Locum tenens is temporary physician work — filling a staffing gap at a hospital, clinic, or practice for a defined period, usually paid at a day rate or hourly rate well above a comparable employed salary once you account for the lack of benefits. It makes the most sense between jobs, while evaluating a permanent move, or as a way to earn more without a permanent commitment. It makes less sense as a long-term substitute for benefits, retirement matching, or malpractice tail coverage that an employed position would otherwise provide.
What is locum tenens, in practical terms?
“Locum tenens” is Latin for “to hold the place of,” and in practice it means a physician takes short-term assignments — weeks to several months — covering for a facility that has a staffing gap: a physician on leave, an unfilled position, a seasonal volume spike. Assignments are typically arranged through a locum tenens staffing agency, which handles credentialing logistics, malpractice coverage for the assignment, and often travel and housing, then places the physician with a facility that pays the agency a placement fee.
Physicians work locum tenens for a range of reasons: bridging the gap between residency and a permanent position, testing out a new city or practice setting before committing, supplementing income during a slower stretch, or as a long-term lifestyle choice for physicians who prefer variety and flexibility over the stability of a single employer.
What does locum tenens actually pay?
Locum tenens pay is structured as a day rate or hourly rate, not a salary, and that rate is typically higher than what an equivalent employed position pays on a per-day basis — which makes sense, since the facility isn’t providing benefits, retirement contributions, or a long-term commitment in either direction. Rates vary substantially by specialty, region, and how urgently a facility needs coverage; a hard-to-staff rural assignment in a shortage specialty commands a materially higher rate than a routine assignment in a well-staffed metro market.
The honest scope limit here: specific day-rate figures shift too often, and vary too much by specialty, region, and assignment urgency, to state as a fixed number in an article like this without risking a figure that’s already stale by the time you read it. The reliable way to answer “what does this pay” for your specialty is a live comparison against current assignments, not a table of numbers from whenever this was published.
What locum pay doesn’t include, and what to account for before comparing it to an employed offer: health insurance, retirement matching, paid time off, and — depending on the agency’s malpractice arrangement — potentially tail coverage after the assignment ends. A day rate that looks 40% higher than an employed salary on paper can end up close to parity once those gaps are priced in.
When does locum tenens actually make sense?
Locum tenens makes the most sense in a handful of specific situations: between permanent jobs, while relocating and deciding on a market before signing a long-term contract, early in a career to sample different practice settings before committing to one, or as a deliberate lifestyle choice for physicians who value flexibility over the security of a single employer. It also functions as a release valve for physicians who need a change of pace without leaving medicine entirely — a point worth sitting with if the appeal of locum work is coming from exhaustion with a current role rather than genuine interest in variety.
It makes less sense as a permanent substitute for an employed position if what you actually need is the stability employment provides — consistent income, employer-sponsored benefits, and a fixed location — rather than a bridge or a deliberate lifestyle choice. If burnout with a current position is the real driver, locum work can be a legitimate reset, but it’s worth being clear-eyed about whether it’s solving the underlying problem or just changing its shape. Our piece on what the data actually shows about physician burnout goes further into that distinction.
What does credentialing for locum tenens actually involve?
Locum tenens credentialing means getting verified by the specific state medical board and the specific facility before an assignment can start, and it’s frequently the single longest step in the entire process — often longer than finding the assignment itself. Every new state requires its own license, and every new facility requires its own privileging process, even if you’ve held a license in that state before under a different employer.
A staffing agency typically manages the paperwork and application logistics, but the underlying timeline is set by the state medical board and the facility’s own credentialing committee, not the agency. That timeline can run anywhere from a few weeks to several months depending on the state and how backed up the credentialing office is at that particular time. Physicians who plan to work locum tenens regularly across multiple states often maintain licenses in more than one state simultaneously specifically to avoid this bottleneck — an upfront cost that pays off in faster placement later.
What changes with 1099 status versus W-2 employment?
Most locum tenens assignments pay on a 1099 basis rather than W-2, which means no tax withholding happens automatically and the physician is responsible for estimated quarterly tax payments and self-employment tax — a meaningfully different cash-flow and tax-planning situation than a standard employed paycheck. Some staffing agencies do offer W-2 arrangements for locum work, which shifts some of that administrative burden back to the agency, typically in exchange for a lower net rate.
The honest scope limit here: the right structure between 1099 and W-2 locum work depends on individual tax circumstances, state of residence, and how many assignments you’re taking in a given year — that’s a tax-planning question specific to your situation, not something a general article can answer responsibly. What’s worth knowing going in is simply that the choice exists and that it changes both your take-home math and your paperwork obligations, so it’s worth raising with whoever handles your taxes before accepting a first assignment, not after.
How do you get started with locum tenens work?
Getting started with locum tenens work means choosing a staffing path, getting credentialed for the target state and facility, and comparing assignments against your specialty’s current market rate rather than the first number offered. Credentialing is often the longest step — hospital privileging and state licensing timelines can run weeks to months depending on the state, so timing an assignment usually means starting that process well before you need income to begin.
DocNation’s Locum Tenens Placement service places physicians into assignments with current market-rate context, rather than leaving you to compare offers against outdated figures or a single agency’s framing of what’s competitive. For physicians deciding between locum work and a permanent position, Job Search and Placement covers the permanent-position side of that same decision, so the comparison is apples to apples rather than one path evaluated in detail and the other guessed at.
What this article doesn’t cover: tax treatment of 1099 locum income versus W-2 employment, which varies by how the assignment is structured and where you live, and state-specific licensing timelines, which change often enough that they need a current, state-specific check rather than a general answer here.
