Locum tenens can be a great option for physicians looking to supplement their income, apply their skills in new settings, or explore alternative career paths. An estimated one-third of physicians are currently working locum tenens or have done so in the past, yet many physicians may not be fully aware of the opportunities available through locums. Read on for your primer on locum tenens.
Quiz: Is locums right for you?
What is locum tenens?
Think of locum tenens physicians as medicine’s substitute teachers. From the Latin phrase meaning “to hold the place of,” a locum tenens provider is a physician who fills in temporarily for another. What began in the 1970s with the purpose of providing physician staffing services to medically underserved areas of the western United States has expanded to a thriving industry and an important option for healthcare facilities nationwide to maintain coverage, fill staffing gaps, and expand specialty offerings.
What are the pros and cons of working locum tenens?
Higher pay but no employer-sponsored benefits
Many physicians say one of the top benefits of locum tenens is the higher hourly or daily pay. However, working as a 1099 independent contractor requires additional work, including handling your own withholding and filing quarterly taxes. The downside is that you need to arrange for your own health, dental, and supplemental insurance and manage your own retirement contributions, benefits often provided by an employer.
How much does locum tenens pay? Check your specialty
Emergency medicine physician Dr. Russ Reinbolt says: “There are pluses and minuses, but I would say on par, locums is better from a financial standpoint, definitely from a lifestyle standpoint, and, in my opinion, a practice setting standpoint. You’re typically paid more—significantly more—but from that, you have to pay things yourself. I think the positives far outweigh the negatives of being a locum doc. For me, it’s a no-brainer.”
Orthopedic surgeon Dr. Sonya Sloan: “I would definitely recommend being on top of your taxes because you’re a 1099 employee. I wish someone had explained taxes and finances to me the first three years, when I made quite a bit of money and paid a lot of taxes.”
More flexible but less predictable
A locum physician can choose where, when, and even how often they work. The flexibility of locums gives you more control over your schedule and supports a better work-life balance, but it also lacks the predictability of a traditional career.
ENT Dr. Benjamin Feldman: “One of the beautiful parts about locums is that it does facilitate a very nice work-life balance because you can have a lot more autonomy over your schedule. In other words, if you know in advance that your spouse has a busy month at work and you need to be more available, you can engineer your schedule that way with maximum flexibility.”
Family medicine physician Dr. Harshal Patel: “The hard part about flexibility is just the irregularity of income. That’s the most challenging.”
Broader experience but fewer career advancement opportunities
A locum physician has the advantage of broadening and diversifying their skill set by working with different patient populations, varied clinical approaches, and new technologies. There is a steeper learning curve with locums that supports clinical growth. However, if you choose locum tenens as a full-time career, the trade-off is that there are fewer opportunities for career advancement within an organization.
Orthopedic surgeon Dr. Nicholas Kusnezov says locums offers the potential to selectively diversify and control the scope of practice, increasing professional experience and skill set—whereas staying with one employer can confine a surgeon to a narrow niche. “Medicine is a dynamic, ever-changing field that is advancing at an accelerated pace,” he adds, noting locums keeps physicians sharp and up to date.
OB-GYN Dr. Derrick Barnes adds: “The classical and traditional way of practicing medicine isn’t the way everyone does it. You can get refreshed by changing your environment and seeing how other people practice.”
Less bureaucracy but limited influence
A locum physician does not have to attend meetings, perform as many administrative tasks, or deal with bureaucracy—which can be a huge help in reducing burnout—but that also means they have little say in decision-making and can feel like an outsider.
Anesthesiologist Dr. Noel Lumpkin: “One of the problems in medicine these days is that the majority of our jobs are no longer in medicine itself… With locum tenens, I always joke that I haven’t been to a meeting in over 11 years, and I haven’t missed that one bit.”
General surgeon Dr. Jon Bowersox: “The positive is that you don’t get involved in hospital politics. The negative is that you’re not fully part of the team at the hospital.”
