Why Clinicians Choose Locum Tenens
The Short Answer
Locum tenens allows physicians, NPs, PAs, CRNAs, and dentists to build a career on their own terms — choosing when they work, where they work, and how many clinical settings they want to rotate through. The pay is a major perk, too. Hourly rates typically run 20–30% above permanent equivalents across most specialties.
Ask clinicians why they made the switch, and the answer is almost always the same: control over their schedule. Not more money, not variety for variety’s sake — control. Once you’ve built your work around your life instead of the other way around, going back to a fixed schedule feels less like a step forward and more like a step into a smaller box.
And this isn’t some fringe career move. More than 50,000 clinicians are practicing locum tenens in the U.S. at any given moment, according to NALTO. On the demand side, 80% of U.S. healthcare facilities rely on locum tenens to fill gaps in care. Locum work isn’t a workaround anymore. It’s how healthcare staffs itself.
Why Clinicians Make the Move
Near 63% of physicians report experiencing burnout, according to the 2023 Medscape Burnout Report. That number is one reason so many clinicians are rethinking what a sustainable practice actually looks like — and finding that locum tenens gives them a way to keep practicing medicine on terms that work.
Seven Patterns: Why Clinicians Come to Locums
Most clinicians arrive at locum tenens work through one of seven paths. These aren't rigid categories — many clinicians recognize themselves in more than one. But understanding the pattern helps clarify what kind of locums practice actually fits your life.
1. Schedule Redesigners
Physicians, NPs, PAs, and dentists who want a defined cadence — two weeks on and two weeks off, one week a month, specific shifts only — and shape their work around it rather than the reverse.
2. Supplemental Moonlighters
Clinicians who hold a permanent W-2 position and add a few locum shifts a month for additional income and clinical variety. No full commitment required.
3. Burnout Recoverers
Clinicians who needed distance from a difficult workplace and used locums to stay in practice while deciding what comes next. As one physician put it: "Locums made me enjoy being a doctor again.
4. Culture Escapes
Clinicians who left a poor work environment and used locums to keep practicing without immediately committing to a replacement employer. A bridge with income.
5. Travel + Variety Seekers
Clinicians for whom locums means working at different health systems, exploring new geographies, or both. The variety compounds into broader clinical judgment.
6. Career Bridge Clinicians
Clinicians finishing training, transitioning between permanent roles, or pacing thoughtfully toward retirement on their own terms.
7. Burnout Recoverers
Clinicians who needed distance from a difficult workplace and used locums to stay in practice while deciding what comes next. As one physician put it: "Locums made me enjoy being a doctor again.
The Math
Hourly rates for locum clinicians run above permanent equivalents in most specialties. Physicians practicing locums earn, on average, 20–30% more per hour than comparable permanent positions in the same specialty. The Barton Salary Guide publishes current ranges by specialty and region.
Dr. Alison Curfman, Chief Medical Officer at Barton Associates, describes her own framing:
I chose locums strategically — not as a fallback. The math at the time was straightforward: four shifts a month at locums rates approximated my full-time emergency-medicine monthly salary. The rest of the month was for the businesses I was building, for time with my family, for the kind of focus you can't get when you're on call every weekend.
The exact number of shifts that makes sense per month shifts by specialty — there’s no universal formula. But the underlying logic holds up across the board: locum hourly rates make it financially realistic to design your own schedule, something a fixed permanent salary almost never lets you do.
How much can i earn as a locum?Career Locums
There’s a version of locums work that’s reactive: the clinician who accepts whatever comes, treats each assignment as a one-off, and wonders why the experience feels unstable. And there’s a version that’s intentional: clinicians who treat their locums work as a portfolio, keep multiple options live, adjust cadence as life changes, and sunset assignments that no longer fit.
The clinicians who build durable locums careers — the ones still doing this work five and ten years in — are almost always in the second group. The following sections cover what each stage of the locums journey requires and what Barton provides along the way.
“Shelby Rogers has been handling my assignments for years now. She is thorough. She represents my best interests in negotiations. She keeps me informed. I’m looking forward to many more years of working with Shelby and Barton Associates as a locum tenens provider.”