Is Locums A Good Fit for My Career? What to Consider When Making the Switch to Locum Tenens
- Apr 11
- 9 min read
As demographics in medicine evolve, we’re seeing more and more physicians in our online communities for doctors considering making the switch to locum tenens work instead of staying in traditional employed position W2 jobs. The motivation for this is multi-fold, but often stems from a desire to have more flexibility in their careers in order to prioritize other aspects of their personal lives, or to make more money as doing locums can be quite lucrative (not to mention coming with tax advantages). That said, locums is not a good fit for all physicians. Below, we’ll dive into which physicians should consider locums work, and what to take into account when weighing a conventional physician career with the somewhat more unpredictable locums life.
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Is locums a good fit for me?
This is a loaded question, and one that every physician should take seriously. Before we go into pros and cons, it’s important to ask yourself a few questions (and be honest with yourself about the answers!), so that you have a framework to assess the benefits and limitations of a career as a locum tenens physician. While locums a great fit for some physicians, it may be a horrible fit for others.
Ask yourself:
Do I need stability in my job, and if so, what is the reason (income, location, benefits, student loans and pursuing PSLF, etc.)?
If I had to prioritize, would I pick freedom and flexibility, or would I prioritize a steady income?
Am I comfortable with a job where I have to get to know new co-workers, teams, hospital systems, and technology routinely?
Is it important for my job satisfaction to have continuity of care with my patients?
Am I okay with working shifts that are generally less desirable to others (which may be the reason they need locums)?
How much money do I have to make in a year, and what’s the worst thing that would happen if I didn’t make that for some reason?
Now that you’ve thought about those, before we move on to pros and cons, know that there are no absolutes in locums life. There are long term locums contracts that can provide more stability, and if you’re flexible in regards to location, you can find gigs that may give you routine daytime shifts instead of having you as a backup for when everyone’s on vacation. Everything is possible, as long as you’re willing to look for these jobs and accommodate where you can, or if you’re okay having less work or less money if you’re only willing to do work that is in a certain location. Everything below is a ‘generally speaking,’ not a rule.
Related PSG Resource
Sign up for our free locums matching database (physician only)
When locum tenens may be a good fit for you
You need flexibility, and traditional clinical medicine jobs don’t work for you
It used to be that most clinicians were solo breadwinners who expected to work in their jobs 50-80 hours a week, take call, and otherwise place their jobs in the center of their lives and work everything else around it.
Increasingly, we’re seeing that members of our physician communities don’t always fit this description. As demographics change, we see doctors that can afford to make less money, but want to be able to take a few months off during the summer, or to travel, or to work on other interests, side hustles, or entrepreneurial pursuits.
We also see physicians at different ends of their careers where they may want to be home more while their children are young, or conversely, they want to scale back clinically during pre-retirement years.
You want to be your own boss
Some physicians are just not meant to be employees. The beauty of locums is that you work when you want, and nobody can make you work when you don’t want to. You also won’t have to deal with workplace politics as much.
You don’t enjoy the administrative tasks and responsibilities that come with employed positions
Perhaps you just want to do the job of doctoring, and focus less on required meetings, committees, teaching responsibilities, or responsibilities of running a practice or being part of a group.
You want to make higher hourly rates, and you’re willing to travel or work less desirable hours to do it
Some of our physicians, especially those at earlier stages of their career, may be saddled with student loans or have other reasons why they want to make extra money. Hospitals and employers in a crunch will typically pay higher rates, so if you’re willing to go to these positions, you could make a lot more money in any given day than you might at a conventional employed physician position.
You’re taking a break in your career, riding out a noncompete clause, or otherwise are between jobs
There are various transition points in a physician’s career where locums can be a great fit. Maybe you’re moving and just want to make some money between jobs, maybe you need to ride out a noncompete clause for a year or two, or maybe you haven’t found the right next job but you don’t want to rush that process.
You don’t mind constantly changing work environments, colleagues, and patients, or you actually enjoy the variety
Locums life is all about being able to adjust to different settings and different people. In order for locums to be a good fit, you’ll have to be okay with learning new EMRs, new processes and protocols, and new routines, as well as be okay with always working with new people and teams. Conversely, you may be someone that gets bored in the same environments with similar case mixes, and find that the variety actually makes work more exciting.
