We often see questions within our physician Facebook groups from members who have received an initial locum tenens offer and aren’t sure if the proposed rate is fair. With our recent update to our Locums Compensation Database for physicians, we wanted to highlight some of the trends we noticed while compiling the data. The purpose of our compensation data is to help physicians know their worth by increasing transparency when it comes to pay and compensation, in hopes that this will help tackle issues such as burnout from poorly negotiated contracts. It’s important to note that locum tenens compensation for doctors will vary a lot by location and specialty, so while this aggregate data is interesting, it’s important to dig into the details. Make sure you check the locum tenens compensation data on our database for true apples to apples comparisons. Also make sure that you check out our primer on locums for physicians, which goes through what you need to know about locums life, as well as important aspects of a locums contract.
Learn more about our pay and compensation data for doctors, including how to access our databases and contribute. Data is unidentifiable and anonymous when contributing and free to access. Please note that to access the data and contribute to it, you will need to be a member of our Physicians Side Gigs Facebook group, which is only open to physicians.
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How do doctors find locum tenens opportunities?
We asked if members find locums opportunities themselves or if they go through a locums company.
About 25% find opportunities on their own, while 40% use a locums company. The other 35% mentioned they do both.
There can be pros and cons of using a recruiter, which we cover on our Locums Primer for Physicians in more detail.
Of the members who reported using a locums company, 85% mentioned that the locums company they work with allows them to work with other companies as well. We do recommend being wary of signing exclusivity agreements with locums companies, as it will limit your ability to negotiate if they know you really want a position. Additionally, this can be a great way to have more than one recruiter working for you to help find the best compensation/benefits package. Using more than one company can also present a wider range of options, since some systems outsource all their openings to one specific company to fill.
How many locums companies do doctors typically work with?
While 85% said they can work with multiple companies, only around 50% of our members reported that they actually do. We often hear that the experience with a locums company relies heavily on who you work with. If you have a recruiter you trust who has shown they have your best interest at heart and keep you gainfully employed with contracts, as well as inherently knows your preferences, it might not be worth the headache of trying to juggle multiple offers and points of contact. Several members of our communities have recommended specific recruiters they’ve enjoyed working with on our databases for locums compensation data.
What hourly rate do doctors receive for locum tenens compensation?
Across all the contributions to our data, we see that the average doctor - across specialties - makes an hourly locums rate of around $200 to $225 an hour.
The highest hourly locums rate reported by our physician members for locums work was around $500 an hour for hematology oncology, while the lowest we saw was $60 an hour for pediatrics. Keep in mind that our database is still in its infancy (please contribute!), so there are several specialties for whom we don’t have many datapoints yet. Anecdotally on our communities we have seen some subspecialists, particularly subspecialty surgeons, who have been able to negotiate more than $500/hour.
Also keep in mind that these datapoints are for the average compensation that our physicians cited across their locums gigs, not the highest they’ve ever gotten. If working in a particularly rural area, holiday period, or because there is an urgent need, we’ve often seen our physicians be able to negotiate higher rates for specific situations.
When breaking down the rates by specialty, a few stood out as the highest paying:
Hematology oncology (average of $405/hr)
Gastroenterology (average of $350/hr)
Interventional radiology (average of $315/hr)
As mentioned above, pay can vary widely by specialty, which is why it’s important to view the locums compensation data for physicians to make sure you have accurate information for your contract negotiations.
If you don’t see contributions for your local area and specialty, working with a local contract attorney who has helped several over physicians successfully negotiate their agreements is another great way to get a feel for what is fair and common in the current market. And please contribute your data to the database as well!
How many days a year do doctors work locums?
Many physicians reported that they do locums full time as their main career. There are pros and cons for this style of career. Whether it’s a good fit for you can depend on your goals. Locum tenens positions offer flexibility, but with that flexibility can come instability in pay and job security.
If you’re interested in locums as a career but are just starting out, consider trying it as a side gig before quitting your current position and making the transition to full time.
Learn more on our physician’s guide to locum tenens.
On the high end of the scale, many doctors reported working 200-300 days a year while earning compensation in the $200,000 to $800,000 range.
Physicians who do locum tenens as a side gig to supplement their full-time physician job reported an average of around 10 - 50 days of locums over the course of the year. Many reported bringing in $50,000 to $100,000 of additional income from their locums side gig.
Again, check specific comps from our locums compensation database to get a better idea for your specialty.
