Locum tenens can be a great option for doctors looking to supplement their income, apply their skills in new settings, or explore alternative career paths. AnĀ estimated one-thirdĀ of physicians are currently working locum tenens or have done so in the past. Yet many physicians may not be aware of the opportunities afforded through locums.
It is actually something I have thought about in the past. And while it is not a great fit for me personally right now, I know many doctors of all career stages who have had a great experience. I therefore asked key resource, Locumstory, to provide a primer on locum tenens for all doctors!
Think of locum tenens doctors like medicineās substitute teachers
From the Latin phrase meaning āto hold the place of,ā 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 prosperous industry and an important option utilized by healthcare facilities nationwide. And more and more physicians are turning to locums for the flexibility and control it provides in their professional and personal lives.
Locum tenens can work at all stages of a physicianās career
Locums can be an exciting catalyst to new opportunities, no matter the stage of your career. Locum physician Dr. Andrew Wilner, author of The Locum Life: A Physicianās Guide to Locum Tenens, speaks to the opportunities available to physicians at each stage of their career.

New graduates
āPhysicians just out of residency have discovered locum tenens is a great way to test out different facilities in new geographic locations. A newly graduated physicianās 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 ā all of which can be accomplished with locum tenens.ā
Mid-career physicians
āMid-career physicians often employ locums to augment their income. There may be life circumstances that destabilize a household budget ā new home, student debt, children ā 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.ā
Late-career physicians
āI consider myself to be in the late-career physician category. At this stage of my career, I feel Iām 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 arenāt ready to fully retire. Patients and facilities alike will also benefit from skilled, experienced physicians and youāll be able to continue doing what you love.”
Nearing retirement but not ready to hang up the stethoscope? Family medicine physician Dr. Marye McCroskey worked locums in Hawaii to keep practicing and travel the globe with her husband. You can hear her story: https://youtu.be/i2eyrMwqD58
Locum tenens doctors work as independent contractors
Locum tenens providers are considered independent contractors. This means that all expenses related to taxes, insurance, and retirement are assumed by the provider. Taxes are not automatically taken out of a locum physician’s compensation. So you, as the locus doctor, are responsible for making quarterly estimated income tax payments.
Neurologist Dr. Simrah Singh did the research and due diligence to ensure her financial affairs were carefully in order.
āI looked at it as an opportunity to learn,ā she says. āAs far as health insurance, you can go on the healthcare marketplace and buy health insurance yourself, which is what I do. You can pick high-cost plans and low-cost plans, depending on your needs, and write them off on your taxes if youāre an independent contractor. And you know, itās really not hard. It just takes a little more time. I also use an accountant, and just have them do it for me.ā
Seasoned locum tenens physicians recommend working with a tax advisor. This will help you better understand and take advantage of the tax benefits available to independent contractors. This includes writing off business travel, business meals, continuing medical education (CME), equipment, lodging, and home-office needs.
Using a locum tenens agency
Providers have the option to research and secure locum tenens positions on their own. However, experienced locums emphasize the benefits of working with a locum tenens agency. Especially when he or she is starting out or working part time.
āIf youāll 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. This way, youāll be all set before you start to work on your first shift,ā says emergency medicine physician Dr. Rip Patel.
Pro tip: If you know someone who works locum tenens, ask them to refer you to their favorite agency. You may both be able to get a referral bonus through programs like these:
Tips for finding an ideal locum tenens agency fit
When it comes to finding an ideal locum tenens agency fit, find an agency with the resources to support both finding and successfully completing a locums assignment.
Here are some questionsĀ to considerĀ 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 encourages prospective locums to select an experienced, established locum tenens agency and recruiter.
āGoing with an agency that is experienced and an agent whoās experienced makes a world of difference,ā he says.
Locum tenens pay
Like any profession, there are many variables that influence locum tenens pay. Rates may vary by specialty, location, shift type, and patient load. An agency can help negotiate pay, as well as shift preferences, housing details, and per diem allowance.
Locum tenens are paid directly by the locum tenens agency. And they typically pay you on a weekly or bi-weekly schedule, as determined by the agency.
In addition to a providerās hourly rate, the locums agency will generally cover additional expenses including housing, transportation, medical malpractice insurance, and costs associated with licensing, credentialing, and privileging.
RELATED: How does locums compensation work?
How doctors can choose their ideal locum tenens assignment
When it comes to choosing a locum tenens assignment, there are several primary factors to consider:
- Location
- Pay
- Case mix
- Patient volume
- Time commitment
In addition to these considerations, experienced locum pediatrician Dr. Trevor Cabrera encourages providers to think outside the box and ask what he considers to be the most important question.
āMy favorite question to ask is why the facility needs a locum provider in the first place,ā he says. āIf itās for a simple maternity/paternity leave or a staff member that has transitioned to another job for a personal reason, Iām less dissuaded. If there is a history of running through one provider after another, I am very wary.ā
Dr. Cabrera also likes to speak with current locums at the facility, if possible, for additional perspective on the facility and assignment.
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. Many locum physicians use this unique opportunity to live like a local and travel extensively before, during, and after their assignment.
