What Good Agencies
do Differently
There are more than 150 locum tenens staffing agencies operating in the U.S., ranging from national firms with decades of history to regional boutiques with narrow specialty focus. Not all of them operate the same way, and the difference often shows in the first five minutes of a recruiter call.
Knowing what to look for — and what to walk away from — gives you leverage before you’ve signed anything.
Why Your Recruiter Matters
Here is the part most locum guides skip: your recruiter on the other end of the phone matters just as much as the agency you’re working with.
Across Barton’s 600+ Trustpilot reviews at the time of this publication (4.7 out of 5, against a 2.6 average for recruitment companies broadly), the pattern is remarkably consistent. Clinicians rarely describe their experience as “Barton helped me.” They describe it as “my recruiter understood me, advocated for me, and stayed in touch.”
That’s not a coincidence. A good recruiter is doing more than filling a shift. They’re the person who:
Vets the opportunity before you ever hear about it.
So the call you get is one worth taking, not a spray-and-pray pitch outside your specialty or geography.
Stays in the loop after the contract is signed.
Checking in on the first day, first week, mid-assignment, and everywhere in-beweee, not disappearing until the next placement is due.
Advocates for you.
Pushing on rate, flagging a site concern, or escalating a credentialing delay before it becomes your problem.
Remembers what you told them.
Your specialty, your preferences, your non-negotiables, and yes, even your dog’s name — so you're not re-explaining your career from scratch on every call.
Nick DeCurtis has been a great recruiter and true advocate for me and only me. I have been working with him for three years now. He’s reliable, responsive, and always willing to find the best assignments that work best for me. He also helps ensure my travel accommodations are nice and suitable for what I need.
This Is Also Why the Red and Green Flags Below Matter
More Than the Headline Pitch.
A recruiter’s behavior on the first call is a preview of how they’ll behave for the length of your relationship with the agency — not just the length of one contract.
Pressure to sign before the opportunity is clear. Representation agreements bind you to a single agency for a specific role. Some agencies push the agreement before disclosing the role in detail. Don’t sign representation without understanding the specific role, the rate range, the duration, and the exclusivity terms.
Spam volume and off-target opportunities.
A recruiter who calls with assignments outside your specialty, geography, or stated preferences has skipped the vetting work. First calls from agencies worth working with land on opportunities that fit.
Impersonal contact. Misspelled names, generic openers, templated outreach that doesn’t reference your practice. Agencies that handle clinicians as pipeline inventory show it on the first call.
Transparent purpose. The recruiter states why they’re calling, what opportunity they want to discuss, and what the next step looks like. No ambiguity about whether the call is exploratory or transactional.
Vetted, targeted opportunities. The role fits your specialty, scope, geography, and stated preferences. The recruiter did the homework before placing the call.
Named clinical infrastructure. Agencies with serious clinical operations have named clinical leadership — a Chief Medical Officer or equivalent — along with defined escalation pathways and infrastructure beyond placement. This signals that the agency invests in your clinical experience, not only the contract.
Representation Agreements: What to Know
A representation agreement gives a single agency exclusive rights to present you to a specific facility for a specific role. It protects the agency’s investment in sourcing and gives you a clear point of contact for that placement
Three things to confirm before signing:
The specific
opportunity it covers.
Representation is role-specific in most cases, not a blanket arrangement across all opportunities.
The exclusivity terms.
Does the agreement prevent you from working with other agencies on other roles, or only on this one?
The expiration.
Representation agreements expire after a defined period. Know when your obligation ends.
Working with Multiple Agencies
Many locum clinicians work with more than one agency. The practice is legitimate and common. The discipline is keeping representation agreements clean — never signing two representations for the same role, communicating active engagements to each recruiter, and tracking which agency owns which conversation.
Most clinicians who work with multiple agencies still have a primary — the agency whose recruiter behavior, contract quality, and clinical infrastructure they trust most. Secondary agencies fill specific opportunity types or geographies the primary doesn’t cover.
Structural Signals Beyond the First Call
A great recruiter matters, but so does the company standing behind them. The strongest locum staffing firms have operational systems that make every assignment smoother and protect you long after your contract ends.
Years in business.
Longevity isn't just a credibility signal. It matters because credentialing records, malpractice documentation, and assignment history may need to be accessed years later. An established agency is more likely to have the infrastructure and stability to support you over the long term.
Clinical leadership.
Look for agencies with a physician chief medical officer (CMO) or other clinical leadership. When questions arise about scope of practice, clinical expectations, or patient care, it's valuable to have experienced clinicians involved in decision-making, not just operations staff.
Operational infrastructure.
Strong agencies invest in systems that reduce administrative burden. Credentialing technology, organized onboarding, transparent communication, and clear escalation paths all signal an organization built to support clinicians at scale.
Malpractice coverage.
Most locum assignments include malpractice insurance through the staffing agency, but the details matter. Ask who carries the policy, what the coverage limits are, whether tail coverage is included, and how claims are handled after an assignment ends. Understanding these details upfront helps you avoid surprises later.