Do doctors need licensing in multiple states to do locum tenens work?
We asked the doctors in our community how many states they currently hold licenses in.
The majority of our physician members report they only hold one or two licenses. While traveling is a part of locums life, our data suggests you don’t always have to travel too far from home, which can provide a better work/life balance than constantly hopping on trains, planes, and automobiles. Though if you do enjoy traveling for work, our members include in our database suggestions such as tips on collecting and using reward points. We also have recommendations for favorite travel rewards credit cards.
Learn more about physician licensing, including the Interstate Medical Licensure Compact (IMLC), if you are looking into starting locum tenens work.
What states do doctors find locums opportunities in?
As you might expect, opportunities exist across the United States. Some of the most popular states for locums work are:
California
Florida
New York
Texas
We can’t help but notice these are also the most populous states in the country where many of our members live, so it’s hard to definitively draw any conclusions about hot areas for locums work. As we get more data, we’ll try and update this.
Several of our members mentioned they are willing to travel anywhere for the right opportunity. This ultimate flexibility can open up a lot of potential both in terms of the number of opportunities and the amount of compensation, if it’s worth the trade offs for you. Not surprisingly, harder to recruit areas have higher compensation, so if you want to take a few weeks and go to a more remote part of Alaska, you’re likely to make more money than doing locums in a major urban area - and you may have some cool experiences!
Can doctors negotiate an extension without a recruiter?
Over 50% of our physician members mentioned they can’t negotiate a contract extension without a recruiter. If you enjoy your locum tenens contract and are looking for long-term possibilities, it may be worth talking about this with your locums recruiter ahead of time and seeing if an arrangement can be made. Obviously, the locums company isn’t going to be excited about giving up their cut, but they may be willing to work with you before you’ve signed a contract to say that after a certain number of shifts, you can independently work with the employer. They may also have a similar relationship in place with the employer.If you love the position you work locums at so much you’d want to consider becoming a permanent employee, some locums companies may allow this without issues. Others may require some sort of placement fee, so if you may find yourself bringing all the parties to the table to negotiate a fair agreement.
Can a doctor make a career out of locums work?
If you don’t mind the travel and a bit of instability in between contracts, working locums can be a long-term option when building your vision of your physician career. The majority of our physicians have done locums work for three years or less, but several reported they have been doing locums work for over a decade, and we anticipate that the number in this category will continue to rise. As more and more physicians seek flexibility in their careers and as physician demographics change to situations where physicians may want to be able to do things like take summers off, many are finding that locums life is a great fit for them.
Malpractice insurance coverage and locums work
We asked our members what malpractice coverage they had for their locum tenens work.
72% had coverage provided by their locums company
13% had coverage provided by the location (claims based)
18% had coverage provided by the location (occurrence based)
9% has to provide their own coverage
(Yes, this totals more than 100%. Some members reported multiple situations based on different contracts.)
Malpractice insurance is a critical component of asset protection for physicians and can be expensive if you have to cover it itself, so it’s important to include this in your contract negotiations.
Learn more about malpractice insurance.
Retirement options with locum tenens work
There are several tax-advantaged retirement plan options for doctors who do locum tenens work either as their main job or as a side gig.
Of the members who reported having their own retirement accounts:
60% have solo 401ks
44% have SEP IRAs
7% have a defined benefit plan
Again, this equals more than 100%, but these retirement plans are not mutually exclusive.
Since data for self-employed retirement options isn’t required to contribute to our locums compensation database, we aren’t sure what percentage of our physician members have these plans. Only around 35% of respondents answered the question.
If you have any side gig income or self-employed 1099 income, don’t overlook these options! They can have great tax advantages now and for long-term wealth building. Additionally, make sure you maximize your 1099 deductions as a locums physician.
A defined benefit plan is a great option for doctors who make a career out of locums work and do it full time.
Solo 401ks and SEP IRAs can both be great options, though a SEP IRA can cause issues with a Backdoor Roth IRA, so we caution physicians to clearly understand the limitations if they do, or plan to do, a Backdoor Roth IRA.
Learn more on our self-employed finances primer and deep dive into the solo 401k plan for physicians.
Conclusion
Locum tenens work is popular among our physician community for its flexibility. Being self-employed as a physician can also come with some great tax advantages. If you’re interested in locums work, taking the time to research what a fair rate in your area is can help you know your worth and help reduce physician burnout that often comes from poorly negotiated contracts simply because you weren’t aware of what to ask for.
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