Before I started practicing locum tenens as an Emergency Medicine Physician, I had a running list of reasons not to do it. They felt rational and responsible at the time. But looking back, every single one of them was fear dressed up as logic. And they almost stopped me from building the career and life I have today.
If you’re a physician, nurse practitioner, physician associate or any other healthcare professional considering locum tenens work and you’ve got a voice in your head listing all the reasons it won’t work, I want you to know that I had that same voice. I listened to it for a long time. Then I stopped, and everything changed.
The Locum Tenens Fears That Feel Real
“What If I Can’t Find Steady Work?”
Many physicians considering locum tenens worry about income stability. This was my biggest one. I’d spent my entire career with a guaranteed paycheck. The idea of not having a set schedule with predictable income felt reckless. I have four kids who eat berries like they are going out of style. I have a mortgage. Walking away from a steady paycheck seemed like something only people without real financial obligations could afford to do.
Here’s what I didn’t understand at the time: physician demand is not slowing down. The United States is facing a projected shortage of tens of thousands of physicians over the next decade. Hospitals need coverage. Rural communities, big cities, and everywhere in between need doctors. Health systems need help during busy seasons, staff transitions, and leave coverage. In fact, over 90% of healthcare facilities use these temporary professionals annually to fill staffing gaps. The work is there if you want it.
I’ve been doing locums for years now along with 8% of the U.S. physician workforce, and I’ve never struggled to find shifts when I wanted them.
“What About My Kids?”
This one cut the deepest because it touched my identity as a mother. Would locums mean more time away? Would I be less present? Was I being selfish by wanting more control over my schedule instead of just accepting the one I had?
The irony is almost painful in retrospect. My traditional job had me working nights, holidays, and weekends on a schedule I couldn’t control. I missed school plays because I was on shift. I missed bedtimes because I was charting. My kids saw a version of me that was chronically exhausted and distracted.
Locums gave me the opposite. I choose when I work. I don’t work night or holidays. I’m home for dinner. I’m present at pickup. The fear that locums would take me away from my kids turned out to be exactly backward. It brought me back to them. (And on a few occasions, they’ve even gotten to come WITH me!) My secret: if you’re traveling for work in a cool place, bring one kid and grandma to join! They can go explore when I’m on shift.
“Is This Irresponsible?”
This fear is uniquely medical. We’re trained to sacrifice and that putting ourselves first is selfish. We watch our mentors grind through 80-hour weeks and we internalize the message that suffering is the price of being a good doctor.
Choosing a career structure that prioritizes your well-being feels irresponsible because it contradicts everything residency taught you about what dedication looks like. But burning out doesn’t make you a better physician. Working until you are too tired to do your job doesn’t serve your patients. Taking care of yourself so you can sustain a long, engaged medical career is the most responsible thing you can do.
“What If I Don’t Know How Things Work?”
One of the most common concerns about starting locum tenens assignments is adapting to new systems quickly. This one is sneaky because it disguises itself as a clinical concern when it’s really just unfamiliarity anxiety. Walking into a new emergency department where you don’t know where the supply closet is, which attending covers which area, or how to put in a consult order — it feels vulnerable. You go from being the person who knows everything about how your department runs to the new person who has to ask where the bathroom is.
But here’s the thing I learned quickly: the medicine is the same everywhere you go. A sick kid presents the same way in Missouri as they do in Massachusetts. Your clinical training doesn’t reset when you walk into a new facility. What changes is the systems — the EMR layout, the call schedule, the way they stock the Pyxis. And those things? You learn them fast. Usually within a shift or two, you’ve got it down.
And you can always ask for help. Every facility has nurses, techs, and staff who’ve been there for years and are happy to show you the ropes. I’ve never walked into an assignment where people weren’t willing to point me in the right direction. You’re not expected to know the systems on day one. You’re expected to know medicine — and you do.
This is also where having the right staffing partner matters. I work with Barton Associates because they truly invest in their physicians’ and providers’ experience. They don’t just place you and disappear. They make sure you have what you need to succeed on every assignment — from credentialing support to making sure you know what to expect before you show up. That kind of partnership takes the edge off the unfamiliarity and lets you focus on what you’re actually there to do: take care of patients.
The Benefits of Locum Tenens Work
Stability on My Terms
Stability doesn’t have to mean one employer, one schedule, one paycheck. I’ve built a practice that includes two local emergency departments where I work locum shifts. I have consistent relationships with facilities that know my work and want me back. I have predictable income because I choose to work a predictable schedule, not because someone assigned it to me.
This version of stability is actually more resilient than traditional employment. If one facility has a problem, I have another. If I need to take time off, no one needs to approve it. My stability comes from the breadth of my options, not the narrowness of a single contract.
Presence With My Family
I sleep in my own bed every night (except, of course, when I’m traveling – my favorite hobby). I haven’t worked a holiday in years. When my kids have a school event, I’m there. When they’re sick, I’m home. These aren’t small things. These are the moments that make up a life, and I was missing them before locums.
The guilt I felt about choosing flexibility has been replaced by gratitude that I found a way to practice medicine and be the kind of parent I want to be. Those two things aren’t in conflict. They only felt that way when I was trapped in a structure that didn’t serve either one well.
A Career That Fits My Life
I still practice pediatric emergency medicine. I still get the adrenaline of a critical case, the satisfaction of reassuring a worried parent, the privilege of taking care of someone’s child during their worst moment. I didn’t leave medicine. I restructured my relationship with it.
Now my career serves my life instead of consuming it. I have time to build companies, pursue speaking opportunities, mentor other physicians, and contribute to the profession in ways that go beyond direct patient care. None of that would be possible if I were still working a traditional full-time schedule.
What Fear Is Actually Telling You
Fear before a career change is normal. It means you care about the outcome. It means you’re taking it seriously. But fear is not evidence that something is a bad idea. It’s evidence that something matters to you.
The question isn’t whether you’re afraid. The question is whether you’re going to let fear make your career decisions for you. I almost did. I almost stayed in a job that was slowly draining me because the alternative felt too risky. I’m glad I didn’t.
How to Move Through the Fear
Start with information, not commitment. Talk to physicians who work locums. Ask them what surprised them, what they wish they’d known, what they’d do differently. Read about how credentialing works, how malpractice is handled, how assignments are structured. The more you understand the mechanics, the less scary the transition feels.
Then start small. Pick up one locums shift while you’re still employed. See how it feels to walk into a new facility, meet a new team, and practice medicine without all the administrative overhead of your permanent position. Most physicians who try it are surprised by how natural it feels.
Working with a career partner who understands physician concerns makes a significant difference. I chose Barton Associates because they didn’t just send me job listings. They listened to my fears, answered my questions, and helped me build a transition plan that felt safe. Plus, the licensing, credentialing and onboarding are quick and easy!
If fear is the only thing holding you back, it’s worth asking what’s waiting on the other side. For me, it was everything I’d been missing.
