Unlocking Locum Tenens Opportunities in PM&R: A Comprehensive Guide

Understanding Locum Tenens in Physical Medicine & Rehabilitation

Locum tenens work—temporary physician coverage for hospitals, rehab facilities, and clinics—has become an increasingly important part of the healthcare landscape. For those in Physical Medicine & Rehabilitation (PM&R), also known as physiatry, locum tenens roles offer a unique blend of clinical variety, geographic flexibility, and income potential.

Whether you are a resident preparing for the physiatry match, a newly graduated attending exploring options, or a mid-career physiatrist seeking a change, understanding locum opportunities is crucial for informed career planning. This guide walks through the structure of locum work in PM&R, types of opportunities, compensation models, lifestyle implications, and how to position yourself competitively.

We will also touch on how a locum tenens path can complement or transition into full-time roles, including travel physician jobs and hybrid practice models.

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Why PM&R Is Exceptionally Well-Suited to Locum Tenens

PM&R is uniquely positioned for locum opportunities because of its versatility, cross-setting applicability, and rising demand.

1. Diverse Practice Settings Needing Coverage

Physiatrists practice across a wide continuum of care, which translates directly into diverse locum tenens gigs:

• Inpatient Rehabilitation Facilities (IRFs)

  • Medical director roles
  • Attending of record for 10–25 inpatients
  • Weekend call-only coverage
  • Acute rehab consult services within hospitals

• Skilled Nursing Facilities (SNFs) & Subacute Rehab

  • Rounding on post-acute patients
  • Managing pain, mobility, spasticity, and discharge planning
  • Locum cover for vacation, maternity leave, or staffing transitions

• Outpatient Clinics

  • General physiatry (spine, musculoskeletal, chronic pain)
  • EMG/NCV labs
  • Interventional spine and pain procedures
  • Spasticity management (Botox, phenol, pump management)
  • Sports medicine or work comp clinics

• Academic & Specialty Centers

  • Traumatic brain injury (TBI) and spinal cord injury (SCI) units
  • Cancer rehab, cardiac rehab, or transplant rehab programs
  • Positioning and seating clinics

Because each of these settings can face short-term staffing needs, the PM&R locum market spans both inpatient and outpatient environments—and often allows you to tailor your assignments to your preferred scope of practice.

2. Growing Demand and Workforce Gaps

Several trends drive the demand for locum tenens physiatry:

• Aging population and higher rates of stroke, joint replacement, and chronic neuromuscular disease
• Expansion of IRFs and post-acute networks
• Under-supply of residency graduates relative to national needs
• Burnout and turnover among hospital-employed physiatrists

Healthcare systems increasingly rely on locum tenens physicians to bridge gaps, especially in regions where recruitment is challenging. This creates leverage for PM&R providers seeking competitive pay, flexible schedules, and travel physician jobs that fit their career goals.

3. Lifestyle and Career Fit

PM&R physicians often value:

• Stable hours compared to many other specialties
• Longitudinal relationships with patients
• Multidisciplinary team collaboration
• A focus on function and quality of life

Locum work can enhance these baseline advantages:

• Control over your schedule: Choose when and where you work
• Geographic flexibility: Explore new cities, coasts, or rural communities
• Varied clinical exposure: Different rehab models, patient populations, and systems
• Income optimization: Target higher-paying short-term assignments during key life phases

For many, the combination of physiatry’s lifestyle plus locum freedom is particularly attractive during transitions—post-residency, between full-time jobs, or when relocating with a partner.

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Types of PM&R Locum Tenens Assignments

Not all PM&R locum roles are created equal. Understanding assignment types helps you decide which fit your skills, risk tolerance, and long-term plans.

1. Inpatient Rehabilitation Coverage

Typical settings:

• Free-standing IRFs
• Hospital-based rehabilitation units
• Large hospital systems with acute rehab consult services

Common responsibilities:

• Daily rounding on a panel of 10–20 patients
• Admission and discharge assessments
• Coordination with PT/OT/SLP, case management, and nursing
• Management of medical comorbidities (often co-managed with hospitalists)
• Team conferences and family meetings
• Occasional on-call coverage for admissions or urgent issues

Who this fits best:

• Physiatrists with strong inpatient training or recent residency graduates comfortable with acute rehab
• Those who enjoy interdisciplinary work, stroke/TBI/SCI management, and system-level care

Pros:

• Predictable routines; less procedural pressure
• Often high day-rate compensation
• Strong continuity over several weeks or months

Potential challenges:

• Documentation requirements can be heavy (e.g., CMS rehab rules)
• Need to adapt to local rehab admission criteria and documentation templates quickly
• On-call responsibilities may extend beyond business hours

