What Locum Recruiters Won't Tell You About Non-Competes and Moonlighting

You’re on the phone with a recruiter who sounds like they’ve found your perfect setup. Good schedule. Clean travel arrangement. Fast credentialing. The facility is somewhere you’d actually consider working longer term. They’re enthusiastic, maybe a little too enthusiastic. Then the paperwork lands in your inbox and the language gets weird.

“Non-compete.”
“Exclusivity.”
“Non-circumvention.”
“No outside clinical work without written approval.”

That’s the moment a lot of physicians make a bad mistake: they keep riding the excitement of the offer and assume the fine print is standard. Recruiters know this. Speed helps them. A signed contract helps them more. The longer you slow down, read carefully, and start asking annoying questions, the more likely the deal gets delayed, narrowed, or dies.

So yes, some recruiters absolutely downplay these clauses. You’ll hear things like, “It’s boilerplate,” “It never comes up,” or “It’s only there if you try to walk away early.” Sometimes that’s true. Plenty of times, it’s nonsense.

The real risk is simple: you sign thinking you picked up one temporary job, but the clause quietly limits where else you can work, who you can work for, or what you can do on your own time. Your weekend telehealth gig. That per diem shift at the competing hospital. A direct job conversation with the facility after the assignment ends. Gone, or suddenly complicated.

This article is for that exact moment. The contract is in front of you. Your recruiter wants a quick yes. And your gut is telling you something smells off.

This article is for educational purposes only, not legal, financial, or tax advice. Contract enforceability varies by state, employer structure, and exact wording, so if a clause could affect your income or practice options, get a physician contract attorney involved before you rely on anyone’s summary.

What Non-Competes Actually Mean in Locum Tenens Contracts

Here’s the first thing to know: “non-compete” is often used as a catch-all term, but locum contracts may hide the real restriction under a different label.

Common versions:

• True non-compete: You can’t work for a competing practice, hospital, or staffing arrangement within a certain area and time period.
• Non-solicit: You can’t approach the facility, its staff, or sometimes even its patients for direct work.
• Non-circumvention: You can’t bypass the recruiter or staffing company and contract directly with the site.
• Exclusivity: While you’re under contract, you agree to work only through that agency for certain services, certain facilities, or sometimes all locum work in a region.
• Facility-specific restriction: You can’t work at Hospital A, Hospital B, or any affiliated site for a stated period unless the agency gets paid.

That last one catches people constantly. I’ve seen physicians finish a clean locum assignment, get approached by the medical director about staying on, and then discover the agency contract says they can’t go direct for 6 to 24 months. Nobody mentioned it on the front end because, conveniently, that would have started a real conversation.

A restriction can hit more areas of your life than you think:

• Your next locum assignment may be blocked if it’s at a related facility.
• Your side practice may count as “outside clinical work.”
• Your telehealth work may fall under broad language if the clause covers patient populations instead of physical geography.
• Your future job search can get messy if the contract says you can’t accept employment with the client or its affiliates.

And yes, recruiters use framing tricks. The classics:

• “It’s standard language.”
• “You’ll never run into this.”
• “This only matters if you leave early.”
• “Legal puts it in every contract.”

I don’t care if it’s standard. Arsenic can be standard too. The question is whether it restricts you.

Here’s what to look for in the actual clause:

• Geography: Is it 5 miles, 50 miles, statewide, or not defined at all?
• Time period: During the assignment only, or 6/12/24 months after it ends?
• Named facilities: Does it list one hospital, all affiliates, all managed sites, or any client introduced by the recruiter?
• Patient populations or service lines: Could it sweep in telepsych, tele-radiology, urgent care, anesthesia coverage, etc.?
• Survival language: Does the restriction continue after termination or expiration?
• Trigger event: Does it apply only if you breach, or regardless of how the assignment ends?

If you can’t explain the clause in one clear sentence, you do not understand it yet. That means you’re not ready to sign.

Moonlighting: When “Extra Shifts” Become a Contract Problem

A lot of physicians assume locums equals freedom. Temporary work, flexible shifts, no strings. That’s only half true. Locums can be flexible, but the contract can still tie your hands.

Moonlighting problems usually come from three different places at once:

1. Your staffing agreement
2. The facility’s rules and privileges
3. Any exclusivity arrangement involving the group or hospital

That means you might be perfectly free under one layer and completely boxed in under another.

Here’s where physicians get tripped up:

• You pick up weekend per diem work at a nearby hospital and learn your agency claims regional exclusivity.
• You do telemedicine from home and assume it doesn’t count because it’s remote. Wrong. If the clause bars outside clinical work, telehealth is still clinical work.
• You sign with two recruiters covering overlapping systems and don’t realize both claim a right to place you.
• You help cover a colleague’s shifts informally and discover that your malpractice, privilege status, or agency agreement doesn’t allow it.

The hidden traps are usually boring-looking phrases buried in dense legal sludge:

• Minimum hour commitments
• Right of first refusal
• Exclusivity windows
• No outside clinical work without written approval
• All professional services must be offered through agency first

That last one is especially ugly. It can mean you’re expected to route certain opportunities back through the agency, even if you found them yourself.

