Explore Locum Tenens: A Physician's Guide to Flexibility & Career Planning

Locum Tenens: A Comprehensive Career Guide to the Pros and Cons

The path through medicine rarely follows a straight line. After residency—or even years into attending life—many physicians reassess their priorities: work–life balance, geographic preferences, clinical variety, or financial goals. Locum Tenens work has become a major alternative in modern physician employment, offering a level of medical flexibility that traditional jobs often can’t match.

This expanded career guide walks you through what Locum Tenens actually is, why it’s growing, and how to realistically weigh the pros and cons for your own healthcare career. Whether you’re a resident planning for life after graduation or a seasoned physician considering a transition, understanding this option can help you design a more intentional, sustainable career.

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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 of.” In practical terms, it refers to healthcare professionals—most commonly physicians, NPs, and PAs—who temporarily fill staffing gaps at:

• Hospitals and health systems
• Community and rural health centers
• Academic medical centers
• Private practices and group practices
• Urgent care and telemedicine groups

Assignments can range from a few shifts to several months, and in some cases, long-term ongoing coverage renewed in blocks. You are usually contracted through a staffing agency or directly with a facility, and you’re paid as an independent contractor (1099) or sometimes as a W-2 employee of the agency.

Why Locum Tenens Is Growing So Quickly

Locum Tenens is not just a niche solution anymore—it’s a central part of the physician employment ecosystem.

Several forces are driving this growth:

• Physician shortages: The Association of American Medical Colleges (AAMC) projects a shortfall of 37,800 to 124,000 physicians by 2034 across primary care and specialties.
• Rural and underserved needs: Many regions struggle to recruit permanent physicians, so they rely heavily on Locum Tenens coverage.
• Burnout and workforce churn: Physicians are changing jobs more often, retiring early, or reducing hours, all of which create coverage gaps.
• Seasonal and predictable surges: Flu season, tourist season, local events, and maternity or medical leaves create temporary staffing needs.
• Shift toward flexibility: Newer generations of physicians prioritize autonomy, work–life balance, and geographic freedom more than previous ones.

For you as a physician, this environment means there are frequent opportunities to practice in diverse settings while maintaining a high degree of control over when, where, and how you work.

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Major Advantages of Locum Tenens Work

Locum Tenens can be a powerful tool when used strategically. Below are the major benefits and how they realistically play out in healthcare careers.

1. Exceptional Flexibility in Scheduling and Lifestyle

Medical flexibility is the top reason many physicians explore Locum Tenens.

You can often:

• Choose when you work (e.g., per diem shifts, part-time blocks, or full-time stretches)
• Choose where you work (specific regions, states, or practice settings)
• Build in extended time off between assignments for family, travel, research, board study, or personal projects

Example scenario:
You’re a hospitalist finishing residency with significant burnout. Instead of committing immediately to a full-time position, you:

• Work 7-on/7-off Locum Tenens blocks in a nearby community hospital
• Use off-weeks to rest, study for boards, and explore fellowship options
• Adjust your schedule to attend key family events or travel abroad between contracts

You still earn income and maintain your clinical skills while gaining breathing room and control over your time.

Actionable tip:
Before starting, define your non-negotiables (e.g., number of nights, maximum commute, minimum guaranteed shifts per month) and communicate them clearly to agencies. Flexibility is powerful only if you know your boundaries.

2. Diverse Clinical Experience Across Settings

Locum Tenens offers exposure to different:

• Practice models (academic, private, employed, community)
• Patient populations (rural, urban, underserved, high-acuity)
• EMR systems and operational workflows
• Interdisciplinary teams and institutional cultures

This diversity can accelerate your growth as a clinician and help you refine what type of permanent role you might want later.

Real-world examples:

• An internal medicine physician rotates through:

  • A small critical access hospital in the Midwest
  • A large suburban health system
  • A safety-net hospital in a major city
    They quickly learn where they feel most supported, which EMR systems they tolerate, and what patient mix keeps them engaged.

• A psychiatrist tries:

  • Inpatient adult
  • Outpatient community mental health
  • Telepsychiatry locums
    This helps them decide to build a long-term career blending in-person and remote work.

Career benefit:
Locum Tenens can function as a structured “sampling period” before you sign a multi-year employment contract that’s hard to exit.

