A late-career guide for physicians considering locums.

As the physician shortage continues to worsen, the locums market is growing fast — it’s projected to reach $23.5 billion by 2027. One survey from the National Association of Locum Tenens Organizations (NALTO) found that 80% of healthcare facilities had used locum tenens staffing within the previous year.

Let’s take a closer look at the benefits of locum tenens and debunk some common myths.

Why more physicians are choosing locum tenens

Challenges like burnout, administrative burdens, and a growing patient-to-physician gap are causing many physicians to become disillusioned with traditional employment arrangements.

Working locums can lead to a more satisfying personal and professional life and remind you why you went into medicine in the first place. The most notable benefits of locum tenens include:

Increased income. Supplement your current income, or increase your overall earning potential.

More time for patients. Fewer administrative tasks means more time to focus on your patients.

Flexibility. Part time or full time — work where, when, and however much you choose.

Variety. Experience new practice settings and patient populations, or enjoy a change of pace.

Travel opportunities. Experience new places and different cultures on every assignment.

Professional development. Develop new skills, learn from other professionals, and build your network.

Work/life balance. Choose assignments that suit your goals, lifestyle, and preferences.

How to decide if working locums is right for you

Everybody’s career and lifestyle aspirations are unique, and there’s no employment arrangement that’s perfect for every physician. To decide if locum tenens is a good fit for you, ask yourself these questions, and keep a few other things in mind:

1. Do you want more flexibility and control over your workload?

2. Do you enjoy travel, and does your personal situation allow it?

3. Do you want to expand your skill set and your professional experience?

4. Do you thrive in changing environments, or do you prefer more of a routine?

Consider your circumstances: Locums is a fantastic way to accelerate your career but may not be ideal for those with young children or aging relatives.

Consult with colleagues: Ask fellow healthcare professionals who have worked locums about their experience.

Talk to an agency: A worthwhile locums agency will be happy to answer questions and explore options without pressuring you into anything.

How locum tenens can benefit physicians at any career stage

Whether you’re a recent graduate, a seasoned physician, or approaching retirement, locum tenens broadens your options. There’s a reason one in three physicians are currently working or have previously worked locum tenens.

Semi-retired physicians can use locums to transition to retirement at their own pace and as a way to remain engaged in medicine and keep their license current without having to work full time. The travel opportunities and supplemental income from working locums also enable a more fulfilling and comfortable lifestyle, both leading up to and following retirement.

Mid-career physicians often work locums to supplement their current salary or increase their full-time earning potential. Building new skills and experiencing different clinical environments keeps physicians at the top of their game, and a switch to locums can also help alleviate burnout and rejuvenate administration-weary physicians who just want to focus on patient care.

New physicians can use locums to help pay off student loans faster or to save for big purchases like a home. It’s an excellent way to explore different practice settings and employment arrangements before committing to a permanent position. Traveling the country and working in different facilities also helps build a vast professional network that often leads to greater opportunities down the road.

Common myths about locum tenens

A few myths about locum tenens persist despite a lack of evidence — or sometimes due to a simple lack of information about available options. Let’s take a look at a few of the most common myths:

Myth #1: Locum tenens physicians deliver lower-quality care.

Locum tenens physicians have no significant difference in mortality rates compared to their full-time colleagues. Some studies have even shown patients treated by locums physicians experience shorter hospital stays with no increase in readmissions. A NALTO survey also showed 94% satisfaction among facilities using locum tenens providers.

Myth #2: Career stability is impossible with locum tenens.

While your location and schedule may change more often, leading agencies can provide consistent placements and ongoing career support. Best of all, you can schedule time off whenever you need it.

Myth #3: Working locums requires constant travel.

Though lots of physicians enjoy traveling, it’s not for everyone. Many regions have local locums assignments available, allowing you to expand your career options while staying close to home. Over half of locums physicians report working close to home. A locums consultant can help you research the volume and variety of assignments in your area.

Understanding the basics of compensation leads to more informed decisions when weighing employment options — and puts you in a better position to negotiate.

What factors determine physicians’ pay?

Experience: Seasoned physicians generally get paid more for their services. 
Location: Cost of living and regional economics make a major difference. 
Specialty: Research average pay for your specialty so you know what’s fair. 
Market factors: Demand, competition, and industry trends all play a role.

Common compensation structures for physicians

Physicians may encounter different compensation models — sometimes even within the same offer. Employers often paint a rosy picture of your potential compensation, so be sure you’re clear on the best- and worst-case income scenarios.

Fee-for-service: Physicians are paid a flat rate for each service, incentivizing them to perform more services and procedures.

Salary: Physicians are paid a fixed salary, encouraging them to focus on quality of care rather than quantity of services.

Productivity-based: Physicians are paid based on productivity metrics—typically the number of patients seen or the number of services performed.

Value-based: Physicians are paid based on quality of care as determined by metrics like patient satisfaction, patient outcomes, and cost efficiency.

Hybrid: A mix of multiple compensation models—for example, a base salary with incentives for productivity, quality metrics, or other performance goals.

How is locum tenens compensation different?

Locums physicians are independent contractors (1099 employees) of a staffing agency and are usually paid by the hour. Some locums contracts also include sign-on or completion bonuses. Like permanent jobs, several key factors influence how much you’ll get paid when working locums.

Relevant skills: Expertise with relevant procedures or patient populations can lead to higher pay.

Location: Areas with severe shortages or higher costs of living may pay more to attract skilled physicians.

Specialty: Physicians in hard-to-fill specialties can command higher rates.

Patient load: High-workload assignments generally pay more than slower-paced facilities.

Shift type: Weekends, holidays, and overnight or call shifts often command higher hourly rates.

For more details, check out our in-depth guide on compensation for locum tenens physicians.

How do taxes and benefits work for locums physicians?

As independent contractors, locums physicians are responsible for paying their own taxes and coordinating their own benefits like health insurance and retirement planning. While this takes a bit of effort, it also opens up some potential opportunities for tax savings and the chance to customize a plan that makes the most sense for you and your family.

It’s also important to remember that locums physicians don’t have to handle everything on their own. Tax experts, CPAs, and financial advisors are valuable resources for any physician, especially independent contractors who coordinate their own benefits.

Check out our detailed tax guide for locum tenens providers, or learn more about benefits for locum tenens physicians.

Important considerations beyond salary and benefits

Career satisfaction is about more than just money — it’s about the lifestyle you’re able to live, the daily realities of your job, and your ability to achieve your goals. While everyone has their own priorities, be sure to consider factors like:

• Patient load and number of call days

• Schedule flexibility and work/life balance

• Telecommuting opportunities

• Development opportunities

• Quality of resources and support staff

• Regulatory and administrative burden

• Facility reputation and culture

• Location and patient population

Locum tenens contract details

Locum tenens contracts are work agreements between physicians and staffing agencies, who have their own contracts with healthcare facilities. Well-renowned staffing agencies can help physicians with:

Negotiating contract terms. Great locums agencies are proactive in pushing for rates and contract terms that benefit their physicians.

Identifying red flags. Locums consultants have seen a lot of contracts, and they can provide support during the review process to point out any abnormalities or areas of concern.

Acting as a liaison. Staffing agencies streamline communication between you and the client organization and ensure contracts and any logistical details are finalized efficiently.

Learn more about locum tenens contract negotiation and important things to watch for when reviewing a locums contract.

Do I need an agency to work locums?

It’s possible to work locum tenens on your own, but it’s complicated. You’ll be responsible for making business connections, negotiating contracts, and coordinating all logistics. Agencies offer many benefits that streamline locums work and provide physicians with peace of mind, including:

Network of opportunities. Well-established agencies have a broad range of clients and assignments at top facilities around the country.

Negotiating power. Agencies can often help physicians negotiate better rates and contract terms.

Legal protections. Reputable agencies have contracts in place to protect physicians from disputes or liabilities.

Licensing and credentialing. Agencies often take on time-consuming tasks like verifying education and securing licensure.

Travel and logistics. Top-tier agencies will book flights, lodging, and rental cars and coordinate all other details.

Malpractice insurance. Many agencies offer malpractice coverage — but not all of them include tail coverage like Weatherby.

Ongoing support. A great agency will be responsive to any issues that arise, inside or outside of the clinic.

How do locum tenens agencies make money?

Locums agencies establish relationships with healthcare facilities around the country, who reach out when they have unmet staffing needs. Agencies then recruit qualified physicians and coordinate all logistics like travel, credentialing, and licensing.

The locums agency negotiates with the facility to establish a rate that benefits the physician, and adds a small markup to cover the agency’s own costs. Facilities often pay locums physicians higher rates than they would for permanent positions because they know the long-term cost of compromising their patient care standards due to understaffing.

How to choose a locum tenens agency

The agency you choose can make a major difference when working locums. Pay attention to these key factors when weighing your options.

Reputation: Check out an agency’s reviews, and ask for input from colleagues who have worked with them.

Specializations: You don’t have to choose a specialty-specific agency to get top-tier service — larger agencies like Weatherby have dedicated teams for different specialities.

Size and reach: Larger agencies often have a broader range of industry contacts and job opportunities.

Available support: From travel arrangements and credentialing to on-assignment support, choose an agency that takes stress off your plate.

Compensation: Rates should be fair and transparent. Watch for bait-and-switch offers that are too good to be true.

Flexibility and communication: Choose an agency that accommodates your preferences and stays in regular contact throughout an assignment.

Malpractice insurance: Ensure your agency’s coverage still protects you in the case of a claim after your assignment ends.

Because locum tenens physicians are independent contractors, there are a few important steps you should take before you start doing business.

Get a federal Employer Identification Number. The IRS will issue you one for free here.

Separate your finances. Open a separate bank account and credit card for your business so it’s not intertwined with your personal finances.

Keep detailed records. Look into bookkeeping software like Quickbooks that will track and organize your income and expenses.

Do I need a business entity to work locum tenens?

You’ll be considered a sole proprietor by default if you don’t set up a dedicated business entity for working locum tenens. This works just fine for many locums physicians, especially those who also receive a W-2 salary from a permanent employer.

Setting up a business entity like an LLC or S corp to work locum tenens doesn’t necessarily reduce your liability or lower your taxes, but it does make sense for some physicians. A financial advisor can help you choose the best option for your circumstances.

Learn more about LLCs and other business entities for locum tenens.

How does the locums agency process work?

Every agency does things a little differently, but a streamlined and straightforward onboarding process can make all the difference when getting into a groove with your first few locums assignments. Here’s how we do things at Weatherby:

Step 1: You’re matched with a specialty-trained consultant who gets to know you and what you’re looking for in an assignment.

Step 2: Your consultant finds and shares suitable assignments and presents them for your review.

Step 3: After you choose an assignment, we’ll walk you through the online application and aid in gathering required documents.

Step 4: Our credentialing team helps you compile all necessary credentials and obtain a state license if necessary.

Step 5: We arrange transportation, rental cars, and accommodations that meet your needs.

Step 6: Your consultant provides ongoing support throughout your assignment — from work issues to restaurant recommendations.

Step 7: Repeat from Step 1, as you and your consultant build a long-term work relationship.

Tips for your first locum tenens assignment

It’s normal to have some nerves before starting any new job, especially one where you’ll be traveling to an unfamiliar location and facility. Building these simple but important habits will ensure things run smoothly on your first assignment and throughout your locums career.

Get organized. Keep important details like location, schedules, and contact information in one place. Weatherby uses a helpful app to keep these details accessible for our physicians.

Ask questions. Clarify your role, responsibilities, and schedule, and make sure you understand a facility’s expectations and requirements.

Stay flexible. Be willing to adjust your schedule if needed, and remain open-minded about new people and work environments.

Communicate effectively. Stay in regular contact with your consultant and facility colleagues, and address any concerns promptly.

Be professional. Punctuality, positivity, and professionalism go a long way toward establishing a good reputation.

Take care of yourself. Your first few assignments may feel chaotic at times. Rest, exercise, and proper nutrition help manage stress and maintain your physical and mental health.

Working locums is an excellent option for physicians at any career stage looking to boost their income, broaden their skills, and explore different practice settings. More physicians are choosing to work locum tenens due to various benefits like higher pay, greater flexibility, and more control over their work/life balance.

When you choose Weatherby as your locums agency, you’ll be partnered with a specialty-trained consultant who can help you launch your career and achieve your full potential. They’ll get to know what you’re looking for in an assignment and walk you through every step of the process from collecting required documents to booking travel arrangements. And thanks to our long-time relationships with leading healthcare facilities, we’re able to offer top-tier assignments in all 50 states and over 100 specialties.

Learn more about the benefits of working locum tenens, or explore our other helpful resources for physicians.