In Part 1 of Locumpedia’s No-BS Guide to Locum Tenens, we covered the basic what, how, and why of locum tenens from the physician’s perspective: What is it? How does it work? And why should I consider it?
One of the common myths we hear about locum tenens providers is that this is a career geared toward “semi-retired doctors.” But that’s far from the truth. And those myths can be damaging because organizations have this misconception that all locums practitioners are at the ends of their careers, unmotivated, and looking to phase out of the field.
Locum tenens assignments can be good for emerging physicians in post-residency to physicians with 10, 15, or 20 years of experience in the healthcare industry. Exposure to different practice areas and healthcare settings can be valuable at any stage of the game.
There’s also a common myth that locum tenens providers are either inexperienced or don’t have “permanent potential,” but in actuality, these locum tenens assignments are an opportunity for facilities to test different providers to see if they would fit in with the team, the company culture, and if they would be ideal for a permanent position.
Whether you’re a physician working locums to make extra money on the side, taking this opportunity to fill a gap in a transition period, or if locum tenens is a full-time career choice, you can find an opportunity that aligns with your goals.
Long story short: There’s no “best time” in a clinician’s career to work locums. People’s wellness and futures are always in need of your expertise.
Locum tenens physician and creator of the personal finance website “Physician on FIRE (Financial, Independence, Retire, Early)” Leif Dahleen created PoF to inspire physicians to take control of their future and take advantage of the opportunities available to physicians to gain financial independence.
Dahleen’s experience with locum tenens began immediately after he finished his residency. He practiced almost exclusively as a locums doc for nearly two years. He says he looked at each assignment as a “try before you buy” opportunity and claims he was offered a job in “just about every place [he] worked.”
This certainly doesn’t happen with every locum tenens assignment, but it does happen. Dahleen made “the locums life” work so well that he achieved financial independence by age 39. Then the former anesthesiologist started a blog through which he teaches others how to do the same.
Medical school requires years of studying and training far beyond an undergraduate degree. New doctors fresh out of school are often left with an average debt between $184,000 – $254,000. In the top 15 medical schools where students left with the “most debt,” the average was about $254,000.
But debt varies from school to school, and there are different variables like whether or not the students attend a public vs. private school or attend an in-state versus out-of-state institution. That balance of debt grows during the 3-to-7-plus-year stretch of residency and fellowship training before a doctor finally starts earning a physician’s salary–the average stipend in a resident or fellow’s first year after medical school is $57,863. In many of those cases, locum tenens assignments help young doctors ditch the debt.
Earn and Learn
Beyond the financial rewards of locum tenens for new physicians, Dahleen says locum tenens became a great training ground. The time in residency helps a physician become proficient in their skills and learn how to work in any scenario, but locum tenens assignments offer more opportunities than a residency by exposing physicians to a variety of workplaces and work styles.
Dahleen trained at a tertiary care facility and had no exposure to rural medicine, limited supervisory experience, and exposure to covering either the OR or OB, never both. But locum tenens afforded him plenty of opportunities in different states, practice sizes, and settings—both urban and rural. This variety is valuable and helps make physicians well-rounded and more adaptable.
If you’re a resident, stories like these might have you wondering, “When can I get started?”
While it’s possible for physicians to accept locum tenens assignments in their last six months of residency (in some specialties), some residency programs, hiring facilities, or agencies won’t allow it.
But physicians pursuing a fellowship are eligible for placement in their residency specialty as long as they’ve been doing clinical work within that specialty. Working locum tenens right out of training is also possible for physician assistants and nurse practitioners, but it can be challenging to find locum assignments if you have “minimal clinical experience.
Locum tenens agency blogs and websites offer plenty of stories illustrating the value of locum tenens practice for more experienced physicians.
Doctors in the middle of their careers often work locum tenens as a way to get experience in a bunch of different locations or environments almost as a way of compiling research before deciding to take on a new, permanent position. Other physicians will work locum tenens as a way to make some extra income and supplement the pay they make at their day job.
