Locum Tenens Is a Career Strategy, Not a Detour
Temporary assignments are no longer just a bridge between jobs. Used deliberately, locums can test markets, fund goals, and restore control, if you understand the tradeoffs.
Locum tenens once carried a quiet stigma. Physicians took temporary assignments between jobs or near retirement, and colleagues wondered why they could not hold a permanent position. That view is outdated. Physicians at every career stage now use locums on purpose, to explore regions, pay down debt, reset after burnout, or build a schedule no employer would offer. It can be a smart move, but only if you go in understanding what you are trading.
What Locums Offers
Flexibility is the headline benefit. You choose when and where you work, often in blocks that leave long stretches free. Daily rates are frequently attractive, and travel and housing are often covered by the agency or facility. Locums also lets you sample practice settings, from critical access hospitals to large urban centers, before committing to one. For physicians unsure whether they want to move, it can be a trial run with a paycheck.
What You Give Up
- Benefits. As an independent contractor, you usually handle your own health insurance, retirement savings, disability coverage, and taxes.
- Continuity. You rarely follow patients over time, which some physicians miss deeply.
- Stability. Assignments can be canceled or shortened, and income can be uneven.
- Belonging. You are always the new person, often navigating an unfamiliar EHR and team.
- Administrative load. Multiple state licenses and credentialing packets take real time and money to maintain.
Locums rewards physicians who are adaptable, organized, and clear about why they are doing it.
How to Do It Well
Treat locums like a small business. Work with more than one agency so you can compare assignments and rates. Read every contract closely, paying attention to cancellation terms, malpractice coverage and tail, housing standards, and who pays for licensing. Confirm what call and patient volume will actually look like before you arrive.
Keep your credentialing documents organized and current, since you will submit them repeatedly. Consider whether an interstate licensure compact would simplify your path in states you want to work. Talk with an accountant about quarterly estimated taxes, deductible expenses, and retirement accounts available to self employed physicians.
On site, be the easiest colleague the team has ever had. Learn names, ask how things are done locally, and document clearly. Facilities remember good locums and often invite them back or offer permanent positions.
Decide in advance what locums is for. A defined goal, such as testing a region, reaching a savings target, or recovering from a hard stretch, helps you recognize when it is time to settle into something permanent, or when locums has quietly become the career you actually want.
Dr. Reyes practices emergency medicine and writes about clinical decision making under pressure and the technology entering the ED.
This article is for professional education and does not replace clinical judgment. Treatment decisions should be based on the individual patient and current guidelines.