With international assignments come important questions and considerations to evaluate in advance, including:
- How long can I commit to living internationally?
- Do I have family who will join?
- If I have pets, will I bring them or leave them at home?
- Am I comfortable living in new, unique cultures?
- Does living like a local sound exciting?
For more information and tips on a successful international locums assignment, read Global Medical’s beginnerās guide.
You can advance your career through working locum tenens
Locum tenens can be an effective way to help you achieve professional goals and aspirations that may feel limited or stifled in a permanent position.
Orthopedic surgeon Dr. Nicholas Kusnezov views locums as a strategic opportunity to experience new settings and gain exposure to different ways of practicing medicine. An up-and-coming orthopedic surgeon, for example, āmay end up in a practice that confines you to a certain āniche.ā You might be the orthopedic āshoulderā guy, stuck filling your schedule with procedures you may not be passionate about,ā he says.
“Locums offers the potential to selectively diversify and control the scope of your practice and thereby increase your professional experience and skill set,” says Dr. Kusnezov. āMedicine is a dynamic, ever-changing field that is advancing at an accelerated pace. Locums will expose you to a variety of different settings, medical staff, and novel concepts in diagnosis and management, which will in turn keep you sharp, relevant, and up to date with the state of the art.
Explore new opportunities by working locum tenens
The experiences and opportunities available to locum tenens providers are as varied at the providers themselves.
Dr. James Stone was drawn to locum tenens for its autonomy and flexibility and quickly discovered a love for locum tenens full-time.
āI wanted to be on my own. I was looking to be my own boss and get the opportunity to travel,ā says Dr. Stone. āOnce I decided to go into being a locum tenens physician, I just went for it and realized I needed to get out and make friends in the industry, and then work as hard as I could. Iāve said yes to practically every assignment Iāve been offered.ā
Dr. Chad Koyanagi is a psychiatrist practicing in his home state of Hawaii. In addition to his position with the State of Hawaii Medicaid, his work in a private hospitalās psychiatric unit and medical outreach to individuals experiencing homelessness, he also devotes one week per month to treating Hawaiiās rural population as a part-time locum tenens psychiatrist.
āOne of the main things that was particularly appealing about this opportunity was that Iāve always spent some more of my time trying to help address more of the rural shortage areas,ā says Dr. Koyanagi. āSo the opportunity to help with coverage on the west side of Hawaii Island satisfied my need for something different.
Family practice physician Dr. Derrick Barnes shares how locum tenens can be rewarding for physicians interested in helping support smaller hospitals and doctors who need some help. And gaining extra skills is another bonus. Watch: https://youtu.be/41eajEelTJc
4 final tips for doctors to find locum tenens success
Locums can be an exciting career path for providers and offer new and uncharted opportunities. With the new can also come the uncertain and even overwhelming. Consider these tips from seasoned locums to set yourself up for locum tenens success:
Communicate your preferencesĀ
Dr. RK Devlin underscores the importance of knowing what you want and clearly communicating your preferences. āThe first step to ensuring a positive locum tenens experience is to clearly communicate your practice and travel preferences to your recruiter. Being honest about the type and amount of work you want to do is imperative, as those choices allow your recruiter to match you with a job opportunity that best meets your expectations.ā
Be openĀ
Dr. Devlin also encourages new locums to approach the experience with an open mind and curious nature. āWhile there is always a bit of anxiety when navigating a new environment, I mostly find locums work to be both interesting and educational. I like learning about patient care in different medical settings and establishing new friendships.ā
Get organized
There are many moving pieces to keep organized and the paperwork alone can, at times, feel cumbersome. Dr. Mayre McCroskye shares tips on keeping the paperwork organized for newcomers and veteran locums alike. āYou will have paperwork to complete for each locums assignment, but it doesnāt have to be painful if you have all the information you need at your virtual fingertips. And the opportunities that locums provide are well worth the work!ā
Be nice
Among all his advice for a successful locums experience, Dr. Patel prioritizes one simple rule above all else: āBe nice. Seriously. Itās really just that simple. Be nice to your staff, be nice to your colleagues, and try your best to be nice to consultants. Sometimes the latter can be difficult, especially ā as I have found in rural localities ā where standards of practice might be different from your own. But simply put, pick your battles. When you remain committed to this mindset, staff will generally go out of their way to help you, assist you in navigating the system, and make your shifts run smoothly.ā
In the end, locum tenens provides a very unique opportunity for doctors to add some flexibility to their schedule while still using their skills to help other doctors and patients in new areas. If you are interested in learning more or getting started, you can start your locums journey with Locumstory here!
And for more tips regarding employment for physicians, check out these posts:
- 8 Reasons Employed Doctors Should Consider Employment Lite
- What Doctors Should Know Before a Private Equity Sale
- How Doctorsā Biggest Practice Expense Can Become a Valuable Revenue Source
- 9 Things You Must Know About Starting a Private Practice
- 7 Doās and Donāts of Building a Successful Medical Practice
What do you think? Have you considered working locum tenens? Why or why not? If you have in the past, what was your experience? Let me know in the comments below!
Do you have a question about locum tenens that wasn’t answered by this article? Email us [email protected]