Sometimes locum tenens simply offers a welcome change of pace: “In times like these, when you’re asking yourself whether you want to leave for good or just need a break, the opportunity for a temporary change is perfect,” says Dr. David Beran, doctor of osteopathic medicine. “I agreed to cover a set amount of hours each month for a set period of time and when those months were done, I had no obligation to return. By doing locums, I was able to explore new opportunities without having to commit.”
Doctors can get tired of working in the same places on the same types of cases, but working in a new system lets physicians reset and get a fresh perspective on their careers by applying medical skills in new ways at new locations.
Sometimes [locum tenens] simply offers a welcome change of pace: “In times like these, when you’re asking yourself whether you want to leave for good or just need a break, the opportunity for a temporary change is perfect.”
— David Beran, DO
Picture a scenario where a physician accepts a position at what they believe to be a great facility only to find out after they accept that job that it’s not what they expected.
This could be for many reasons, such as:
Locum tenens is one of the ways doctors can try out these different healthcare facilities to find the ideal physician job.
Unfortunately, general surgeon Dr. Demetri Poulis lived the scenario we just mentioned. Poulis had started his position working alongside a surgery partner who left his post a few years later. The move left Dr. Poulis on call for about 15 hours a day. For two years, he didn’t go on vacation and he didn’t see his children.
For five years, Poulis worked as the only surgeon on his team. Finally, his wife at the time gave him a reality check: “They’re going to kill you. You can’t keep doing this,” she said.
As Poulis sought career alternatives, he landed on locums: the opportunity to travel and work at different hospitals without committing long-term. It helped Poulis see how other facilities treated their doctors and helped him address the burnout he had been facing. Locum tenens work eventually took Poulis to an Adventist hospital where he accepted a full-time position. He credited his experience and relationships in locum tenens for motivating him to practice surgery on his terms.
Heading Toward, or During, Retirement
Many physicians and advanced practitioners do work locum tenens as a way to dial back and work less as they near retirement. Locums assignments help physicians return to the roots of why they chose medicine.
Dr. Steven Berman discovered locum tenens after working in medicine for 35 years after he was recruited by agencies while on medical leave recuperating from shoulder surgery and subsequent complications. Dr. Berman was “disenchanted by private practice,” so he decided to pursue locums. And he endorses the practice alternative as a great way to transition between employment and retirement.
He used his vacation time to work locum tenens, and then he eventually took a full-time job in North Carolina after working there on an assignment where he got to know people in the hospital and the community.
“I knew what I was getting into. I knew the community. I knew the hospital, I knew the politics of the hospital, so it was certainly much easier to take a job knowing fully what that job was before committing,” he said.
“I knew what I was getting into. I knew the community. I knew the hospital, I knew the politics of the hospital, so it was certainly much easier to take a job knowing fully what that job was before committing.”
— Steven Berman, MD
Just about every specialty and subspecialty in medicine benefits from locum tenens providers. These medical professionals fill an important need by enabling healthcare facilities to provide services that wouldn’t otherwise be available to patients in their communities.
Locum tenens is the chosen career path for more than 50,000 physicians across the US, and more than 90% of all US healthcare facilities take advantage of these fill-in physicians.
The most recent data has these 10 physician specialties as the most in-demand currently:
Across the board, physicians are faced with the same economic and compensation pressures as the broader workforce as inflation impacts these doctors’ income. The average pay for physicians increased last year, and primary care physicians received the biggest increase from 2021-2022. But those gains were overtaken by the rate of inflation at 7% in 2021 and 6.5% the following year.
Doximity’s outlined in its Physician Compensation Report that neurology was the specialty with the highest average annual compensation at $788,313. Most of the highest-paying specialties tended to be surgical, while the lowest average annual compensation tended to be pediatric and primary care specialties — pediatric endocrinology salaries averaged $218,266.
Demand for specific locum tenens specialties varies by facility and geographic location, but there’s an ongoing need for family medicine physicians, psychiatry, urgent care, and anesthesia care providers. And, on average across all specialties, physicians who work locum tenens full-time make at least $32.45 per hour more than permanent-only doctors, So, while every physician is feeling the impact of inflation on their income, locum tenens still presents the greatest opportunity to earn more money, which makes locums the ideal solution for meeting your financial goals — we’ll go deeper into this later!
Demand for specific locum tenens specialties varies by facility and geographic location, but there’s an ongoing need for family medicine physicians, psychiatry, urgent care, and anesthesia care providers.
Physicians experienced increases in compensation because of the astronomical strain and demand placed on the healthcare industry following the COVID-19 pandemic. But only a few years later, we’ve seen physicians’ pay either decline or remain the same across many specialties
Emergency medicine physicians saw a big increase in compensation (just over 6%) in the first two years following the pandemic. That makes sense, too, because there was a continuous demand for those services in emergency departments across the country. But other increases for medical specialties depend on the employment setting, with single-specialty, solo practice, and multi-specialty groups ranking toward the top of average annual compensation.
If you’re a physician whose income has either gone down or remained stagnant, Inflation is to blame. In June 2022, inflation in the US reached a a 40-year high at 9.1%. As a result, many doctors’ real incomes took a hit.
The entire healthcare industry has had to endure fallout as these economic and financial pressures impact the quality of life and overall job satisfaction for physicians and other providers in the healthcare field.
Providers have reported high levels of burnout since the start of the COVID-19 pandemic and it’s led many to even consider pursuing a career change. Practicing locum tenens can help providers alleviate the burnout they’re faced with. Reports show that contracted locum tenens clinicians experienced significantly lower levels of burnout, with a majority even reporting little to no burnout.
Locum tenens helped those physicians alleviate the pressures that impact burnout levels. Locum tenens providers can choose the schedules they work, experience a wide range of locations, and it removed some of the administrative burdens of medical practice and freed them up to pursue outside interests other than their jobs. More physicians are open to working as locum tenens. The demand for providers in emergency fields and specific specialties will force healthcare facilities to rely even more on the help of locum tenens physicians to continue to provide optimal patient care in communities across the US.
So, you may be thinking, who benefits most from locum tenens? Or you might feel like it’s too late to start a locums career. But, keep reading… You’ll see that’s not the case.
As a certain would-be PR firm account executive was asked once in an interview, “How well do you handle ambiguity?” If you’re a stickler for consistency and routine — and you’re willing to trade off an employer’s structuring your work (and, thus, personal) time in exchange for the security of having that paycheck hit your bank account every two weeks, maybe the sometimes-erratic nature of locum tenens medical practice isn’t for you.
Are you a bit of an extrovert who enjoys meeting new people and exploring new places? If you’re more introverted, are you somewhat adaptable — open to learning new systems and processes and ‘seeing how the other half lives?’
Are you up for a bit of travel and adventure for at least part of a given month? If you prefer staying relatively close to home, are you willing to work extra shifts to back up or fill in for peers within driving distance in your “off-time?”
Do you long to set boundaries for your work life that don’t include office politics, work-related social events or limits on personal/vacation time? Are you willing to provide for your own — or your family’s — health, life, disability and other benefits coverages without an employer’s contribution?
Are you ready and willing to take charge of your career, scheduling when; where; for what duration and how often you will provide medical care for which patient population(s)? Can you manage a barrage of agency recruiters, sifting through the players and opportunities until you boil it down to what works?
Lots to think about, for sure.
If we’ve piqued your interest and you seriously wonder if locum tenens could work for you, visit the National Association of Locum Tenens Organizations website (NALTO.org) or refer to the Locum Tenens Staffing Agencies Directory on Locumpedia. In both locations, you’ll find links to member-agency websites that can give you a sense of possible assignment and service options.
Several agencies offer quizzes and tools to help you ponder the possibility of working locum tenens. Try out Barton & Associates’ quiz to see if locum tenens is the right career choice for you. Locumstory also offers this tool to help providers decide if the locums pros outweigh the cons.
This is not to imply that you should think this decision to death. Maybe you should just gather your documents, pick an assignment or two of interest, and give it a shot!
Staffing agencies, healthcare facilities, locum tenens providers, and industry followers can stay in the locums loop with the free Locumpedia Newsletter. We publish about two issues per month, and you can unsubscribe anytime.
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