Exploring Locum Tenens: A Smart Move for Healthcare Careers

The Pros and Cons of Locum Tenens: A Crystal Ball into Your Medical Career

In today’s rapidly changing healthcare environment, physicians and advanced practice providers are rethinking what their careers can look like. Traditional full-time employment is no longer the only—or even the default—path. Many are asking how to protect their work-life balance, maintain autonomy, and still build a strong, sustainable career.

Locum tenens work has emerged as a powerful option in that conversation. Whether you’re a resident about to graduate, a fellow considering next steps, or an attending reevaluating your current role, understanding the pros and cons of locum tenens can help you make smarter decisions about your future in healthcare.

This guide takes an honest, detailed look at locum tenens as part of modern healthcare careers—what it is, how it works, who it’s best for, and what trade-offs you should understand before you commit.

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Understanding Locum Tenens in Modern Healthcare Careers

What Is Locum Tenens?

“Locum tenens” is Latin for “to hold the place of.” In medicine, it refers to clinicians—physicians, nurse practitioners, and physician assistants—who work temporary assignments to cover staffing gaps. These assignments may last:

• A few shifts or weekends
• Several weeks or months
• Repeating blocks (e.g., one week a month for a year)

You’ll find locum tenens roles across multiple settings:

• Community and academic hospitals
• Critical access and rural hospitals
• Outpatient clinics and urgent care centers
• Telemedicine platforms
• Private practices and group practices

Locum tenens providers are typically credentialed like any other staff member but are brought in through medical staffing agencies or directly by facilities to address short-term needs—such as vacancy, leave coverage, expansion, or seasonal volume.

Why Locum Tenens Is Growing So Quickly

Locum tenens has shifted from a niche solution to a mainstream workforce model. Several trends are driving this growth:

• Nationwide physician shortage
  Many regions—especially rural and underserved urban areas—struggle to recruit permanent clinicians. Locums help maintain access to care.

• Burnout and physician turnover
  High administrative burden, RVU pressures, and EHR fatigue have pushed many clinicians to seek alternatives that offer more physician flexibility.

• Demographic shifts
  An aging population with more chronic disease increases demand for services, while many senior physicians are retiring.

• Changing generational expectations
  Younger physicians often prioritize autonomy and lifestyle, viewing healthcare careers more flexibly than prior generations.

• Post-residency transition needs
  New graduates may want to explore different practice settings, geographic regions, or work models before signing a long-term contract.

In that context, locum tenens isn’t just a stopgap. It can be a strategic career tool at multiple phases—especially in the post-residency and early attending years.

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Key Advantages of Locum Tenens for Physicians and APPs

Locum tenens offers several compelling benefits. Understanding them in detail will help you decide whether this path aligns with your professional and personal goals.

1. Unmatched Flexibility and Autonomy

For many clinicians, the number one draw of locum tenens is physician flexibility.

Control Over When and Where You Work

Unlike traditional employment, where your schedule is largely dictated by your employer, locum tenens allows you to:

• Accept or decline specific assignments
• Build in extended breaks between contracts
• Cluster shifts (e.g., 7-on/7-off) to maximize time off
• Choose geographic regions that fit your lifestyle or family needs

Example:
A hospitalist might choose to work 7 consecutive 12-hour shifts each month in a different state, then take the remaining 3 weeks off for family time, research projects, or travel.

This kind of control can significantly enhance your work-life balance, allowing you to reclaim time for:

• Parenting and caregiving responsibilities
• Personal health and wellness
• Academic or entrepreneurial pursuits
• Long-term travel or living in multiple locations

Ability to “Test-Drive” Different Practice Environments

Locum tenens also functions as a low-risk way to explore:

• Academic vs. community practices
• Large health systems vs. small groups
• Rural vs. urban vs. suburban settings
• Different EHRs and operational structures

You can experience the culture, workload, and expectations of a potential employer before committing. Some physicians intentionally use locums for 1–2 years post-residency to clarify what they actually want in their long-term role.

2. Strong Earning Potential and Financial Flexibility

Locum tenens can be financially attractive—especially for those in high-demand specialties.

