As the landscape of healthcare continues to evolve, physicians find they now have a broad range of career choices. One such option is locum tenens, a Latin phrase meaning “to hold the place of.” 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
CHG’s State of Locum Tenens Report, a survey examining healthcare staffing trends, found that nearly 50,000 physicians are currently working locums. 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 its flexibility. Having more options for when, how, how long, and where you work can open up your schedule for more time to spend with family, pursue outside interests, and travel.
“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.”
Physicians also point to the strong earning potential associated with locums.
According to the Medscape 2023 Physician Compensation Report, self-employed physicians — which includes locum tenens physicians — earn nearly 10% more than their employed counterparts. A Hanover Research study, conducted in partnership with CHG Healthcare, found that locum tenens physicians earn an average of $32.45 more per hour than full-time physicians in permanent positions.
Many locums use those earnings to pay off student debt, afford luxury items, or save toward financial independence, all with the flexibility to scale their work hours to fit their desired work/life balance.
“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.”
Locum tenens assignments may pay as much as 50% more per hour than full-time positions. According to Locumstory.com, current rates for in-demand specialties are:
- Anesthesiology — $275-325/hour
- Cardiothoracic surgery — $2,000-2,500/day
- Cardiology, invasive — $325-375/hour
- Cardiology, noninvasive — $275-300/hour
- Family medicine — $90-125/hour
- General surgery — $1,400-1,800/day
- Neurological surgery — $2,000-2,500/day (stroke, up to $5,000 daily)
- Obstetrics — $1,200-1,400/day
- Oncology — $410-475/hour
- Orthopedic surgery — $1,200-1,500/day
- Pediatrics — $100-120/hour
- Pediatric surgery — $2,000-4,000/day
- Psychiatry — $180-210/hour
- Pulmonary critical care — $225-250/hour
Dermatologist Dr. Carrie Cera Hill worked locum tenens part time to supplement her income as she established a private practice near her home in Colorado.
“I knew I would need to supplement my cash flow in the beginning while I grew my patient base,” says Dr. Hill. “I was able to [work locums] and still be available to see patients regularly at my own growing practice. I feel extremely fortunate. I was able to build the business I wanted, earn the extra income I needed to do it, and still be home with my husband and children every night. It was truly the best of both worlds.”
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,” according to 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.”
Another key benefit of locum tenens work is the opportunity to sharpen your professional skills. Locum tenens assignments offer exposure to the 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. And I’m able to do both because I work locum tenens.”
Finally, many locum tenens doctors say the experience of locum tenens allowed them to refocus on practicing medicine and re-engage with the aspects of medicine that initially drew them to the profession.
OB/GYN Dr. Zakera Nanabawa has delivered care around the globe through both international locums work and medical missions. She feels passionately about giving back and making a difference in the world. Most recently, on a mission trip to Argentina, Dr. Nanabawa had the opportunity to work with the Huarpe indigenous people.
Related: Learn about medical missions with the Making a Difference Foundation
Challenges of locum tenens
With the many benefits of locum tenens, it also has its challenges.
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 is helping to simplify the process, as well.”
Prospective locum tenens physicians should research and familiarize themselves with the credentialing process and work with an experienced and trusted healthcare staffing agency. Most agencies have dedicated licensing and credentialing personnel who will take care of everything, including the license application fees, verification fees, delivery fees for the application, and verifications to be sent to the licensing board. Reputable agencies also have the advantage of well-established relationships with medical boards, which can more smoothly facilitate the process.
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.”
Working with a certified public accountant (CPA) or financial advisor can prove beneficial for locum tenens physicians, not only in navigating the unique complexities of contract work, but also in identifying tax benefits applicable to an individual’s particular situation.
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.”
LEARN MORE: What are the tax benefits of locum tenens?
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.
Though working locum tenens with a family requires advance planning, scheduling, and flexibility, many physicians say locums can be a rewarding career choice that affords more balance than they realized.
Dr. Jenny Underwood, an OB/GYN based in Texas, accepts locums assignments seven to 10 days per month so she can be home and spend the rest of the time with her three young children.
“I honestly think the kids like it better because they know it’s seven days and when I come back, I’m all theirs,” Dr. Underwood says. “You’d be really surprised how refreshing it is to be able to walk away from a job knowing that all the paperwork is done, all the calls are done. Now when I leave, I just get to focus on my family.”
Another creative solution to maintain your home base and support network is to accept locum assignments close to home. Local locum tenens jobs facilitate ease of travel, the ability to manage work/life balance, and the chance to deliver care in your community. Local assignments also offer an educational window into other local health systems and settings.
“I enjoy dropping into other places and seeing how things run,” says Dr. Michael Cormican. “I enjoy seeing a different side of things, seeing different hospitals, and getting to know different people. And then, as well, seeing how other places do things while also trying to impart my ways to these different places.”
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.