Serving where needed but fewer long-term patient relationships
Locums offers physicians the opportunity to serve in underserved communities, which can be rewarding and fulfilling. However, many miss the long-term patient relationships, though some take ongoing assignments that last for years.
Emergency medicine physician Dr. Rip Patel describes rural patients as “immensely grateful that somebody would leave their home and their big city to come to their rural community to help them.”
Pediatrician Dr. Trevor Cabrera: “I’ve gotten to know patients, and then it’s hard to leave, to be someone that’s just a temporary person. You make relationships, and if you’re doing it purposefully, you’re going to care about people.”
Locum tenens can work at all stages of a physician’s career
Neurologist Dr. Andrew Wilner, author of The Locum Life: A Physician’s Guide to Locum Tenens, speaks to the opportunities available to physicians at each stage of their career.
Early career physicians
“Physicians just out of residency have discovered locum tenens is a great way to test out different facilities in new geographic locations. A new attending physician’s priorities are different than seasoned physicians. They want to refine clinical skills, quickly pay off student loans, and take the time to scrutinize employment options before signing a long-term contract—all of which can be accomplished with locum tenens.” — Dr. Andrew Wilner
Finishing up residency? Explore your options
Mid-career physicians
“Mid-career physicians often employ locums to augment their income. There may be life circumstances that destabilize a household budget—new home, student debt, children—but working locums can help restore financial balance when cash flows out faster than it trickles in. More and more mid-career physicians wishing to leave medicine are exploring non-clinical careers. Locums can be a bridge to a non-clinical job by providing an income stream until the new venture takes off.” — Dr. Andrew Wilner
Late-career physicians
“At this stage of my career, I feel I’m able to preserve my physician identity by working locums if I decide to leave my full-time academic position. Locum tenens is also great for physicians who just aren’t ready to fully retire. Patients and facilities alike will also benefit from skilled, experienced physicians, and you’ll be able to continue doing what you love.” — Dr. Andrew Wilner
Reasons to work locum tenens
According to CHG’s 2025 State of Locum Tenens Report, the top 10 reasons physicians work locums are:
- Focus more on quality patient care.
- Earn extra income.
- More schedule control and flexibility.
- Bridge career gaps.
- Keep clinical skills sharp.
- Try out different facility and practice types.
- Take a work vacation or sabbatical.
- Make a difference where care is needed.
- Avoid overwork and burnout.
- Transition into retirement.
Ways to work locums
Locum tenens is often thought of as traveling all over the country from one assignment to another, but this isn’t always the case. Locum assignments can be as short as a weekend and as close as your own town. While many physicians work locum tenens as their full-time career, 47% work locums on the side or for brief periods during transitions. Common formats include full-time travel assignments, local locums or telehealth on the side, a temporary career transition, a working vacation, or a sabbatical in another country.
Interested in telehealth? Read the locums guide
International locum tenens
For the adventure-seeker, international locums assignments can be a great way to experience another country and culture while providing needed care.
Emergency medicine physician Dr. Joseph Leary: “For me, it wasn’t about the money. It was an opportunity to expand, broaden my horizons, and connect with physicians from other countries.”
The logistics of working locum tenens
Locum tenens doctors work as independent contractors
As independent contractors, all expenses related to taxes, insurance, and retirement are assumed by the provider. Taxes are not automatically taken out of compensation, and providers are responsible for quarterly estimated income tax payments.
Learn the difference: W-2 vs. 1099 for locums
Neurologist Dr. Simrah Singh: “I looked at it as an opportunity to learn. As far as health insurance, you can go on the healthcare marketplace and buy health insurance yourself… it’s really not hard. It just takes a little more time. I also use an accountant and just have them do it for me.”
Locum taxes deep dive: A locum physician’s tax guide
Locum tenens pay
Like any profession, there are many variables that influence locum tenens pay: specialty, location, season, shift type, and patient load. An agency can help negotiate pay, shift preferences, housing, and per diem allowance. In addition to hourly or daily rate, agencies generally cover additional expenses such as housing, transportation, medical malpractice insurance, and costs associated with licensing, credentialing, and privileging.