The tax benefits of being 1099 would be beneficial for you and/or your family
1099 work can be extremely beneficial for some families, as it opens the door to tax savings and deductions on every dollar that you earn that may not be open to you through a traditional job. This could allow you to keep more of what you earn and put larger amounts into retirement, for example.
Related PSG resource:
You’re feeling burnt out and need more breaks
In today’s healthcare environment, this is a real concern for many doctors trying to preserve the love of what they do while still prioritizing their personal well being. For some, having the ability to do locums work on their terms, and then take extended time off when they need it, may be just the breath of fresh air that they need to be excited about their career again.
You actually want to travel more and explore new cities and places
Depending on your phase in life, you may be wanting to live a more nomadic lifestyle, go visit friends and family in different cities, or have the opportunity to see new places on someone else’s dime. If you’re trying to figure out where you want to settle down, for example, this may be a great way to do explore different places and friend groups before taking a permanent job in a city.
You find it gratifying to work with rural or underserved populations
While locums opportunities are available everywhere, there are many in more rural areas where less physicians choose to live. The medical needs in these communities can be significant, and it can be very rewarding to work in these settings where you are truly needed.
Related PSG Resource
Sign up for our free locums matching database (physician only)
When locums may not be the right fit for you
Not having guaranteed earnings is a deal breaker
If you need to earn a certain amount of money that you can count on, locums may not be the best fit. While there’s in theory always locums jobs out there, the uncertainty may be stressful. For example, if hospitals are having budgetary constraints, they may opt to push their employed physicians harder and cut locums budgets.
You and/or your family need benefits and the cost or options on the open marketplace don’t fit your needs
While you may make more money doing locums, you do sacrifice benefits such as PTO, CME funds, health insurance, employer sponsored retirement accounts, and more. While you can certainly set up your own retirement accounts as a self employed physician, you won’t get the match from the employers, so you’ll want to make sure you consider your full compensation including benefits when you do the math comparing locums vs employed positions.
You like having a routine and stability
If you want to fully embrace locums life, you’ll have to be okay with the ebbs and flows of work, as well as the fact that your environment and the people you work with are constantly changing. If that is unsettling to you, it may not be a great fit.
You enjoy working on a team, and enjoy having colleagues for backup and second opinions
While there are certainly locums positions where you work in a team setting, especially for certain specialties, know that in a lot of locums situations, you may be the only physician on site since you are filling a need. If you are someone that likes to run cases by colleagues or if you feel like it’s helpful to have an extra set of hands around if the work gets overwhelming, locums may be anxiety provoking.
You don’t like the travel lifestyle, or have a family that you don’t want to be away from a lot
While some physicians are lucky to find enough work locally, most locums physicians do a fair amount of travel. That comes with travel arrangements, disruptions, and other potential issues, as well as potentially eating out, staying in different types of accommodations, and potentially having to adjust parts of your routine, such as fitness.
For a lot of physicians, the dealbreaker is actually the time away from family and friends. While some argue that they get more quality time with loved ones because they work a lot less in terms of number of days, and then can be fully present at home the rest of the time, if you want to put your kids to bed everyday or make it to every school event, locums life may not be for you.
You desire continuity of care with your patients
Again, although some physicians are able to find long term locums gigs, most of your gigs will likely have transient patient relationships.
You are looking to purchase a home in the near future
Securing a mortgage during your first few years as a locums physician can be difficult. If you know you’ve got a home purchase in your near future that you’ll require financing for, it’s probably better to secure the mortgage prior to making the switch. Read more about mortgages for locums doctors.
The idea of having to get and maintain multiple state licenses and undergo credentialing at different institutions is exhausting
While locums companies can often help you with these things, it may be annoying to you to have to do so much each time you want to work in a new place. Sometimes this can lead to postponed start dates that you don’t get paid for, and for some states, the nuances to maintaining licensure include lots of hurdles or paperwork that you don’t want to do.
You want to advance your career through promotions and titles
Unfortunately, your ability to grow within an organization or a role may be limited by the transient nature of your relationship with the institutions you work with. Even if you have a long term assignment, most promotions, titles, and leadership opportunities are given to permanent staff.
Conclusion
Locums life is becoming increasingly popular with physicians who desire flexibility in their schedules or the ability to earn more money while working less hours. However, it is definitely not for everyone. It’s important to be honest with yourself about what matters to you when approaching this decision. Talk to colleagues about their experiences, try out an assignment during a vacation week, etc., before making a permanent decision.
Related resources for locums physicians
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Related PSG resources: