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Locum Tenens: How to Directly Contract With a Hospital and Bypass the Locums Company or Recruiter

Physicians who do locum tenens as a side gig or a main gig can find locums opportunities in several different ways. While many assume that you have to go through a locums company or staffing agency, doctors in our online physician community are increasingly interested in avoiding recruiters and contracting directly with hospital systems or other employers seeking locums doctors. The hope is that by cutting out the middleman fees associated with locums companies, more money will land in the physician’s pocket as there will be more leverage or margins in negotiations. Additionally, one may be able to avoid some of the red flags associated with contracting with locums companies. While many larger institutions and hospital systems have standing arrangements in place with locums companies, making it difficult to come by certain opportunities, others have shared ways to circumvent this system. Of course, there are both pros and cons to this, as making arrangements yourself can have its own costs and headaches. Below, we cover avenues to help you find and secure direct locums contracts, as well as tips to prepare for your outreach and onboarding.


Disclosure/Disclaimer: Our content is for generalized educational purposes.  While we try to ensure it is accurate and updated, we cannot guarantee it. We are not formal financial, legal, or tax professionals and do not provide individualized advice specific to your situation. You should consult these as appropriate and/or do your own due diligence before making decisions based on this page. To learn more, visit our disclaimers and disclosures.


Six different methods to help physicians bypass locums recruiters to find locum tenens opportunities by contracting directly with an institution


How to find locum tenens opportunities


There are two main ways doctors find locums opportunities – by looking for engagements themselves or by working with a staffing agency or third party locums company. There are advantages and disadvantages to each of these options, which we’ve covered separately in our physician’s guide to locum tenens, but the TL:DR is that when you work with an agency, they cover a lot of the logistics and costs, but take a hefty middleman fee and may have contractual restrictions that make it difficult for you to renegotiate contracts or take a permanent job without paying the company a large fee.


All in all, your ability to negotiate better terms at both the initial assignment and for ongoing assignments may be hampered by the locums’ companies interest. 


Some locums and staffing company recruiters can be easier to work with than others, so you shouldn’t assume that they’re all bad. Obviously, they do need to make money and there is a price to pay for convenience, but if you choose this route, make sure you negotiate the fees as much as possible, as locums companies could take as much as 50% of the money the hospital pays to have you work there. The specific recruiter can make a big difference as well, as we’ve also seen in the comments contributed to our locums compensation database.


We’ve covered tips and tricks for establishing a successful relationship with a locums company recruiter, but if you do decide to try this on your own, we cover avenues to do so below. 



Where to look for locums opportunities where you can contract directly and bypass recruiters


The default for many hospital systems or institutions is to contract directly with a specific third-party locums company or recruiting company that they rely on to fill all their staffing needs. This can make finding positions independently a little more difficult, as they may refuse to consider options outside of their existing arrangement, as they enjoy the ease of having someone else handle the onboarding and logistics without having to get involved in 1:1 negotiations.


However, don’t be discouraged by this. As they say, when there’s a will, there’s a way, and if you’re able to put together an attractive offering or fill a need, they may be willing to sidestep these processes. And of course, some systems are openly fine with direct contracting.


There are certainly options for doctors to explore:


  • Leverage connections in your network. Let your friends and colleagues in your personal network know that you’re interested in locums opportunities and see if they know of any opportunities, or know of anyone else who might. This is typically the best way to hear about positions and to land locums positions without working with a recruiter. As an added bonus, if you know someone either directly or indirectly with the institution, you can get reliable insights into what working for a potential employer will be like.


  • Browse society websites. Employers may list positions with your specialty’s society. These jobs are commonly permanent positions versus locums, but even if you can’t find a specific opportunity, your research can give you an idea of companies looking to hire or who have unmet needs. Reach out to the in-house recruiter or other point of contact listed on the job description for the available position and let them know you’re interested in temporary or fill-in help if they have any relevant positions that come up. Even if their long term goal is to hire for a permanent position, they may be happy to have some help in the interim - and if it goes well for both parties, you may even end up in a permanent position!


  • Look for online job listings: A Google search can provide job listings across the internet and provide you with numerous potential job boards to explore. Similar to postings on society websites, these are often for permanent positions, but you may be able to find listings for temporary contracts or fill-in positions. (Don’t forget to check out our PSG job board while you’re looking.) When reviewing listings, pay attention to who is advertising the position, as recruiters often also post on these boards.


  • Research openings at specific institutions. Make a list of what geographic areas you’d be interested in working in and research hospitals, health systems, urgent care centers, large private practices, clinics, etc. in that area. Check their websites for a career section and see if they have any listings available.


  • Cold outreach to institutions and hospital systems. This can be a more challenging avenue (and may honestly end up a fruitless endeavor), but it’s one you can try if you’re interested in contracts in specific areas or with specific institutions. Go back to your list of institutions and reach out to the medical director, department head, or in-house recruiter and let them know you’re interested, as well as what value you could bring to their team. If their contact information isn’t readily available on the website, consider looking at a source like LinkedIn for a potential way to reach out.



Use our free locums opportunity matching database


Hospital systems, institutions, and locum tenens companies often come to us looking to connect with physicians for locums opportunities. To help facilitate, we offer free side gig matching databases to all members of our online physician community, and reach out to physicians who match opportunities based on their expressed interests. You would negotiate the rates for these opportunities and manage logistics yourselves.


If you would like alerts of relevant opportunities, sign up for our locums side gig matching database (you must be a member of our free physician only Physician Side Gigs group to access, but it’s completely free to join).


Also explore our job board for physicians and look for locums positions currently listed and available.


Also make sure you sign up for our PSG weekly newsletter, where we publish current and upcoming opportunities.



Tips for preparing to contract directly for a locums opportunity


Once you know how to find locums opportunities outside of a staffing agency or third-party locums company, take some time to prepare before you reach out. The sooner you can act on the following, the faster you can potentially close on relevant opportunities when they come across your radar. Remember, hospital systems are used to having locums companies hand this information to them in an organized manner, so if you want them to bypass their normal procedures, you’ll want to make it as smooth for them as possible and assure them that you’re a professional. They will be much less likely to work with you if they feel they have to hold your hand.


10 tips to help doctors successfully navigate contracting directly with a hospital for a locums opportunity

  • Have your CV updated and ready to send. Your CV is often your opportunity to shine and to show a company what value you can bring to their team, so make sure you have this ready before you reach out. You want an organized and professional document that highlights your accomplishments, unique talents, and experience. Your CV should include your professional experience, training, current certifications with expiration dates, any publications you have, and other relevant information.


  • Have your list of available dates ready. Along with letting a company know you’re interested in work, you’ll want to let them know when you’re available to work so they can rapidly assess whether you can fill their needs.


  • Make sure your licensing is covered. If you’re looking locally for opportunities, you likely don’t need to obtain any additional licenses. If you’re considering out of state opportunities, you will need to apply for a state medical license, and this can take months, so plan ahead. Explore our guide to physician licensing, which includes a PSG member perk for a resource that can help.


  • Have your information and documents ready for onboarding. To help you not only find but start opportunities quicker, have your information pulled together and ready so that once you’ve contracted, you can get through the credentialing and onboarding  processes quickly. This includes your medical licenses, DEA licenses, professional references (this is especially important because they can take a while to get and you may be asked for them during discussions!), employment history, and CME documentation. Learn more about the documentation to have ready for the locums credentialing process.


  • Give your references a heads up. If you have references listed with their contact information that you’re submitting to a potential employer, let them know you’re applying so that they aren’t surprised or confused when they receive a call or email as a follow up.



  • Consider establishing an LLC for your locums work. If you’re only planning on doing one or two short term contracts, this might not be worth the cost or the effort. If you end up working with companies that hire locums physicians as W2 employees, it won’t be necessary. If, however, you plan on building up a steady side gig or career with locums work that will produce a significant 1099 income stream, this can provide some additional protections and potential tax advantages compared to working as a sole proprietor. Explore our guide to side gig finances (including types of business structures) and if you need an LLC for your locums work.



  • Be ready for your contract review. Having a written contract, even for a short-term gig, helps ensure everyone is on the same page in terms of expectations and having protections in place. Make sure you understand all the terms and conditions for any contract you sign. We highly recommend reaching out to a contract review attorney in our database to look over your contract, but also want you to be familiar with what to expect, as well as what potential red flags to look out for. Review our red flags to avoid in locum tenens contract agreements for some tips. We also host free contract negotiations webinars, so make sure you sign up for our PSG weekly newsletter for alerts on future events.


  • Have a backup plan for malpractice insurance lined up. In most cases, the malpractice insurance coverage you have through your primary job won’t cover the locums work you’re doing at other institutions. If you can’t negotiate malpractice insurance coverage through the institution you’re contracting with (many will have something for temporary workers), you’ll want to make sure you have a policy in place before starting your first assignment. Explore malpractice insurance and tail coverage for doctors, which includes potential resources that might be able to help.


  • Scrub your social media. It’s not a bad idea generally to set your social media accounts to private and to screen who you friend and allow to follow you. Regardless of whether your accounts are private or public, take a moment to review what’s present. Your online presence is an outward persona you put into the world, and potential employers may very well check. Ensure there isn’t anything you wouldn’t want publicly associated with you on any of your accounts.



Reaching out directly to hospital systems and institutions for locums positions


Once you have your materials ready and have targeted potential companies you’d like to work with or specific roles, it’s time to reach out.


If you’ve found the opportunity through a personal connection, see if they would mind setting up an introduction for you. A warm lead is always a better shot than a cold outreach. If meeting in person, or virtually on a video call, make sure you dress professionally. You don’t know the persona of the person on the other side and first impressions matter.


If you don’t have the opportunity for an introduction, prepare your outreach via email or LinkedIn with a professional and direct message. If there’s a specific position you know they’re looking to hire for, reference it. Otherwise, let them know the type of position(s)/contract(s) you're interested in.



No matter how you reach out to connect, be polite and respectful. If/when you receive a response, be prompt with your reply. You want to show that you are reliable and available, particularly in this line of work.



Conclusion


Contracting directly with hospitals and other healthcare institutions can be both professionally and financially rewarding and can remove some of the frustrations physicians often face when dealing with locums recruiters. Direct contracting, however, offers potential challenges of its own, such as malpractice coverage, arranging and booking travel and lodging logistics, and finding relevant opportunities without a recruiter’s connections.


If you’re willing to manage the logistics typically handled by recruiters, you can gain autonomy, potentially earn more, and over time create a network of connections within healthcare systems to grow your client base and potential opportunities. Bypassing recruiters requires a proactive and engaged approach, but can pay off handsomely in the long run by avoiding potentially years of middleman fees.



Additional locums resources for physicians


Explore related PSG resources:


Don’t forget to sign up for our locum tenens opportunities matching database (physician only) and our PSG weekly newsletter, where we publish current and upcoming job and side gig opportunities.


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