2. Subacute & SNF-Based Rehab

Typical settings:

• Skilled nursing facilities
• Long-term care facilities with rehab components
• Post-acute networks linked to hospital systems

Common responsibilities:

• Weekly or biweekly rounding on a panel of post-acute patients
• Evaluations for weakness, debility, contractures, chronic pain, and spasticity
• Goals-of-care conversations, discharge planning, and coordination with PCPs

Pros:

• Often less intense daily pace
• Good for building experience in post-acute transitions and geriatric rehab
• Can be a stepping stone to long-term medical director roles

Potential challenges:

• Variability in resources, staffing, and documentation support
• Some facilities expect extensive non-billable administrative work
• Potentially lower pay versus IRF or interventional outpatient work

3. Outpatient General PM&R & EMG

Typical settings:

• Private practices
• Hospital-based outpatient rehab clinics
• EMG labs and neuromuscular clinics

Common responsibilities:

• Evaluations for back and neck pain, radiculopathy, peripheral neuropathy, myopathy
• EMG/NCS studies and interpretation
• Mobility assessments, bracing, orthotics, and spasticity management
• Non-procedural pain and MSK management

Pros:

• Daytime hours with minimal call
• High demand for EMG-trained physiatrists
• Steady clinic-based work that can be extended if both parties are satisfied

Potential challenges:

• Need to quickly adapt to new EHR and EMG equipment
• Productivity pressures in some private practice environments
• Documentation intensity tied to complex neuromuscular evaluations

4. Interventional Spine & Pain Locum Roles

Typical settings:

• Outpatient spine and pain clinics
• Hospital-based procedure suites
• Ambulatory surgery centers

Common procedures:

• Epidural steroid injections (cervical, thoracic, lumbar)
• Facet blocks and medial branch blocks
• Radiofrequency ablation
• Sacroiliac joint injections
• Peripheral joint injections and advanced ultrasound-guided procedures

Pros:

• Among the highest-compensated PM&R locum roles
• Procedure-focused work with less rounding or call
• Often structured as a block of procedure days with optional clinic

Potential challenges:

• Credentialing and privileging can be more complex
• Malpractice coverage specifics for procedures must be carefully reviewed
• Need to be fully comfortable with standards of safety and fluoroscopic techniques in unfamiliar environments

5. Hybrid & Travel Physician Jobs in PM&R

Some assignments mix inpatient and outpatient responsibilities, or are part of ongoing regional travel physician jobs. For example:

• Covering IRF in city A two weeks per month, then outpatient EMG in city B
• Rotating between multiple facilities in a health system that uses you as a “regional floater”

This model can provide:

• Steady, near-full-time income with built-in variety
• Frequent flyer miles and hotel points
• An opportunity to “try out” different markets before settling down

However, it requires a genuine tolerance for frequent travel, new teams, and continuous onboarding.

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Getting Started: Pathways into Locum Work for PM&R Physicians

1. Timing: Residents, New Grads, and Established Attendings

Residents & Fellows:

• You cannot practice independently until licensed and board-eligible/board-certified, but:
  • Use your final year to learn about locum tenens options
  • Attend recruiter sessions and talk to faculty who do locums or moonlighting
  • Understand which skills (e.g., EMG, spasticity, interventional) are highly marketable

New Attendings:

• After the physiatry match and completion of residency, many physiatrists:

  • Work full-time and do occasional locum work on vacations or between jobs
  • Or start directly with locum tenens roles to explore regions and practice types

• Locum work can also help supplement income while paying down loans.

Mid/Late-Career Physicians:

• Locums can be a bridge between jobs, a gradual step-down to partial retirement, or a way to shift focus (inpatient → outpatient, or vice versa) without committing long-term.

2. Working with Locum Tenens Agencies

Most PM&R locum tenens positions are brokered through staffing agencies. A structured approach helps you get the best fit:

How to choose an agency:

• Ask whether they have a dedicated PM&R or physiatry recruiter
• Request data on:
  • Typical day rates for inpatient rehab in your regions of interest
  • EMG or interventional spine assignments
  • Average assignment length and extension rates
• Talk to other physiatrists about their experiences with specific agencies

Questions to ask a recruiter:

• What is the actual patient volume and mix?
• Who handles admission orders—hospitalist vs physiatrist?
• What is the call schedule and call compensation?
• Is travel and lodging fully covered? Per diem or direct booking?
• Does the agency provide malpractice (claims-made vs occurrence; tail coverage)?