3. Potential for Higher Short-Term Compensation

Because facilities may be filling urgent or hard-to-staff roles, Locum Tenens rates are often:

• Higher hourly/shift pay compared to many employed positions
• Structured with travel and housing stipends
• Negotiated with overtime or call differentials

A few typical patterns (actual numbers vary by specialty and region):

• Emergency medicine: Higher hourly rates for nights, weekends, rural sites, or high-volume EDs
• Hospitalists: Premiums for short-notice needs, nocturnist roles, or holidays
• Psychiatry and anesthesia: Often strong Locum Tenens markets due to persistent shortages

Case study-style illustration:
A family medicine physician in a traditional employed outpatient clinic might earn a stable salary but feel capped on income. By adding periodic Locum Tenens weekend urgent care shifts, they:

• Increase annual income significantly
• Maintain primary job benefits
• Reduce financial pressure from student loans

Actionable tip:
Don’t focus only on headline hourly rates. Ask specifically about:

• Guaranteed minimum hours or shifts
• Non-billable time expectations (charting, meetings)
• Call requirements and how it is compensated
• Travel time and whether it’s paid or supported

4. Geographic and Lifestyle Exploration

Locum Tenens is often described as “paid travel with a stethoscope.” For physicians open to relocating or exploring, it can be a unique lifestyle.

You can:

• Try living in different regions before committing to a move
• Work in rural settings or small towns you might never otherwise consider
• Experience major cities without signing a long local lease
• Combine work blocks with regional travel or outdoor activities

Example:
A pediatrician interested in mountain living takes repeated 2–3 month assignments in the Pacific Northwest and Colorado. They:

• Hike and ski on off days
• Evaluate cost of living, schools, and community fit
• Later choose a permanent job in the region that best matches their family’s needs

5. Expanded Professional Network and Future Options

Each assignment introduces you to:

• New physician colleagues and subspecialists
• Nurse practitioners, PAs, and nursing teams
• Hospital leadership and medical directors
• Administrators and recruiters

These connections can lead to:

• Offers for permanent employment
• Recommendations for future Locum Tenens assignments
• Research or quality improvement collaborations
• Mentorship and specialty-specific guidance

Practical advice:
Treat each Locum Tenens assignment as both clinical work and professional reconnaissance. Show up as if you’re a long-term colleague:

• Be reliable and collegial
• Help solve problems, not just meet minimum expectations
• Ask thoughtful questions about how the system could work better

Your reputation will follow you and can significantly influence future options.

6. A Tool to Combat or Recover from Burnout

For many physicians, burnout stems from:

• Loss of autonomy
• Excessive administrative burden
• Rigid scheduling
• Toxic or unsupportive work environments

Locum Tenens won’t magically eliminate all of these, but it can:

• Allow you to step away from a toxic permanent job without leaving medicine
• Give you control over your workload and time off
• Offer short-term assignments where you can test different cultures and workloads
• Create space for therapy, coaching, or personal reset between contracts

Mental health perspective:
Some physicians use Locum Tenens intentionally as a recovery phase—easing back into clinical work after experiencing severe burnout, personal loss, or major life transitions.

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Key Challenges and Downsides of Locum Tenens

While the advantages are real, Locum Tenens is not an ideal fit for everyone. Understanding the potential drawbacks will help you make a clear-eyed decision.

1. Income Instability and Lack of Long-Term Security

Unlike salaried employment, Locum Tenens pay is usually tied to actual shifts or hours worked. This means:

• No guaranteed long-term job security
• Potential gaps between assignments
• Susceptibility to seasonal or regional fluctuations in demand

Example scenario:
A hospitalist enjoys high-paying Locum Tenens work for several months. Then:

• A facility hires permanent staff and reduces Locum Tenens needs
• Another contract is delayed due to credentialing
• A planned assignment falls through at the last minute

This can leave weeks or months with significantly lower income.

