Unlocking Locum Tenens Opportunities in Family Medicine: A Guide

Understanding Locum Tenens in Family Medicine

Locum tenens—Latin for “to hold the place of”—refers to temporary physician assignments that fill staffing gaps in clinics, hospitals, and community health centers. For family medicine, these roles have become a major part of the workforce, offering flexibility, travel, and unique clinical experiences that differ substantially from a traditional full-time job.

Family medicine physicians are particularly well-suited to locum work. Their broad clinical training, comfort with all ages, and adaptability to different care settings make them among the most in-demand specialties for locum tenens assignments. Whether you are a resident planning life after the FM match, a new grad considering a “bridge year,” or an established physician seeking variety or semi-retirement, locum tenens can be an important part of your career strategy.

Key reasons family medicine locum tenens roles are in demand:

• Persistent primary care shortages in rural and underserved areas
• Rising use of urgent care, walk-in, and retail clinics
• Burnout and turnover among permanent staff physicians
• Maternity leave, medical leave, and sabbatical coverage
• Rapidly growing health systems using flexible staffing models

Understanding how locum tenens fits within family medicine is essential for making informed decisions about your career—especially if you’ve just completed or are about to complete a family medicine residency.

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Why Consider Locum Tenens After Family Medicine Residency?

Many physicians think of locum tenens late in their career, but it can be beneficial at almost any stage. For residents approaching the end of training—or those changing positions post-residency—it can be a powerful and strategic career tool.

1. A “Bridge” After the FM Match and Residency

After the FM match and completion of residency, many new graduates feel pressure to lock into a permanent job quickly. Locum tenens can serve as a valuable transition phase:

• Explore practice settings: Try rural vs. urban, outpatient-only vs. inpatient/outpatient, FQHCs vs. private groups, or integrated health systems.
• Clarify preferences: Gain real-world insight into your ideal patient population, call schedule, and clinic culture.
• Avoid early long-term contracts: Instead of signing a multi-year agreement you might regret, use locum assignments to test different models.

Example:
A new graduate who thought they wanted a purely outpatient, suburban job accepts a 3-month assignment in a rural critical access hospital with clinic plus inpatient rounding. They discover they enjoy hospital medicine, small-community relationships, and procedural work—information that significantly reshapes their permanent job search.

2. Financial Benefits and Debt Management

Locum tenens work can be financially competitive or even superior to some entry-level employed positions, depending on location and scope.

Typical financial advantages:

• Higher hourly rates compared to some salaried positions, particularly in high-need regions.
• Overtime potential if you pick up extra days or shifts.
• Housing and travel benefits commonly covered by the agency, decreasing out-of-pocket expenses.
• Short-term “locum pushes” to rapidly pay down credit card or high-interest debt, fund board review courses, or save for a down payment.

However, locum work usually means:

• You are 1099 (independent contractor) rather than W-2 employee.
• You must arrange your own benefits (health insurance, retirement, disability, etc.).
• You are responsible for quarterly estimated taxes and self-employment tax.

This trade-off can still be attractive—especially early in your career—if you plan appropriately.

3. Flexibility, Autonomy, and Control

Locum tenens is especially appealing if you value control over your schedule and work style.

You can:

• Choose when you work (seasonally, year-round, or intermittently).
• Decide where you practice (close to home or across the country).
• Control how much you work (full-time equivalent, partial FTE, or sporadically).
• Accept or decline assignments based on scope, EMR, call responsibilities, and compensation.

For physicians with family responsibilities, academic interests, or side projects (e.g., teaching, research, startup ventures), locum work can provide room to balance diverse priorities.

4. Professional Growth and Breadth of Experience

Family medicine locum tenens roles expose you to a wide range of practice styles and systems:

• Different EMRs and documentation workflows
• Variations in team-based models (APPs, care coordinators, behavioral health integration)
• Diverse patient populations (rural, immigrant communities, tribal health, academic settings)
• Varied procedures and scopes (OB vs. no OB, inpatient vs. outpatient, urgent care integration)

This breadth can build adaptability and resilience—skills that are attractive to future employers and valuable in leadership roles.

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Types of Locum Tenens Opportunities in Family Medicine

Family medicine physicians can choose from a surprisingly wide range of locum roles. Understanding the main categories will help you align opportunities with your long-term goals.

1. Outpatient Primary Care Locums

This is the most common type of family medicine locum tenens assignment.