Higher Hourly or Daily Rates

Because you’re filling an immediate need and not receiving a full benefits package, your base compensation is often higher. Many locum tenens roles offer:

• Higher hourly/daily rates than comparable employed positions
• Overtime or call pay on top of base rates
• Premium pay for hard-to-staff locations or urgent needs

For new graduates facing substantial student loans, this can be a powerful way to:

• Pay down debt aggressively
• Build an emergency fund quickly
• Save for a home down payment
• Fund future career pivots or sabbaticals

Covered Expenses and Travel Perks

Many medical staffing agencies and facilities provide:

• Housing or housing stipends
• Travel reimbursement (airfare, rental car, mileage)
• Licensing and credentialing support
• Malpractice insurance (often with tail coverage for that assignment)

When structured well, these benefits can significantly reduce your out-of-pocket costs and increase your net take-home income.

Example:
A locum anesthesiologist working a 3-month assignment in a rural hospital might receive free fully furnished housing plus a rental car, with all travel covered. Their only major personal expenses may be food and leisure.

3. Accelerated Professional Development and Skill Building

Locum tenens can be a powerful accelerator for clinical and professional growth.

Exposure to Diverse Patient Populations and Systems

By working in multiple settings, you’ll encounter:

• Different patient demographics and disease patterns
• Varied resource levels (e.g., tertiary center vs. critical access hospital)
• Different clinical protocols and practice styles

This can sharpen your clinical judgment, adaptability, and confidence. You may acquire:

• Expanded procedural experience
• Greater comfort managing limited-resource environments
• Enhanced familiarity with multiple EHRs and workflows

A More Robust and Interesting CV

For employers who value versatility and resilience, a thoughtfully structured locum career can signal:

• Ability to adapt quickly to new teams and systems
• Broad clinical exposure
• Willingness to work in underserved or challenging environments

To maximize this advantage, keep careful documentation of:

• Types of settings and case mixes
• Leadership roles (e.g., leading codes, supervising APPs)
• Quality improvement or systems projects you contributed to, even briefly

You can then translate locum experiences into compelling talking points during interviews for future permanent roles.

4. A Strategic Tool Against Burnout

Physician burnout is a critical issue across healthcare careers. Locum tenens can be both a safety valve and a reset button when used thoughtfully.

Step Back Without Stepping Out of Medicine

If you’re feeling trapped in an unsustainable position, locums can offer:

• A way to leave a toxic environment without a long employment gap
• Space to reassess your career goals while still earning
• The chance to experiment with different workloads and cultures

You might reduce to part-time locums, build in regular recovery periods, or design a work pattern that feels more sustainable over the long term.

More Agency Over Your Workload

While some locum assignments are intense, you can:

• Avoid chronic overtime or excessive call by choosing assignments carefully
• Decline roles that seem understaffed or poorly supported
• Insist on clear expectations during contract negotiation

This sense of control can be psychologically protective and help you reconnect with the parts of medicine you enjoy most.

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Important Downsides and Risks of Locum Tenens

Locum tenens is not ideal for everyone. Understanding the trade-offs clearly will help you avoid common pitfalls and make informed choices.

1. Reduced Job Security and Income Predictability

The flexibility that makes locums appealing also creates uncertainty.

Gaps Between Assignments

Assignments are inherently temporary. Even with strong demand in many specialties, you may experience:

• Weeks or months between contracts
• Seasonal fluctuations in available work
• Cancellations or schedule changes on short notice

To manage this, you’ll need:

• A robust emergency fund (commonly 3–6 months of living expenses or more)
• A proactive approach to lining up future assignments
• Comfort with variable income rather than a fixed salary

No “Guaranteed” Long-Term Position

If you value stability and a clear long-term trajectory within one organization, locum tenens can feel fragmented. You may miss:

• Gradual career progression within a single system
• Long-term leadership or administrative opportunities
• The identity of being “part of” one institution

Some physicians address this by mixing locums with a part-time permanent role, gaining a baseline of security with added flexibility.

2. Limited or Absent Traditional Benefits

Most locum tenens roles classify you as an independent contractor (1099), not an employee, which has major implications.

