Locum tenens (Latin for “to hold a place”) refers to physicians who take on temporary assignments, filling in for other doctors as needed. In 2025, the use of locum tenens physicians is at an all-time high – close to 90% of U.S. healthcare facilities report using locum tenens providers to fill staffing gaps. With ongoing physician shortages and the desire for flexibility, many doctors are exploring locum tenens work for its professional and financial benefits.
Nearly half of physicians who accept locum tenens roles primarily do so to supplement their existing income, while a significant number highlight higher compensation compared to permanent positions as a major motivation.
Factors Influencing Locum Tenens Salary
Several key variables impact locum tenens physician earnings:
- Medical Specialty: Physicians with specialized skills generally earn higher rates. Surgical specialists and subspecialists typically receive higher compensation compared to general practitioners or primary care providers.
- Geographic Location: Areas experiencing high costs of living or significant shortages in healthcare providers usually offer elevated compensation to attract locum physicians. Rural communities, underserved regions, and certain high-demand states may also provide premium pay rates.
- Experience and Skills: Physicians with extensive experience (typically over five years) can negotiate higher pay, often significantly above the rates for less experienced doctors. Additional certifications, such as in critical care or proficiency in telemedicine, further enhance earning potential.
- Urgency and Timing of Assignments: Facilities frequently offer higher compensation for urgent staffing needs, including last-minute placements, holiday coverage, or less desirable shifts (such as nights or weekends). Flexibility and availability for these types of assignments can notably increase hourly earnings.
- Workload and Availability: Since locum positions usually compensate physicians based on hours or shifts worked, those who take on a greater number of assignments or maintain a more intensive schedule can substantially increase their annual income.
Furthermore, while locum tenens roles typically lack traditional employee benefits such as health insurance and retirement matching, reputable staffing agencies commonly cover significant expenses like malpractice insurance, travel, and housing costs. These agency-covered expenses significantly enhance the overall value of locum tenens compensation packages by reducing physicians’ out-of-pocket expenditures.
Locum Tenens Salary by Specialty in 2025
Locum tenens pay rates vary widely by medical specialty. The table below highlights approximate 2025 locum tenens earnings for several common physician specialties. Hourly rates and the equivalent full-time annual income potential are shown (assuming a 40-hour workweek for a year):
| Specialty | Typical Locum Rate | Annual Locum Salary (Full-Time) |
| Family Medicine | ~$100/hour | ~$208,000 | ziprecruiter.com |
| Pediatrics | ~$93/hour | ~$192,000 | ziprecruiter.com |
| Internal Medicine | ~$137/hour | ~$285,000 | ziprecruiter.com |
| Emergency Medicine | ~$148/hour | ~$308,000 | ziprecruiter.com |
| Psychiatry | ~$125/hour | ~$259,000 | ziprecruiter.com |
| Obstetrics/Gynecology (OB/GYN) | ~$126/hour | ~$262,000 | ziprecruiter.com |
| General Surgery | ~$137/hour | ~$285,000 | ziprecruiter.com |
| Anesthesiology | ~$189/hour | ~$393,000 | ziprecruiter.com |
| Radiology | ~$166/hour | ~$345,000 | ziprecruiter.com |
| Cardiology | ~$172/hour | ~$357,000 | ziprecruiter.com |
| Urology | ~$177/hour | ~$368,000 | ziprecruiter.com |
Table: Estimated locum tenens pay by specialty, 2025. Annual figures assume full-time locum work; many physicians choose to work fewer locum hours, so actual earnings will vary.
As shown, most locum tenens physicians can earn into the mid-6-figures annually if they maintain a full locum schedule. High-demand specialties like anesthesiology, cardiology, and surgical sub-specialties top the list, often exceeding $350,000 per year in locum roles (ziprecruiter.com). Even primary care fields such as family medicine and pediatrics, which are on the lower end of locum rates, still offer significant income potential around $180,000-$210,000 for full-time locum work.
It’s important to note that these are gross earnings (before taxes) and do not include benefits. Locum tenens physicians are typically independent contractors, meaning you must budget for self-employment taxes and provide your own benefits. However, given the flexibility of locum work, you can choose to work as much or as little as desired – some use locums part-time to supplement an employed position, while others make it a full-time career.
Locum Tenens vs. Permanent Physician Salaries
A common question is whether doing locum tenens pays more than a traditional permanent position. In general, locum tenens providers do earn a higher hourly rate than their full-time employed counterparts.
Locum tenens roles offer greater flexibility and higher hourly rates but require proactive management of assignments, expenses, and benefits to achieve or exceed permanent position earnings.
Hourly Pay Comparison:
- Permanent Physician: Internal medicine physician averages approximately $200,000 annually, or roughly $96 per hour.
- Locum Tenens Physician: Internal medicine locum physician typically earns about $136 per hour, considerably higher than permanent counterparts.
Annual Earnings:
- Occasional Assignments: Physicians who take fewer locum tenens roles annually may earn less overall due to reduced total working hours.
- Consistent Schedule: Physicians maintaining a busy locum schedule, including overtime or additional shifts, can surpass annual earnings of permanently employed peers.
Benefits and Expenses:
- Permanent Positions: Typically offer comprehensive benefits, such as paid vacation, health insurance, and retirement plans.
- Locum Positions: Usually lack traditional benefits but often include coverage for malpractice insurance, travel, and accommodation provided by staffing agencies.
- Tax Advantages: Locum physicians can optimize taxes by deducting eligible business expenses. Consulting a tax professional is recommended for detailed guidance.
Tips to Maximize Your Locum Tenens Earnings
If you’re considering locum tenens opportunities, these strategies can help maximize your earnings:
Choose High-Paying Assignments: Prioritize assignments in specialties or regions experiencing provider shortages, which often offer higher compensation. Rural and underserved areas frequently provide premium pay to attract physicians.
Flexible Scheduling: Being open to night, weekend, and holiday shifts can significantly increase your hourly rate. Facilities often provide enhanced pay for less desirable or urgent staffing needs.
Negotiate Using Your Experience: Leverage your professional track record when negotiating pay rates. Facilities value reliability and quality care; know the current market rates for your specialty and advocate for competitive compensation.
Partner with a Reliable Staffing Agency: Working with a reputable locum tenens agency, such as Wapiti Medical Staffing, simplifies logistics, secures desirable assignments, and ensures coverage of critical expenses such as malpractice insurance and travel, enhancing your take-home pay.
Manage Finances Proactively: Since locum tenens compensation is generally reported on a 1099 form, taxes are not withheld. Plan ahead by setting aside funds for taxes, securing your own health insurance and retirement savings, and consulting with an accountant to maximize deductions and financial planning.
Implementing these strategies—selecting lucrative assignments, negotiating confidently, and efficiently managing your finances through a trusted agency—can significantly enhance your locum tenens income.
For U.S. physicians in 2025, locum tenens work offers a compelling combination of competitive pay and flexibility. Doctors can earn excellent income through locums, with many specialties seeing potential salaries well above national averages. Whether you take locum assignments full-time or as a side gig, the financial rewards can be significant, especially if you leverage the factors that drive higher pay. Keep in mind the trade-offs (like lack of traditional benefits), but for many physicians, the freedom and earning potential of locum tenens is well worth it.
If you’re interested in exploring locum tenens opportunities, now is a great time.
To learn more about getting started, read our guide to working locum tenens for a step-by-step overview. When you’re ready to find your next assignment, visit our locum tenens jobs board to see current physician openings across the country. With the right approach, locum tenens can be a rewarding and lucrative path, allowing you to earn top dollar while practicing medicine on your terms.