Typical settings:

• Community-based primary care clinics
• Federally Qualified Health Centers (FQHCs)
• Rural health clinics
• Hospital-owned outpatient clinics
• Private practices in transition (e.g., covering a vacancy or maternity leave)

Scope of practice often includes:

• Acute and chronic disease management
• Preventive care and wellness visits
• Pediatric and adult care (newborn to geriatric)
• Basic in-office procedures (depending on clinic capabilities)
• Limited call or nurse triage backup (varies by site)

These assignments can be highly predictable and are often Monday–Friday with no or minimal weekend work.

Good fit for: New grads, physicians wanting schedule stability, and those focusing on outpatient procedural skills (joint injections, biopsies, women’s health).

2. Urgent Care and Walk-In Clinics

Urgent care has become a major employer of locum tenens family physicians.

Characteristics:

• High-volume, fast-paced environment
• Mostly episodic care: minor injuries, infections, simple lacerations, fractures, etc.
• Shift-based work (e.g., 8–12 hour shifts, often evenings/weekends)
• Frequent X-ray and minor procedure use
• Very limited continuity, primarily acute complaints

This type of locum work can offer higher hourly rates, but also more intense shifts and varied acuity.

Good fit for: Physicians who enjoy procedures, fast decision-making, and shift work; those wanting to avoid panel management and chronic care documentation.

3. Inpatient and Traditional FM Locums

In some regions, family medicine physicians still provide inpatient care, sometimes including ICU co-management.

Potential components:

• Daily inpatient rounding on your clinic patients
• Swing shift or night coverage in small hospitals
• Coverage for critical access hospitals where FM physicians act as hospitalists
• Occasional emergency department backup in very small facilities (with clear contractual boundaries)

Compensation for inpatient-inclusive roles is often higher, but the workload and responsibility are also greater.

Good fit for: FM physicians with inpatient training and comfort, especially those coming from residency programs with strong inpatient exposure.

4. OB-Integrated Family Medicine Locums

Some locum assignments require or welcome family physicians who do obstetrics.

• Rural hospitals and clinics that rely on FM-OB for maternity care
• FQHCs with integrated prenatal and obstetrics services
• Facilities seeking coverage for maternity leaves in OB-capable departments

These roles usually pay more due to the added responsibility and narrower candidate pool, but will require proof of recent OB experience and procedure logs.

Good fit for: Graduates from FM-OB tracks, rural-focused residencies, or those with recent, active labor and delivery experience.

5. Telemedicine Locum Tenens

Telehealth surged during and after the COVID-19 pandemic and remains an important area for locum tenens work.

Features:

• Remote clinical work from your home or office
• Video visits or phone calls for primary care, urgent care, or chronic disease follow-up
• Strict requirements for multistate licensing and telehealth documentation
• Often shift-based or visit-based compensation

Telemedicine can be used alone or combined with in-person locum work to add income, cover “off” days, or create a hybrid schedule.

6. Locum Tenens as a Travel Physician Job

Many family physicians use locum tenens as their version of travel physician jobs—choosing assignments specifically for geographic and lifestyle appeal:

• Seasonal coastal or mountain towns
• National parks gateway communities
• Alaska, Hawaii, or U.S. territories
• Tribal health or Indian Health Service sites
• Remote Northern or frontier communities

In these roles, the travel component is part of the attraction. You may work intensively for a stretch (e.g., 3–4 months), then take time off to explore before your next assignment.

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How to Start a Locum Tenens Career in Family Medicine

Transitioning into locum tenens takes planning, but the process is manageable if you approach it step-by-step.

1. Clarify Your Goals and Non-Negotiables

Before contacting agencies or searching postings, outline your priorities:

• Timeline: When are you available? Immediately after graduation? In six months?
• Location flexibility: Will you consider multiple states, or only one region?
• Practice scope: Outpatient only? OK with inpatient? OB? Urgent care?
• Schedule needs: Consecutive blocks vs. sporadic shifts, nights/weekends preferences
• Income targets: Monthly or yearly income goals; tolerance for unpaid downtime

Having a clear self-assessment helps recruiters match you with the right assignments and protects you from accepting a role that doesn’t fit.

2. Understand Credentialing and Licensing Timelines

Locum assignments require:

• An active, unrestricted medical license in the state of practice
• DEA registration, often with appropriate state-level controlled substance registration
• Board certification or eligibility in family medicine (highly preferred or required)
• Hospital privileges (if inpatient or hospital-based)
• Payer enrollment (for longer outpatient roles)

Timelines to expect:

• State license: 2–6 months, depending on the state (some are faster for compact states if you hold an IMLC-qualifying license).
• Hospital credentialing: Typically 60–120 days.
• Agency onboarding: 1–4 weeks, once documents are ready.

If you plan to rely heavily on locum tenens, consider:

• Applying for licensure in several states strategically (e.g., a mix of high-demand and compact states).
• Maintaining clean and complete documentation (case logs, procedure lists, CME, immunization records).

3. Selecting Locum Tenens Agencies

Most locum tenens physicians work with one or more staffing agencies. When evaluating agencies, consider:

• Experience with family medicine: Are they strong in outpatient, inpatient, or urgent care?
• Geographic reach: Do they have opportunities where you want to work?
• Support services: Licensing assistance, credentialing help, travel coordination, malpractice coverage.
• Communication quality: Responsiveness, transparency about compensation, and honest description of sites.
• Reputation: Talk to current locum physicians, check online reviews, and ask your faculty or mentors.

You are not obligated to work with just one agency; many physicians register with several but eventually develop 1–2 “primary” relationships with agencies that fit them best.

4. Understanding Contracts, Pay, and Benefits

Locum tenens assignments are typically based on a contract specifying:

• Hourly or per diem rate (sometimes per shift or per patient)
• Guaranteed minimum hours or shifts per pay period
• Call responsibilities and compensation
• Housing and travel arrangements (and whether you can self-book with reimbursement)
• Malpractice coverage type (claims-made vs. occurrence; tail coverage details)
• Duration of assignment and options to extend

Key points to negotiate or clarify:

• What happens if the facility cancels shifts or ends the assignment early?
• Is orientation time paid?
• Are there penalties if you need to leave before the contract end date?
• What is the policy regarding charting time after shifts, overtime, or double-booking?

Because you’ll be working as a 1099 contractor with most agencies:

• Consult a tax professional early.
• Consider forming an LLC or S-corp if advised by your accountant.
• Set aside 25–35% of your income for taxes until you have a precise estimate.

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Practical Tips for Thriving as a Family Medicine Locum Tenens Physician

Once you’ve started taking assignments, your effectiveness and satisfaction will depend heavily on how you prepare and manage your work.

1. Prepare a “Locum Toolkit”

Keep an organized digital and physical toolkit that can travel with you:

• Updated CV with detailed chronology
• Copies of medical license(s), DEA, board certification, immunizations, BLS/ACLS/PALS/NRP as applicable
• Procedure logs (if doing OB or inpatient)
• Professional references with contact information
• Scanned identity documents (passport, driver’s license)
• Templates for letters of explanation (e.g., for any gaps or malpractice claims)

Clinically, consider:

• A compact reference (or apps) for local prescribing guidelines and formularies
• Personal stethoscope and any favored diagnostic tools
• A checklist of key questions for orientation (EMR, order sets, referral patterns, call procedures)

2. Master Quick Integration Into New Systems

Every new site will have its own medical record system, protocols, and culture. Efficiently “plugging in” is one of the core skills of a good locum tenens physician.

During orientation and your first few days:

• Ask for EMR shortcuts, templates, and order sets relevant to family medicine.
• Identify key support staff: lead nurse/MA, clinic manager, front desk supervisor, IT support.
• Clarify clinic flow: average patient volume, visit lengths, same-day add-ons, double-booking policies.
• Understand referral networks: local specialists, imaging centers, behavioral health resources.
• Learn emergency protocols: what to do for chest pain in the clinic, code procedures, after-hours plans.

Taking notes early can save hours later and improve patient safety.

3. Protect Your Time and Boundaries

Because you’re often being brought in to fill gaps, there can be pressure—subtle or explicit—to see more patients, stay late regularly, or absorb administrative work.

To manage this:

• Confirm target patient load before you arrive (e.g., 18–22 per day for standard outpatient; more for certain urgent cares).
• Be transparent with the scheduler if volumes become unsafe for quality care or documentation.
• Clarify whether you are expected to manage inboxes, refill requests, or only patients you see.
• Know your contractual rights regarding hours worked and maximum daily volume.

You’re there to provide high-quality coverage, not to silently accept unsustainable workloads.

4. Maintain Continuity of Care Ethically

One common concern among family medicine physicians is that locum tenens might compromise continuity. While you can’t replace a longitudinal relationship in a short stint, you can still contribute meaningfully:

• Document clearly and thoroughly so permanent staff can easily follow your plan.
• Use problem lists and health maintenance tools consistently.
• Close the loop on critical follow-ups (e.g., flagging urgent referrals, arranging close follow-up).
• Communicate with local PCPs or clinic leads for complex patients or unusual dispositions.

Done well, locum coverage can actually support continuity by preventing service gaps and overload on existing physicians.

