For many physicians, the routine—packed schedules, administrative burden, EMR battles, and the sense that there’s never quite enough time for patients—has become normalized, even expected. But it doesn’t have to be the only way to practice medicine.

Locum tenens offers a flexible alternative—one that lets physicians control when, where, and how they work, while often earning more. Whether supplementing income, exploring new settings, or building a career around your life, locums opens the door to greater freedom.

So, what does compensation for locum tenens look like? Learn what factors influence earnings, and why this alternative model is gaining traction among physicians at all stages of their careers.

Why do physicians choose locum tenens?

Physicians turn to locum tenens for a variety of reasons, and surprisingly, it’s not just about the money—although that certainly plays a role. The most common motivation is control—control over your schedule, control over where you work, and perhaps most importantly, control over how much of your professional time is spent actually practicing medicine.

Locums assignments tend to come with less bureaucracy, fewer meetings, and minimal administrative load. That means more clinical focus and less time fighting with systems that don’t serve patients or providers. It’s a chance to return to the essence of the profession, even if only for a few weeks at a time.

There are a variety of reasons physicians choose locum tenens work:

  • To supplement their regular income
  • To bridge a gap between permanent roles
  • To travel or work closer to family temporarily
  • To ease into retirement without fully stepping away
  • To test-drive a different clinical setting or geographic region

Average locum tenens pay rates by specialty

One of the most appealing aspects of locums work is compensation. Hourly rates are often higher than those in employed positions. Here’s what you can expect in terms of pay for a typical locum assignment, based on recent industry data:

  • Anesthesiology: $300–$425/hour
  • Emergency Medicine: $250–$300/hour
  • Family Medicine: $120–$135/hour
  • General Surgery: $150–$200/hour
  • Hospitalist: $170–$190/hour
  • OB-GYN: $150–$200/hour

See more locum pay ranges by specialty (Locumstory)

Depending on your specialty, experience, and flexibility, hourly rates for locums are often higher than employed physicians doing the same work.

What influences locum tenens compensation?

Pay isn’t one-size-fits-all, even in the locum tenens world. Key factors include:

  • Location: Facilities in rural or underserved areas tend to offer higher rates due to difficulty attracting physicians.

  • Specialty demand: High-need fields like anesthesiology, cardiology, and emergency medicine consistently offer competitive compensation.

  • Schedule flexibility: Willingness to take on-call shifts, nights, weekends, or holiday coverage can increase your hourly rate.

  • Volume and complexity: Higher patient loads or procedures requiring specialized skill sets may command a premium.

Put simply: The more adaptable you are—and the more in-demand your specialty—the higher your earning potential.

Top-paying states for locum tenens physicians

Some regions offer better pay than others. According to recent industry data, physicians working locum tenens tend to earn the most in the following states:

  • Arkansas
  • Colorado
  • Delaware
  • Indiana
  • Michigan
  • Mississippi
  • Ohio
  • South Dakota
  • Tennessee
  • West Virginia

These states reflect a mix of high demand and fewer available permanent physicians, creating opportunities for well-compensated temporary coverage.

What agencies typically cover

When you take on a locums assignment through an agency, they generally handle much of the logistics for you—including your paycheck. Agencies pay locums directly (not the facility), and often cover:

  • Travel and lodging
  • Credentialing and licensing fees
  • Malpractice insurance (often with tail coverage included)

This administrative support is a core part of what makes locums work appealing. You focus on clinical care while the agency handles the paperwork and booking.

What agencies don’t cover

Because you’re technically an independent contractor, you’ll be responsible for your own:

  • Taxes (federal, state, Social Security, Medicare)
  • Health insurance, life insurance, and retirement planning
  • Business expenses not covered in your contract

The upside? You may be able to deduct a wide range of work-related expenses, from travel and lodging to CME and licensure. Still, tax planning is essential—most locum physicians benefit from working with a knowledgeable accountant who understands contractor rules.

How and when you get paid

Agencies vary, but most pay physicians weekly via direct deposit. You’ll log your hours through a portal or app, and the process tends to be simple and efficient. It’s worth noting that in most arrangements, you won’t be waiting on hospital systems to process time sheets or go through internal payroll delays—your agency handles it all.

Is it worth working with a locum tenens agency?

For most physicians, the answer is yes. A good locum tenens agency does more than match you with open roles. They negotiate pay on your behalf, align assignments with your lifestyle preferences, and manage all the red tape. That includes credentialing, licensing, travel, and housing, all of which can otherwise be time-consuming or costly.

Many physicians build long-term relationships with their recruiters, returning to the same agency across multiple stages of their careers. For those seeking flexibility, high-value clinical work, and logistical support, it’s a worthwhile partnership.

Reclaiming autonomy and earning potential

Locum tenens is more than a temporary fix—it’s a legitimate career strategy for physicians who want to break free of the constraints of traditional employment. Whether you’re looking to grow your income, explore new opportunities, or simply regain control over your time, it offers a pathway that aligns with both professional goals and personal values.

It won’t be the right fit for everyone. But for those who value flexibility, efficiency, and well-compensated clinical care, it might be the smartest move you make in your medical career.

To learn more about locum tenens opportunities in your specialty and how to boost your income, call CompHealth at 800.453.3030 or view locum tenens job opportunities in your specialty.