You Must Arrange Your Own Benefits

Common employer-provided benefits you’ll need to handle independently include:

• Health, dental, and vision insurance
• Disability and life insurance
• Retirement savings (e.g., solo 401(k), SEP-IRA)
• Paid vacation, sick leave, CME days

This requires:

• Advance planning and financial literacy
• Working with a financial advisor or accountant familiar with independent clinicians
• Building “unpaid time off” into your income projections and savings goals

Some agencies do offer limited benefits or W-2 employment models, but these often come with lower pay rates. You’ll need to compare total compensation carefully—not just the headline hourly rate.

3. Challenges in Building Long-Term Patient and Team Relationships

Continuity is one of the most meaningful parts of practice for many clinicians. Locum tenens changes that dynamic.

Limited Continuity of Care

Because you’re often present for a finite period:

• You may not see the outcomes of your treatment plans
• You won’t build multi-year relationships with patients or families
• You may feel less rooted in one community

This is particularly impactful in specialties where long-term relationships are central (e.g., primary care, pediatrics, psychiatry, oncology).

Social and Professional Disconnection

Rotating through multiple sites can create:

• Difficulty feeling part of a cohesive team
• Fewer opportunities for deep mentorship or collaboration
• Occasional feelings of being “the outsider” or “just a temp”

Some hospitals integrate locum providers well; others may not. Locums often need to make deliberate efforts to:

• Introduce themselves assertively
• Learn local norms quickly
• Build micro-communities of support outside of work

4. Licensing, Credentialing, and Logistical Complexity

One of the less visible downsides of locum tenens is the administrative load—though many agencies help significantly.

Multi-State Licensing Requirements

If you plan to work in several states:

• You may need multiple state licenses, each with its own fees and timelines
• The Interstate Medical Licensure Compact (IMLC) can help, but not all states participate
• Keeping licenses active and in good standing requires organization

You’ll also need to stay current on:

• DEA registration (and potential state-specific controlled substance registrations)
• Required CME and maintenance of certification (MOC)
• Background checks and immunization records

Constantly Learning New Systems

Each facility may have:

• A different EHR (EPIC, Cerner, Meditech, various homegrown systems)
• Unique order sets, formularies, and protocols
• Different documentation and billing expectations
• Varied support staff and resource availability

This “perpetual orientation” can be tiring. High-functioning locum clinicians develop strategies to:

• Standardize their own note templates where allowed
• Ask focused questions during onboarding
• Keep personal checklists for common workflows (e.g., admitting, discharging, ordering tests)

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Is Locum Tenens Right for You? Key Considerations by Career Stage

Locum tenens can serve different purposes depending on where you are in your medical career.

For Residents and Fellows Approaching Graduation

Locums may be a good fit if you:

• Are unsure about your ideal practice setting and want to explore
• Have geographic flexibility and are open to travel
• Need to pay off debt quickly and can tolerate some income variability
• Don’t yet have strong family or location ties

However, it may be less ideal if you:

• Want intensive mentorship available day-to-day
• Prefer a very structured early-career pathway
• Need immediate stability for partner/family considerations

One practical compromise: sign a permanent job with a delayed start date and do locums for 6–12 months first, or mix part-time locums with a primary employed role.

For Early- to Mid-Career Attending Physicians

Locums can be especially valuable if you:

• Are burned out in your current role and need a reset
• Want experience in a new region or system before relocating
• Are considering a specialty pivot that requires flexible time for additional training or coursework
• Have children or aging parents in another state and want to work near them temporarily

You’ll need to think strategically about:

• Maintaining your reputation and references across short-term roles
• How locum stretches will be perceived by future permanent employers (framed properly, they can be positive)
• Long-term financial planning as an independent contractor

For Late-Career Physicians

In late career, locum tenens can:

• Provide a gradual transition to retirement
• Allow you to work seasonally or part-time
• Keep clinical skills sharp without full-time demands

Key considerations include:

• Your tolerance for change and frequent onboarding
• The physical demands of travel and unfamiliar environments
• Ensuring you have a solid plan for benefits and retirement savings

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Practical Tips for a Successful Locum Tenens Experience

If you decide to pursue locum work, a few proactive steps can make a big difference in your satisfaction and safety.