5. Build a Sustainable Lifestyle Around Locum Work

Locum tenens can be exciting but disruptive if not structured thoughtfully.

Practical lifestyle considerations:

• Home base stability: Do you maintain a permanent residence? How often will you be away?
• Partner/family involvement: Discuss travel frequency, communication plans, and possible family travel with you on longer assignments.
• Financial planning: Smooth out variable income with budgeting, emergency funds, and automatic savings.
• Professional development: Plan for CME, board recertification, and skills maintenance (especially if doing inpatient or OB).
• Burnout prevention: Use the flexibility of locum work to schedule true downtime between assignments.

Many locum tenens physicians report high satisfaction when they intentionally design both their work and non-work life.

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Locum Tenens and Long-Term Career Strategy in Family Medicine

Locum tenens does not have to be “all or nothing.” You can integrate locum work at multiple points in your career:

1. Early Career: Exploration and Flexibility

After the family medicine residency and FM match era, a few years of locum tenens can help you:

• Clarify ideal practice settings and geographies
• Accelerate loan repayment with focused work blocks
• Gain confidence and independence in diverse clinical environments

Some physicians shift from locums into a permanent job once they discover the right setting—sometimes at a site where they previously worked on assignment.

2. Mid-Career: Strategic Transitions and “Side Gigs”

During mid-career, locum tenens can:

• Bridge gaps between permanent jobs (e.g., after leaving a position or during relocation).
• Supplement income intermittently (weekend urgent care, telehealth shifts).
• Offer a “sabbatical with income” by mixing travel physician jobs with personal travel or academic pursuits.

You can maintain your primary practice while doing limited locum work, as long as conflict-of-interest and non-compete clauses are respected.

3. Late Career: Phased Retirement and Mission-Driven Work

For senior family medicine physicians, locum tenens offers a way to:

• Reduce hours gradually without fully retiring.
• Focus on meaningful assignments in underserved or rural areas.
• Avoid long-term administrative burdens while still practicing clinically.

Many experienced physicians find locum work refreshing after years of panel management and administrative responsibilities.

4. Building a Professional Brand as a Locum Tenens Physician

Over time, you can cultivate a reputation as a reliable, high-quality locum tenens physician:

• Consistently show up prepared and on time.
• Communicate clearly with permanent staff and leadership.
• Be flexible within safe and reasonable bounds.
• Ask for feedback and maintain good relationships with recruiters and medical directors.

This reputation leads to better offers, repeat assignments at desirable locations, and more negotiating power.

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Frequently Asked Questions (FAQ)

1. Can I do locum tenens work immediately after finishing family medicine residency?

Yes. Many new FM graduates begin locum work right after training, especially if they are board-eligible and licensed. However, you’ll need to plan ahead:

• Start state medical license applications during your final year of residency.
• Have your documentation (CV, references, procedure logs) organized before graduation.
• Coordinate with agencies early so credentialing can begin as soon as possible.

2. Is locum tenens work stable enough to be my primary income source?

It can be, especially in high-demand specialties like family medicine. Many physicians work full-time as locum tenens, but you must be comfortable with:

• Occasional gaps between assignments
• Travel and relocation for certain positions
• Variable income month-to-month

Building relationships with multiple agencies, holding multiple state licenses, and maintaining financial reserves all improve stability.

3. How does malpractice coverage work for locum tenens physicians?

Most reputable locum agencies provide malpractice insurance for assignments they arrange, usually with:

• Coverage from the first day of the assignment
• Defined policy limits and scope
• Either claims-made or occurrence-based coverage

If coverage is claims-made, clarify who is responsible for tail coverage after the assignment ends. In some cases, the agency covers this; in others, you might be advised to carry a personal policy or negotiate tail provisions in writing.

4. Can locum tenens experience hurt my chances of getting a permanent job later?

Generally, no. If anything, it can be advantageous, provided you:

• Show a coherent narrative: learning different systems, clarifying career goals, or serving underserved areas.
• Maintain continuity of employment with minimal unexplained gaps.
• Obtain strong references from medical directors or colleagues at your locum sites.

When applying for permanent roles, frame your locum work as a period of deliberate exploration and growth, highlighting the skills and perspective you bring from working across different settings.

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Locum tenens work in family medicine can be far more than a temporary fix; it can be a deliberate, flexible, and rewarding career path. Whether you’re fresh out of residency or rethinking your mid-career trajectory, understanding how to leverage locum tenens opportunities—financially, professionally, and personally—empowers you to design a career that fits your life, not the other way around.