Risk-mitigation tips:

• Maintain an emergency fund (ideally 3–6 months of living expenses or more)
• Work with more than one Locum Tenens agency or maintain multiple leads
• Keep licenses active in key states to broaden opportunities
• Consider mixing a part-time employed role with Locum Tenens to stabilize income

2. Limited or No Traditional Employee Benefits

Most Locum Tenens physicians are independent contractors, meaning:

• No employer-provided health insurance (you must buy your own plan)
• No employer-sponsored retirement plan or matching
• No paid vacation, CME, maternity/paternity leave, or sick days
• No long-term disability or life insurance unless you arrange it independently

Financial significance:
You may earn higher gross income, but you must allocate funds for:

• Self-employment taxes
• Private health insurance
• Retirement contributions (e.g., SEP IRA, Solo 401(k))
• Paid time off, because any break from work is unpaid

Actionable planning:

• Engage a CPA or financial planner familiar with physician 1099 work
• Set a fixed percentage of each paycheck aside for taxes and retirement
• Shop carefully for individual or family health plans and disability insurance

3. Constant Adaptation to New Systems and Workflows

Each new facility can mean new:

• EMR systems (Epic, Cerner, Meditech, or smaller platforms)
• Order sets, formulary constraints, and documentation requirements
• Call structures, consult processes, and escalation pathways
• Local culture: communication styles, expectations, and unspoken norms

For some physicians, this variety is energizing. For others, it is exhausting.

Common challenges:

• Inefficiency and frustration during the first week or two of each assignment
• Risk of errors if orientation is rushed or incomplete
• Stress from “figuring it out as you go” repeatedly

Practical preparation:

• Ask ahead about orientation: duration, who trains you, what’s covered
• Request access to EMR training materials or a test environment
• Create a personal checklist for first-day questions (codes, consults, workflow)

4. Administrative and Credentialing Burden

Behind every Locum Tenens assignment is a substantial administrative layer:

• State medical licenses (potentially multiple)
• DEA registration and state-specific controlled substance registrations
• Hospital privileging and credentialing packets
• Malpractice coverage details and tail coverage questions
• Background checks, immunization records, references, etc.

Agencies often help manage this, but you remain responsible for accuracy and timeliness.

Time impact:
Initial onboarding for a new state or hospital can take weeks to months. This can delay your start date and therefore your income.

Efficiency strategies:

• Maintain an up-to-date digital credentialing packet (CV, licenses, CME, immunizations, malpractice history)
• Respond quickly to credentialing requests to avoid bottlenecks
• Consider participating in Interstate Medical Licensure Compact (IMLC) if eligible

5. Risk of Professional Isolation

Locum Tenens physicians may experience:

• Fewer long-term colleague relationships
• Limited involvement in department decisions or QI projects
• Less access to formal mentorship or academic communities
• Emotional distance from the workplace because “you’re just passing through”

Mental health and career development impact:

• Some physicians feel like “outsiders” at every site
• It may be harder to build a cohesive CV in academic or research-focused paths
• Support systems can be weaker if you move frequently

Strategies to counter isolation:

• Stay engaged with your specialty society or alumni network
• Join virtual physician communities, journal clubs, or interest groups
• Develop long-term recurring Locum Tenens relationships with favored sites
• Consider a hybrid model: a home base part-time role plus Locum Tenens

6. Challenges with Community Integration and Continuity of Care

Locum Tenens can complicate the continuity that many physicians value:

• You may not see the same patients over long periods
• You often sign out complex cases to permanent staff at the end of your contract
• Patients may be wary of “another new doctor”

This can be especially impactful in fields like:

• Primary care
• Psychiatry
• Pediatrics
• Oncology

Professional implications:

• Less opportunity to see long-term outcomes of your care
• Harder to build a local reputation solely through continuity
• Some physicians miss the relationships that come with years in one community

Mitigation approaches:

• Communicate clearly with patients about your role and time frame
• Invest in thorough handoffs and documentation to support continuity
• When possible, commit to recurring blocks at the same site (e.g., 1 week/month for 6–12 months)

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Is Locum Tenens Right for You? A Practical Decision Framework

Deciding whether to incorporate Locum Tenens into your healthcare career is highly personal. Consider these domains as you plan.

1. Clarify Your Professional and Personal Goals

Ask yourself:

• Do I value flexibility and variety or stability and long-term roots more right now?
• Am I trying to explore different practice settings or build seniority in one system?
• Is my priority to maximize near-term income, relocate, recover from burnout, or something else?

You might find that Locum Tenens is ideal as:

• A transitional strategy right after residency or fellowship
• A mid-career reset or bridge between permanent jobs
• A supplement to a part-time academic or administrative role
• A late-career path to scale down hours gradually before retirement

2. Assess Your Financial Readiness and Risk Tolerance

Consider:

• Do I have a sufficient emergency fund to tolerate gaps in assignments?
• Am I comfortable managing self-employment taxes, benefits, and retirement planning?
• Can I emotionally handle variable monthly income, or will this create significant stress?

