When I left my full-time job as a pediatric emergency physician, most people assumed I was leaving medicine. My colleagues were confused. A few were worried. Some probably thought I was having some kind of professional crisis. But I wasn’t walking away from medicine. I was redesigning how I practiced it.
That redesign started with locum tenens, and it changed everything about how I think about my career, my income, and my life. If you’ve heard the term but aren’t sure what it really means or how it works, this is the primer I wish someone had given me before I made the leap.
What Is Locum Tenens and How Does It Work for Physicians?
Locum tenens is Latin for “to hold the place of.” In practice, it means a physician or any other medical professional steps in to provide temporary coverage at a hospital, clinic, or health system. Maybe someone is on maternity leave. Maybe there’s a staffing gap in a rural community. Maybe a hospital just needs extra hands during a busy season.
Assignments can range from a single weekend shift to several months of coverage. You work as an independent contractor, which means you choose which assignments to accept, when to work, and how much time to take off between jobs. There’s no annual review, no mandatory committee meetings, no fighting over the holiday schedule.
The logistics and administrative work are handled by your agency partner: credentialing, malpractice insurance, travel arrangements, and housing if the assignment is away from home. You show up, take care of patients, and leave when the assignment ends.
The Biggest Misconception About Locum Physician Work
You Don’t Have to Get on a Plane
Most physicians picture locums as packing a suitcase and flying across the country to work in a small-town hospital for weeks at a time. That version exists, and some physicians love it. But it’s far from the only option.
For me, I take local assignments. I practice at two different emergency departments near my home. I sleep in my own bed every night! In some specialties, you can even do locums via telehealth without leaving your house.
The flexibility is the point. You can travel if you want to see new places and practice in different settings. Or you can stay close to home and build a local locum practice that gives you scheduling freedom without the suitcase. There’s no single right way to do it.
Why I Chose Locum Tenes Over a Traditional W-2 Physician Job
I Needed to Control My Schedule
I was building a company and I needed time that a traditional W-2 job wouldn’t give me. I couldn’t tell my department chair that I needed three weeks off to work on a product launch. I couldn’t skip shifts because I had investor meetings. The rigid scheduling of traditional employment was incompatible with everything else I was trying to build.
Locums solved that problem immediately. I could block out weeks for my business and then schedule clinical shifts around my other commitments. No one was going to fire me for not picking up enough shifts. No one was going to guilt me about coverage gaps. I was in control of my calendar for the first time in my medical career.
The Math Made Sense
When I found locum positions that allowed me to concentrate my clinical work into just four days a month with strong earning potential, the math changed everything. Four days of clinical work. Twenty-six days for everything else: building my businesses, being present for my four kids, and actually living my life instead of just surviving it.
Locums pay rates are often significantly higher than permanent positions because you’re filling an urgent need and you don’t come with the overhead of benefits, PTO, or retirement contributions that hospitals build into salaried compensation.
What Being a Locumpreneur Actually Means in Today’s Healthcare Market
I use the word “locumpreneur” because it captures something important that most physicians miss: when you work locums, you are running a business. You are the product, the service, and the CEO. You have control over your rates, your schedule, where you practice, and your growth strategy.
This mindset shift is critical. If you approach locums like a temporary gig while you wait for a “real” job, you’ll miss the point entirely. The physicians who thrive in locums are the ones who recognize that they’ve built something valuable: a flexible, portable, high-income medical practice that they control.
That doesn’t mean you need an MBA or a business plan. It means you think strategically about which assignments serve your goals, you manage your finances like a business owner, and you treat your career as something you design rather than something that happens to you.
Common Questions Physicians Ask About Locum Tenens
Is Locum Tenens Stable Enough?
Physician demand in the United States isn’t slowing down. The Association of American Medical Colleges projects a shortage of up to 86,000 physicians by 2036. Hospitals and health systems need coverage, and locum physicians fill that gap. I’ve never had trouble finding work when I wanted it.
Stability in locums looks different from stability in a salaried position. You don’t have a single paycheck from a single employer. Instead, you have a skill set that’s in high demand across thousands of facilities nationwide. That’s a different kind of security, and in many ways, it’s more resilient.
What About Benefits?
You’ll need to handle your own health insurance, retirement accounts, and disability coverage. This is the part that intimidates most physicians, but it’s more straightforward than it sounds. The higher pay rates in locums generally more than offset the cost of purchasing your own benefits. You also get to choose exactly what coverage you want instead of accepting whatever your employer offers. If you are married and your spouse has insurance, that’s a viable option as well. Either way, Barton Associates steers me in the right direction with all of it.
What About Malpractice Insurance?
Most locum agencies provide malpractice coverage as part of the assignment. This is typically occurrence-based coverage, which means you’re covered for any incident that occurs during the assignment period regardless of when a claim is filed. It’s one of the major advantages of working through an established agency partner like Barton Associates.
How to Start Exploring Locums
You don’t have to quit your job tomorrow. Many physicians start by picking up locum shifts on their days off or during vacation time. This gives you a feel for the work, the pace, and the lifestyle without any financial risk.
If you’re further along in your thinking, consider reducing your FTE at your current position. Going from 1.0 to 0.8 FTE while filling the gap with locum shifts can be a low-risk way to test whether this model works for you. Many physicians are surprised by how much better they feel with even a small reduction in their committed schedule.
The key is working with a career partner who understands your goals, not just an agency looking to fill slots. I work with Barton Associates because they take the time to understand what I’m building and match me with assignments that fit my life, not just their open requisitions.
The Bottom Line
Locums isn’t a Plan B. It isn’t what you do when you can’t find a permanent job. For a growing number of physicians, it’s a deliberate career choice that provides income, flexibility, and autonomy that traditional employment simply cannot match.
I left my full-time ER job and redesigned my career around locum work. I still practice pediatric emergency medicine. I still take care of sick kids. I still love what I do. I just do it on my own terms now, and that has made all the difference.