Choose Reputable Medical Staffing Partners

Not all agencies are equal. When evaluating them, consider:

• Their experience with your specialty
• Transparency about rates, expenses, and contract terms
• How they handle malpractice coverage and tail
• Their reputation among colleagues (ask peers or mentors)
• Whether they provide robust credentialing and licensing support

You don’t have to limit yourself to one agency, but beware of overcommitting or double-booking.

Read Contracts Carefully and Negotiate Wisely

Pay attention to:

• Cancellation policies (by you and by the facility)
• Expectations for call, procedures, and extra duties
• Malpractice coverage type (claims-made vs. occurrence)
• Non-compete or non-solicitation clauses (especially if you might want a permanent job at that site)

When in doubt, consider having an attorney familiar with physician contracts review major agreements.

Protect Your Work-Life Balance Intentionally

Locum tenens creates the possibility of work-life balance but doesn’t guarantee it. To safeguard your well-being:

• Set clear boundaries on how many hours or shifts you’ll work
• Schedule recovery time between intense assignments
• Maintain routines that support health (exercise, sleep, therapy, hobbies)
• Stay connected with friends, family, or professional networks—even when traveling

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Frequently Asked Questions (FAQ) About Locum Tenens

Q1: How do I find legitimate locum tenens positions and avoid scams?
Most clinicians use established locum tenens agencies that specialize in medical staffing. Look for agencies that:

• Are members of industry organizations (e.g., NALTO in the U.S.)
• Provide clear written contracts before travel
• Are transparent about compensation and expenses
• Have strong references from physicians in your specialty

Avoid offers that pressure you to sign quickly without full details or that ask for unusual upfront payments.

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Q2: Do locum tenens positions always pay more than full-time jobs?
Not always, but often. Hourly or daily rates tend to be higher because:

• You’re not receiving a comprehensive benefits package
• You’re filling urgent or hard-to-cover needs

However, when you factor in paying for your own benefits, taxes as an independent contractor, unpaid time off, and potential gaps between assignments, the effective annual income may or may not exceed a well-compensated permanent role. It’s important to:

• Compare total annualized income, not just hourly rates
• Work with a tax professional to optimize deductions and planning

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Q3: Will working locum tenens hurt my chances of getting a permanent job later?
In most cases, no—if you structure and present it well. Employers often value:

• The adaptability and breadth of experience locums provides
• Willingness to work in diverse or underserved settings

To keep your options open:

• Maintain strong references from each site
• Be able to explain your choices clearly and positively in interviews
• Highlight specific skills, systems experience, and insights you gained from each assignment

Periods of locum work can actually strengthen your application if framed as a purposeful exploration or a thoughtful response to burnout.

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Q4: Can I do locum tenens part-time while holding a permanent position?
Yes, many physicians blend the two. Common patterns include:

• A full-time employed job with occasional locum weekend shifts
• A 0.5–0.8 FTE permanent role plus recurring locum assignments elsewhere

Before doing this, check:

• Your primary employer’s contract (moonlighting clauses, conflict-of-interest policies)
• Malpractice coverage (whether your employer’s policy covers external work—it usually doesn’t)
• Your personal capacity and burnout risk; adding shifts without reducing elsewhere can be unsustainable

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Q5: What are the main emotional or psychological challenges of locum tenens work?
Common challenges include:

• Feeling like an outsider at new sites, repeatedly
• Lack of deep, ongoing relationships with patients and colleagues
• Stress of frequent transitions and learning new systems
• Anxiety about future assignments and income stability

You can mitigate these by:

• Building a stable support system outside of work
• Cultivating routines that travel with you (exercise, journaling, therapy)
• Being selective about assignments and avoiding chronically chaotic environments
• Periodically reassessing whether locums is still serving your long-term goals

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Locum tenens can be a powerful tool in shaping your medical career—a way to explore, earn, reset, or transition with greater control. It is not inherently better or worse than a traditional job; it’s simply a different model with its own advantages and trade-offs.

By understanding those clearly and aligning them with your values, financial needs, and life circumstances, you can decide whether locum tenens should be a brief chapter, a recurring theme, or a central pillar of your healthcare career.