Red flags:

• Vague answers about workload or call
• Pressure to sign quickly without full details
• Contracts that penalize you heavily for cancellation due to legitimate reasons

3. Credentialing, Licensing, and Logistics

To function effectively as a locum tenens physician, you’ll need to manage several administrative pieces:

• State medical licenses:

  • High-yield states: those with many IRFs and large post-acute networks (e.g., TX, FL, CA, NY, PA).
  • Consider the Interstate Medical Licensure Compact if eligible.

• Hospital credentialing:

  • Can take 60–120 days; start early.
  • Maintain a digital portfolio with:
    • CV, diplomas, board certs
    • Procedure logs (for interventional work)
    • CME certificates, immunization records, BLS/ACLS

• Malpractice insurance:

  • Many agencies provide coverage, but confirm:
    • Limits (often $1M/$3M)
    • Claims-made vs occurrence
    • Tail coverage if you later face a claim

• Travel arrangements:

  • Some agencies book flights/hotels directly; others reimburse
  • Clarify rules for rental cars, mileage, and incidentals
  • Keep organized records for tax deduction purposes (if you are 1099)

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Compensation, Contracts, and Financial Strategy

One of the most common motivations for locum work is financial, but the details matter. Understanding how PM&R locum tenens assignments are structured helps you avoid surprises and negotiate effectively.

1. Compensation Structures in PM&R Locums

Typical models include:

• Daily rate (flat):

  • Example: $900–$1,400/day for inpatient rehab, depending on region and volume
  • May include a certain patient cap and expectations about call

• Hourly rate:

  • More common for call-only or part-day coverage
  • You may see rates in the $120–$200/hour range, with variation based on demand

• Per-procedure rates (for interventional or EMG):

  • Base hourly or daily minimum + per-case bonuses
  • EMG labs may pay per study or per day with volume expectations

• Blended models:

  • A fixed daily rate plus RVU-based incentives or bonuses for exceeding a certain volume

2. What’s Typically Covered

• Travel expenses:

  • Round-trip airfare or mileage reimbursement
  • Rental car or rideshare coverage
  • Lodging (hotel or extended-stay accommodations)

• Licensing and credentialing costs:

  • Many agencies cover state license fees when needed for an assignment
  • Some will reimburse DEA registration if required

• Malpractice insurance:

  • Usually included, but confirm coverage scope and tail provisions

3. Reading and Negotiating Contracts

Before signing any locum tenens agreement, pay close attention to:

• Cancellation terms:

  • What if the facility cancels the assignment a month before start?
  • Is there a guaranteed minimum number of weeks or a cancellation fee?
  • What if you must cancel due to illness or family emergency?

• Non-compete clauses:

  • Some contracts restrict you from taking a permanent job at the facility within a defined timeframe without going through the agency
  • Consider whether this affects your long-term plans in that region

• Scope of practice and expectations:

  • Clearly outline:
    • Patient volume cap
    • Call responsibilities and compensation
    • Weekend coverage expectations
    • Whether you must manage medical comorbidities or share with hospitalists/PCPs

• Payment terms:

  • Are you paid as a W-2 employee of the agency or 1099 independent contractor?
  • Payment frequency (weekly, bi-weekly, monthly)
  • Method (direct deposit vs check)

4. Financial Planning as a Locum Tenens Physiatrist

Particularly if you are 1099:

• Tax planning:

  • Set aside a portion (often 25–35%) of each paycheck for taxes
  • Consider working with a CPA familiar with locum tenens physicians
  • Track all deductible expenses: work-related travel not reimbursed, licensure, CME, home office costs

• Retirement accounts:

  • Without a traditional employer 401(k), consider:
    • Solo 401(k)
    • SEP IRA
    • Backdoor Roth IRAs (depending on income)

• Insurance beyond malpractice:

  • Health insurance (via ACA marketplace, spouse’s plan, or private)
  • Disability and life insurance—critical if you’re independent

Strategic planning allows locum tenens income to be a powerful tool for debt repayment, building savings, and funding future flexibility.

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Lifestyle Implications, Pros and Cons, and Long-Term Career Strategy

Locum tenens in PM&R offers significant upside, but it’s not ideal for everyone. Understanding the trade-offs helps you determine whether it fits your current phase of life and career goals.