Get all the details: How does locum tenens pay work for physicians?
Licensing, credentialing, and privileging
To work a locum assignment, physicians must be licensed in the state of practice, credentialed with the health system, and privileged with the facility. Most agencies provide robust support to make the credentialing process easier.
Using a locum tenens agency
While providers can research and secure locum tenens positions on their own, experienced locums emphasize the benefits of working with an agency, especially when starting out or working part time.
Emergency medicine physician Dr. Rip Patel: “If you’ll end up working locums part time, I would say working with an agency is nice because they make sure everything is set up on time, such as travel and housing arrangements.”
Pro tip: Referral programs include CompHealth’s referral program and Weatherby Healthcare’s referral program.
Tips for finding an ideal locum tenens agency fit
Questions to consider when choosing a locum tenens agency and recruiter: Are there enough job opportunities to offer a pick of assignments? Do I have flexibility to work as much or as little as I want? Am I comfortable with this recruiter? Can I build a long-term relationship with this recruiter? Does this recruiter understand my needs and put my interests first?
Dr. Patel: “Going with an agency that is experienced and an agent who’s experienced makes a world of difference.”
Interested in working with an agency? View our comparison chart
Working with an agency
Getting to know you: Every agency works differently, but the process typically starts with a phone call covering clinical experience, licenses and certifications, work frequency preferences, availability, location, desired earnings, and lifestyle.
Finding and accepting a job: Once you submit your CV, licenses, and certificates, your recruiter looks for matches, presents you to facilities, and negotiates pay and assignment details. You’ll receive a confirmation letter outlining all terms.
Locum tenens assignment 101: A checklist for locums success
Preparing for an assignment: Before your assignment, your agency coordinates licensing, credentialing, privileging, paperwork, travel, and housing, and offers malpractice with tail coverage.
Explore locums in your specialty
How to choose your ideal locum tenens assignment
Key factors when choosing a locum tenens assignment: location, pay, case mix, patient volume, and time commitment.
Pediatrician Dr. Trevor Cabrera’s key question to ask is why the facility needs a locum provider in the first place: “If it’s for a simple maternity/paternity leave… I’m less dissuaded. If there is a history of running through one provider after another, I am very wary.”
Ready for your first assignment? 5 tips for your locum job search
Tips for locums success
- Communicate your preferences — Infectious Disease physician Dr. R.K. Devlin underscores the importance of clearly communicating your preferences to your recruiter.
- Be open to new ways of doing things — Dr. Devlin encourages new locums to approach the experience with an open mind and curious nature.
- Get organized, especially your paperwork — Dr. Marye McCroskey shares tips on keeping the locum tenens paperwork organized for newcomers and veterans alike.
- Be nice to colleagues and support staff — Dr. Rip Patel prioritizes one simple rule for locums success above all else: be nice to staff, colleagues, and consultants.
Myths about locum tenens
Myth: Locums work is unstable
Good agencies have consistent, year-round demand, with the option to work back-to-back assignments or extend for long-term stability.
Myth: Locums involves a lot of travel
Local locums is a growing trend—58% of physicians who work locum tenens do so locally. Many specialties, like psychiatry and urgent care, have telehealth options that don’t involve travel at all.
Myth: The staff treat locums like outsiders
Most facilities are happy to have help and welcome locums with camaraderie and support.
Myth: Only desperate hospitals hire locums
More facilities are using locums strategically to plan for coverage and expansion. In the last five years, requests for locum tenens have more than doubled, and that trend is expected to continue.
Myth: Locums is not a real career path
Many physicians have built entire careers on locums because of high earnings, less burnout, greater flexibility, and more autonomy.
Myth: Locums is only for new doctors or retirees
Physicians turn to locums throughout their careers—to boost income, mitigate burnout, balance parenting, or transition between jobs. It’s a strategic option available at any career stage.
Have a question about locum tenens that wasn’t answered? Email info@locumstory.com
