Locum tenens is a term used to describe physicians who provide temporary coverage to help fill gaps in service at hospitals and other healthcare systems. Locum tenens is a compelling career choice for physicians seeking growth, flexibility, mobility, and supplemental or augmented income. For physicians interested in learning more about locum tenens, consider these perspectives on the pros and cons.
Benefits of locum tenens
According to a survey examining healthcare staffing trends (administered pre-pandemic), an estimated 52,000 physicians worked as locum tenens in 2019 (up from 26,000 in 2002). The growth in the number of locum tenens providers speaks to the benefits of the temporary work arrangement, including:
One of the most commonly cited benefits among locum tenens physicians is the flexibility the temporary work arrangement affords.
“The most attractive thing about locum tenens is the flexibility,” says hospitalist Dr. Ali Chaudhary. “The ability to create my own life and own schedule has allowed me to pursue other passions like starting my own company, starting a blog, traveling more, and spending more time at home with my family. It has allowed me to feel more fulfilled in my career. I felt stuck in the grind of having to have regular and consistent shifts. Now, I’m able to adjust my schedule according to my life and not have to work my life around my schedule.”
Hospitalist Dr. William Gruss agrees, expounding on the flexibility to choose locations and assignments best suited to his needs.
“Even within locums, there are so many different options,” says Dr. Gruss. “Do you want a hospital in a city or large metropolitan area? Do you prefer something in the suburbs? Your age, your spousal situation, your kids’ ages and situations — it all plays a part. I wish I had known about locums a long, long time ago.”
Reduced administrative burden
Another benefit of short-term assignments is lighter administrative duties.
“The biggest difference between a locum assignment and being in private practice is the amount of administrative responsibilities,” says urologist Dr. Robert Biggers. “Other than keeping up with your electronic medical records, there really isn’t anything. I’m not on any committees and I’m not responsible to the hospital administration for anything other than my own conduct. Administrative responsibilities — such as dealing with insurance companies and state boards — can really wear you down.”
Dr. Jenny Martino, pulmonologist and intensive care physician, also appreciates the ability to remain removed from office politics.
“Something I appreciate about being a locum is that I don’t have to get involved in the politics of medicine,” says Dr. Martino. “I go to the hospital; I take care of patients; and I try to do a really good job. I don’t have to go to meetings; I don’t get involved in all the politics — I just get to take care of people.”
Physicians also point to the strong earning potential associated with locums. Locum tenens physicians earn more per hour, on average, than permanent physicians. Many locums use those earnings to pay off student debt, afford luxury items, or save toward financial independence.
“I started doing locums while I had my full-time job to supplement my income and pay off my student debt more quickly,” says Dr. Chaudhary. “I soon realized I had full flexibility and was getting paid more doing locums than I was at my full-time job. I could work less and earn the same amount, or I could work the same amount and earn a lot more. Eventually, staying at my full-time job didn’t make sense from a financial standpoint.”
Finally, a key benefit of locum tenens work is the opportunity to sharpen one’s professional skills. Locums assignments offer exposure to myriad ways of practicing medicine and delivering care.
Dr. Martino has practiced in a broad range of assignments, including international destinations from South Sudan to Bangladesh, and in areas of domestic need, including Elmhurst, Queens, when New York was declared a state of emergency at the onset of the COVID-19 pandemic.
“I learn something from every hospital, whether international or U.S.,” says Dr. Martino. “You always take away something, whether it’s something you do or do not want to incorporate into your practice. I think it makes me a better critical care doctor to do international work, and it makes me a better international doctor to do American work.”
Challenges of locum tenens
With the many benefits of locum tenens, there are also challenges of which to be mindful.
Credentialing and licensing
One of the primary challenges with locum tenens is the process involved in privileging and licensing, particularly if a physician plans to accept locum assignments outside his or her state of residence.
“The biggest challenge is getting credentialed and licensed in a new state,” says Dr. Biggers. “Plan for the process to be complicated the first time you do it, and after that it gets easier. The joint licensing agreement among 33 states is helping to simplify the process, as well.”
Responsibility for benefits and taxes
Unlike employer-provided benefits packages, locums are independent contractors and therefore responsible for researching and securing their own benefits — including health insurance, life insurance, and retirement plans. And since locum tenens are 1099 employees, they’re responsible for filing their own taxes.
“The downside when you’re an independent contractor is having to get your own health insurance,” says Dr. Gruss. “It’s a little bit of a challenge, but it’s fine. You’re also making a much higher salary in this situation than you would normally under a contract.”
Dr. Chaudhary agrees and adds, “the benefits should not be the main thing that keeps you away from locums. It takes a bit of research, but it’s possible to actually end up saving money and getting better insurance.”
Potential lack of social and emotional support
Another potential drawback that may vary from provider to provider is the feeling of loneliness or isolation on short-term assignments.
While some locum tenens physicians may have the flexibility to travel with a partner or family, circumstances may prevent others from doing so. The temporary nature of assignments can also impact locums’ opportunity to develop long-term friendships with colleagues or feel fully integrated socially in the workplace.
Navigating new systems
Finally, getting up to speed on a facility’s systems and processes can be challenging with each new assignment.
“Systems such as electronic medical records, or EMRs, can be a headache to learn at each hospital,” says Dr. Biggers. “When you get recruiting information such as what a facility is looking for in terms of clinic days and ER calls, be sure to also ask which EMR they use. If it’s a system you’re familiar with, you can quickly get a feel for it. And in my experience, the staff has always been fabulous and appreciative of the help.”
Dr. Martino also recommends asking questions to get up to speed quickly.
“I might not be perfect at each facility’s systems. But I just need to know the basics of how the hospital likes to work, and then I ask a lot of questions to integrate into any hospital system quickly,” says Dr. Martino.
Locum tenens can be a richly rewarding career path for physicians, and it is especially important to be informed about the benefits and potential challenges
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