sustain your career by:

• Setting maximum weekly or monthly shift limits
• Scheduling intentional time off between contracts
• Prioritizing sleep, exercise, and personal relationships
• Checking in regularly with your own goals and satisfaction

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Frequently Asked Questions About Locum Tenens

1. What is locum tenens, and who typically uses it?

Locum tenens refers to clinicians—most often physicians, nurse practitioners, and physician assistants—who temporarily “hold the place” of other providers or fill staffing gaps in healthcare facilities. It’s used by new graduates, mid-career clinicians seeking change or flexibility, and late-career physicians who want to scale back without fully retiring.

2. Is working locum tenens financially better than a permanent job?

It can be, but it depends on your specialty, location, and how you manage benefits and taxes. Many locum tenens roles pay higher hourly or daily rates and cover housing and travel, which can boost net income. However, you’re often responsible for your own health insurance, retirement savings, disability coverage, and unpaid time off. With careful planning, locums can be financially advantageous, especially for those prioritizing flexibility and short- to medium-term income maximization.

3. How does locum tenens affect work-life balance?

For many, locum tenens improves work-life balance by allowing them to control when and where they work and to build extended breaks into the year. You can cluster shifts, take months off, or work seasonally. However, frequent travel, new environments, and administrative tasks can be stressful for some. The impact on work-life balance largely depends on your personality, family situation, and how intentionally you structure your schedule.

4. What are the biggest downsides or risks of locum tenens?

Common drawbacks include:

• Lack of long-term job security and predictable income
• Limited traditional benefits (no employer-sponsored health or retirement)
• Repeated licensing and credentialing processes
• Needing to adapt quickly to new systems, cultures, and EMRs
• Possible isolation or disruption to personal relationships due to travel

These risks can be mitigated with financial planning, careful assignment selection, and clear boundaries around workload and travel.

5. How can I tell if locum tenens is the right choice for my career?

Reflect on three core areas:

• Personal life: Do you have the flexibility to travel or rearrange your schedule? Are you comfortable with temporary roles?
• Professional goals: Will locum tenens help you explore settings, pay off debt, prevent burnout, or create space for other projects?
• Financial readiness: Do you understand 1099 income, and are you prepared to manage insurance, retirement, and variable cash flow?

If your answers align with the advantages of locum tenens—and you’re willing to accept its trade-offs—it can be a powerful way to build a sustainable, flexible, and rewarding medical career.