1. Advantages of Locum Tenens PM&R Work

• Maximum flexibility:

  • Choose your assignments, durations, and downtime between jobs
  • Take extended breaks for travel, family, research, or personal projects

• Clinical variety and growth:

  • Experience multiple practice models and patient populations
  • Learn different EMR systems, rehab program structures, and team cultures
  • Accelerate your learning curve early in your career

• Income potential:

  • Higher effective hourly/day rates than many staff positions, especially in underserved markets
  • Ability to stack assignments or pick up extra weeks during high-demand periods

• Test-driving locations and roles:

  • Try out regions before committing to a permanent move
  • See whether you prefer inpatient vs outpatient, academic vs private, urban vs rural
  • Some locum roles convert into permanent offers (locum-to-perm)

2. Challenges and How to Mitigate Them

• Lack of stability and roots:

  • Constantly changing teams and systems
  • Harder to build long-term continuity with patients

  Mitigation:

  • If you value some continuity, aim for longer assignments (3–6 months)
  • Consider recurring locum roles at the same facility several times a year

• Travel fatigue:

  • Frequent flights, different hotel beds, and time away from home

  Mitigation:

  • Favor assignments within driving distance or direct-flight routes
  • Negotiate for predictable schedules that allow return home on weekends

• Benefits gaps:

  • No employer-sponsored retirement plan or health insurance (if 1099)
  • No paid vacation or sick time

  Mitigation:

  • Price these costs into your rate negotiations
  • Work with financial advisors to build your own benefits package

• Professional isolation:

  • Less involvement in long-term projects, research, or academic mentoring
  • Fewer leadership opportunities in a single system

  Mitigation:

  • Maintain professional memberships, attend conferences, and network
  • Consider combining locum work with part-time academic or telemedicine roles

3. Integrating Locum Work into a Long-Term PM&R Career

Locum tenens does not have to be “all or nothing.” Many physiatrists use it strategically:

• Immediately post-residency:

  • Use 6–24 months of locum work to:
    • Explore IRF vs outpatient vs interventional
    • Pay down debt aggressively
    • Identify preferred regions and practice cultures

• Mid-career:

  • Combine a part-time permanent role with several locum assignments yearly
  • Use locum work to maintain certain skills (e.g., EMG) if your home job is narrow

• Pre-retirement:

  • Gradually scale back full-time work and fill in with occasional locums
  • Focus on low-intensity, enjoyable assignments (e.g., SNF consults or outpatient MSK)

In short, PM&R locum tenens roles can be a flexible tool to design a career that evolves with your life circumstances—whether your goal is maximizing autonomy, income, geographic freedom, or all of the above.

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FAQs About Locum Tenens in Physical Medicine & Rehabilitation

1. Can I do locum tenens work as a PM&R resident?

You generally cannot independently practice as a locum tenens physician until you are fully licensed and have completed training. However, during residency you can:

• Moonlight internally within your training institution (if allowed)
• Prepare for future locum work by:
  • Gaining strong inpatient rehab, EMG, and interventional skills
  • Understanding documentation requirements for IRFs and SNFs
  • Talking with attendings who currently do locum or travel physician jobs

Once you graduate and obtain a state license and board eligibility/certification, you can begin taking locum assignments.

2. Is locum tenens experience viewed negatively when applying for permanent PM&R jobs?

In most cases, no. Many employers view locum tenens experience positively, especially if you:

• Can demonstrate reliability (completed full contracts, earned strong references)
• Bring exposure to multiple rehab systems and best practices
• Maintain a clear narrative: e.g., “I used locum work to explore IRF vs outpatient settings before committing long-term.”

However, frequent very short assignments with gaps and no clear story may raise questions. Be ready to explain your choices in a coherent way on your CV and during interviews.

3. How does locum tenens income compare with a typical PM&R salary?

In many markets, PM&R locum tenens physicians can earn:

• Higher effective daily or hourly rates than comparable employed positions, particularly with interventional skills or in high-need regions
• However, you must factor in:
  • Lack of employer-paid benefits (health insurance, retirement match)
  • Unpaid time off between assignments
  • Self-employment taxes if working as a 1099 contractor

A well-structured locum career can still be financially advantageous, especially in your early or flexible years, but detailed budgeting and tax planning are essential.

4. Can locum tenens roles convert into permanent PM&R positions?

Yes. Many facilities use locum tenens coverage as a bridge while recruiting full-time physiatrists. If you enjoy a specific site, you can:

• Express interest in a permanent role to both the facility and the agency
• Negotiate terms that reflect the value you’ve already provided
• Be aware of any “conversion clauses” in your locum contract (some require the facility to pay the agency a fee if they hire you)

This locum-to-perm path is common and can be an excellent way to “test drive” a position before committing.

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Locum tenens opportunities in Physical Medicine & Rehabilitation can be a powerful way to shape a career around your priorities—whether that’s flexibility, income, travel, or exploring different models of care. By understanding the range of PM&R residency training outcomes, how the physiatry match sets you up for this path, the nuances of contracts and compensation, and the realities of locum work, you can make informed decisions and build a sustainable, rewarding life in physiatry.