So when is moonlighting usually safe? Usually—not always—when all of these are true:

• Your locum contract has no exclusivity or outside-work restriction
• Your facility privileges don’t conflict
• Your moonlighting work is outside the restricted geography or facility network
• There’s no overlap that creates scheduling, call, fatigue, or coverage problems
• Your malpractice and credentialing setup clearly cover the work

When is it dangerous?

• The assignment contract expressly bars outside work
• The moonlighting site is a client, affiliate, or competitor named in the restriction
• You’re working through another agency in the same system
• Your call responsibilities or schedule commitments could be viewed as compromised
• You’re relying on verbal “it should be fine” instead of written approval

Verbal approval is worth exactly nothing when the contract says otherwise. I’ve seen physicians get frozen out of future placements over this. Not because patient care suffered. Not because they did anything unethical. Just because they assumed “extra shifts” were harmless.

How to Protect Yourself Before You Sign

This is the part where you stop being agreeable and start being precise.

Don’t ask, “Is this standard?” That’s a useless question. Ask what actually matters.

Use questions like these:

• What exactly am I restricted from doing?
• Which facilities or employers does this apply to?
• What geographic area is covered?
• How long does the restriction last after the assignment ends?
• Does this apply to telehealth?
• Does this apply to moonlighting, per diem work, or work through another recruiter?
• Does this only apply if I breach the contract, or even if the assignment ends normally?
• If the facility ends the assignment early, does the restriction still survive?
• Can I accept a direct job with the site later? If so, when and under what terms?
• Can this clause be narrowed in writing?

Then get the full contract. Not the summary. Not the recruiter’s explanation. Not the “don’t worry, I’ve never seen it enforced.” The contract.

Now compare every verbal promise to the actual language. If the recruiter says, “It only applies during the assignment,” but the clause says it survives for 12 months after termination, believe the clause. Always the clause.

Here’s my rule: if a restriction could block future income, it deserves redlines. Period.

What that might look like:

• Narrow the clause to one named facility
• Limit the restriction to the assignment term only
• Exclude telehealth explicitly
• Exclude unrelated moonlighting explicitly
• Strike vague references to affiliates, managed entities, and future clients
• Add language that the restriction does not apply if the company or facility terminates without cause
• Require that any outside-work approval be not unreasonably withheld and documented in writing

When should you bring in a physician contract attorney? Earlier than most people do. Especially if:

• The clause is vague
• The geography is broad
• The restriction survives after the assignment
• You’re considering a direct role with the site
• The moonlighting limitation affects a real side income stream
• The recruiter keeps paraphrasing instead of sending cleaner language

And yes, sometimes the right move is to walk away. A “great” locum job that quietly blocks your next three opportunities isn’t great. It’s expensive.

Quick self-check before signing:

• Can you explain the restriction in one sentence?
• Do you know exactly where it applies?
• Do you know exactly how long it lasts?
• Do you know whether telehealth and moonlighting are included?
• Do you have any exceptions in writing?

If the answer to any of those is no, stop. Don’t sign yet.

If You Already Signed: What to Do When You Suspect a Problem

First, don’t panic and don’t wing it. Guessing is how people turn manageable contract issues into ugly ones.

Do this in order:

1. Pull every document

   • Signed contract
   • Offer letter
   • Recruiter emails and texts
   • Any written approvals
   • Privileging or onboarding materials

2. Figure out the actual overlap

   • What dates are involved?
   • Is the assignment still active?
   • Is the moonlighting work in the same facility, same system, same geography, or same specialty line?
   • Did the clause survive termination?

3. Check whether you already have written permission

   • If yes, follow that permission exactly
   • If not, stop assuming verbal comments protect you

Then escalate calmly. Not emotionally. Not with threats.

A practical sequence:

• Ask your recruiter for clause-specific clarification in writing
• If needed, go to the recruiter’s manager
• Contact the staffing company’s legal or compliance team
• If facility rules are part of the problem, ask credentialing or medical staff services
• If there’s still real exposure, call your own contract attorney

Before you moonlight anyway, assess actual risk:

• Are you still within the restricted term?
• Is the work inside the named facility network?
• Does your state heavily restrict or disfavor physician non-competes?
• Is this a non-solicit issue, a direct-hire fee issue, or a true work restriction?
• Have you given any required notice?

If you want out, your options are usually straightforward:

• Negotiate a waiver
• Wait out the restriction
• Ask for a written carveout
• Challenge the clause as overbroad or unenforceable through counsel

Most of the time, this gets solved by paper and patience, not drama. But you need documentation. Clean, dated, written documentation.

The Bottom Line

If a recruiter brushes off a restriction, take that as your cue to read harder, not relax. The smile on the phone doesn’t matter. The clause does.

And moonlighting? It’s not automatically allowed just because you’re locum. Your contract, your privileges, the facility’s setup, and agency exclusivity language can all create separate landmines.

Your move is simple:

• Get every restriction in writing
• Ask for plain-English clarification
• Redline anything that threatens future income
• Don’t rely on verbal reassurance
• Bring in counsel before you make a side-work decision that could cost you the main contract

If you’re staring at a locum agreement right now and one paragraph is making your stomach tighten, listen to that feeling. Slow down. Mark it up. Ask the uncomfortable questions. That’s not being difficult. That’s being smart.