If the financial uncertainty feels overwhelming, a hybrid approach (part-time employed + part-time Locum Tenens) may balance security with flexibility.

3. Evaluate Your Adaptability and Learning Style

Reflect honestly:

• Do I enjoy learning new systems and workflows often?
• Am I comfortable walking into a new environment and asking for help?
• How do I handle ambiguity and “figuring things out on the fly”?

If you strongly prefer stable routines and tightly defined expectations, a heavily Locum Tenens-based career may be more draining than energizing.

4. Consider Your Need for Community and Belonging

Think about:

• How important is team camaraderie to me?
• Do I need long-term patient relationships to feel fulfilled?
• Will frequent travel or relocations strain my relationships or family life?

Physicians with young families, partners in very location-bound careers, or strong local commitments may prefer regional Locum Tenens only—or a more anchored role with limited Locum Tenens on the side.

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FAQs About Locum Tenens for Physicians and Advanced Practice Providers

1. How do I find reputable Locum Tenens opportunities?

You can find Locum Tenens roles through:

• Specialized Locum Tenens staffing agencies (e.g., large national firms and smaller boutique agencies)
• Health system in-house locums programs
• Specialty society job boards and physician networking groups
• Direct outreach to hospitals or groups in regions you’re interested in

When evaluating an agency or assignment:

• Ask about malpractice coverage (type, limits, tail coverage)
• Clarify travel and housing arrangements (who books, quality, stipends vs direct payment)
• Review the contract carefully, especially cancellation clauses and non-compete language

Consider speaking with other physicians who have used the same agency or worked at the same site.

2. Is Locum Tenens appropriate for new graduates right out of residency or fellowship?

It can be, but with caveats:

Advantages for new physicians:

• Flexibility to explore different settings before committing
• Opportunity to pay down debt earlier with higher short-term income
• A way to take a breather after intense training

Potential downsides:

• Steeper learning curve adapting to new systems without a built-in mentor structure
• Less support than a well-designed first-job onboarding program
• Risk of getting stuck in “permanent temporary” roles without building your ideal long-term CV

Ideally, new grads should:

• Choose assignments with strong orientation and support
• Avoid being the sole overnight or high-risk coverage too early without backup
• Consider a first year or two in a supportive permanent role, then adding Locum Tenens later if desired

3. How is malpractice insurance handled for Locum Tenens work?

Most Locum Tenens agencies provide malpractice insurance for the duration of your assignment, but details matter:

• Type of coverage: Claims-made vs occurrence
• Tail coverage: Who pays for tail if needed and under what circumstances
• Limits: Per-claim and aggregate limits

Before starting:

• Request coverage details in writing
• Confirm whether your personal policy (if any) overlaps or conflicts
• If working as an independent contractor directly with a facility, you may need your own policy—discuss with a malpractice broker familiar with Locum Tenens arrangements

4. Can Locum Tenens support continuity of care and quality patient care?

While continuity is inherently more challenging, you can still promote quality and safe care by:

• Performing thorough charting and clear handoffs to permanent teams
• Communicating clearly with patients about your temporary role and the plan for follow-up
• Collaborating closely with nurses, primary teams, and outpatient providers
• Returning to the same site periodically to create semi-regular presence if possible

Many facilities rely on Locum Tenens providers specifically to maintain access and safety standards; your work can be critical to patient care in underserved regions or during staffing crises.

5. Which specialties are most in demand for Locum Tenens work?

Demand fluctuates by region and time, but specialties with consistent Locum Tenens needs often include:

• Family medicine and internal medicine (outpatient and inpatient)
• Hospital medicine (hospitalists, nocturnists)
• Emergency medicine
• Psychiatry (adult, child/adolescent)
• Anesthesiology and CRNAs
• Radiology
• Obstetrics and gynecology
• Critical care and some surgical subspecialties

If you are still in training and interested in a career with built-in flexibility, understanding market trends in Locum Tenens demand can inform your choice of specialty and subspecialty.

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Locum Tenens can be a powerful, flexible tool in modern physician employment—one that supports travel, career exploration, and tailored work–life balance. It also requires deliberate planning, financial literacy, and honest self-assessment.

If you align your Locum Tenens choices with your values, goals, and tolerance for uncertainty, it can serve as either a valuable career bridge or a long-term professional lifestyle that keeps your healthcare career both sustainable and rewarding.