Insights From Wapiti

Locum tenens, Latin for “to hold the place of,” describes physicians or healthcare providers who temporarily fill roles normally held by permanent staff. They commonly work in hospitals, clinics, and medical facilities to cover:

• Staff absences
• Vacations
• Temporary vacancies

This flexible staffing solution has become widespread across the U.S., with thousands of doctors choosing locum assignments annually.

Considering Locum Tenens?

Many physicians wonder how locum tenens works and if it aligns with their career goals. Wapiti Medical offers clear guidance on:

• Step-by-step locum tenens processes
• Essential considerations and benefits
• Common physician questions about temporary assignments

Understanding these practical aspects can help determine if locum tenens suits your lifestyle and professional ambitions.

Why Do Physicians Choose Locum Tenens?

Locum tenens has become increasingly popular among physicians due to several unique advantages over traditional permanent roles. Here are key reasons why doctors choose locum tenens:

Flexibility and Control: A major benefit of locum tenens is the ability to control your schedule. Doctors select when, where, and how long to work, providing excellent work-life balance. You can arrange assignments around personal commitments, taking extended breaks between jobs, giving you more freedom for family, travel, or personal interests.

Variety of Practice & Locations: Locum tenens allows exploration of diverse practice settings and geographic locations without a long-term commitment. You can experience rural, urban, or suburban healthcare environments, helping to sharpen your skills, keep your work interesting, or even evaluate potential permanent positions.

Higher Earning Potential: Typically, locum tenens doctors earn higher hourly compensation compared to salaried positions because facilities pay premiums for urgent staffing needs. Earnings correlate directly with how frequently you accept assignments, enabling you to scale income up or down as desired.

Avoiding Burnout and Office Politics: Locum assignments often focus purely on patient care, reducing exposure to administrative duties, hospital bureaucracy, and workplace politics. Physicians appreciate the relief from these pressures, helping them regain professional satisfaction and reduce burnout.

Career Freedom and Transitions: Locum tenens provides valuable flexibility during career transitions. Newly graduated physicians gain varied experiences, mid-career professionals bridge employment gaps or pursue other interests, and those nearing retirement can gradually scale back workload.

While beneficial, locum tenens also includes some challenges:

Travel and Time Away From Home: Assignments might require extended travel, resulting in time away from family. Though manageable with planning or selecting local roles, frequent travel isn’t suitable for everyone.

Learning Curve in New Environments: Each assignment involves adapting to new systems, teams, and protocols, requiring physicians to quickly adjust. Facilities typically support orientation efforts, easing this transition.

Lack of Traditional Benefits: As independent contractors, locum tenens physicians don’t receive employer benefits such as insurance, retirement contributions, or paid leave. Doctors manage their own taxes, health coverage, and retirement planning—though higher compensation and tax deductions can offset these expenses.

Job Security and Scheduling: Income depends on securing regular assignments, which can occasionally result in uncertain scheduling. Physicians who prefer consistent patient relationships may find the temporary nature less satisfying.

Despite these considerations, many doctors who try locum tenens enjoy the arrangement significantly. By planning effectively, physicians can maximize benefits and successfully manage challenges, making locum tenens a rewarding professional choice.

How the Locum Tenens Process Works (Step by Step)

If you’re considering locum tenens, understanding the process can help you confidently get started. Essentially, working locum tenens is similar to freelancing as a physician, typically involving collaboration with a staffing agency such as Wapiti Medical, which facilitates assignments and logistics. Here’s an overview of how the process generally unfolds:

1. Partnering with a Staffing Agency

Initially, you’ll sign up with a reputable locum tenens staffing agency, providing essential credentials such as your CV, medical licenses, references, and practice preferences. You’ll specify desired specialties, regions, scheduling preferences, and travel limits, enabling the agency to match you with suitable assignments. The agency confirms your qualifications, ensuring you meet necessary requirements such as board certification and licensing.

2. Assignment Selection and Interview

Your recruiter presents assignment opportunities fitting your criteria, providing details on locations, responsibilities, schedules, and pay rates. If interested, you’ll typically interview with the hiring facility’s management via phone or video to discuss expectations. Once both parties agree, the assignment is finalized. You retain full control to accept or decline any role.

3. Credentialing and Licensing 

Upon assignment acceptance, you’ll undergo credentialing, including hospital privileges and licensing paperwork. Your staffing agency assists significantly with documentation, ensuring you quickly and efficiently complete credentialing processes. They manage coordination with the facility, reducing your administrative workload.

4. Contract Signing

You’ll sign a contract detailing assignment terms such as pay rates, responsibilities, schedule, and covered benefits (e.g., travel, housing, malpractice insurance). Review and clarify any questions before signing, confirming your assignment start date.

5. Travel and Accommodation 

Most agencies or facilities handle and cover travel logistics and accommodations, including flights, rental cars, and housing arrangements. Typically, physicians face no out-of-pocket expenses for these arrangements. Agencies such as Wapiti Medical ensure travel coordination is seamless and convenient.

6. Orientation and Assignment

Upon arrival, you’ll receive an orientation covering EMR systems, facility protocols, and introductions to staff. You then begin clinical duties as outlined, supported by colleagues and facility staff. Agencies provide ongoing support throughout the assignment, offering assistance as needed, ensuring smooth operations.

7. Payment and Compensation 

Locum physicians receive payment directly from the staffing agency based on agreed-upon rates. Agencies usually offer reliable, regular payment schedules through direct deposit. Payments are gross amounts, as taxes are your responsibility as an independent contractor.

8. Malpractice Insurance

Locum tenens agencies typically provide comprehensive malpractice insurance, covering you throughout each assignment. Coverage includes tail insurance when applicable, eliminating personal malpractice-related expenses and offering peace of mind.

9. Assignment Completion and Future Steps

After completing an assignment, you may return home, accept extensions, or even transition into permanent positions if mutual interest arises. Agencies continue offering new assignments, allowing flexibility to work as much or as little as preferred. The ongoing cycle of matching, credentialing, and logistical support becomes increasingly streamlined as you gain experience.

Locum tenens offers physicians an efficient and flexible approach to practice medicine, facilitated by staffing agencies like Wapiti Medical, which manage logistical complexities and support your professional journey.

Frequently Asked Questions About Locum Tenens

Even with the above explanation, you may have specific questions. Below we answer some common queries physicians have about how locum tenens works:

How long are locum tenens assignments?

There is no single set length for locum tenens jobs – assignments can be as short or long as needed. In many cases, locum tenens physicians are hired for brief periods, such as a few days or weeks to cover vacations, medical leave, or a busy spell. For example, an urgent care might need a locum doctor for one weekend a month, or a hospital could bring someone in for a two-week block. On the other end, some assignments last several months – say, 3 to 6 months to fill a vacancy until a permanent doctor is hired. It’s even possible to work somewhere on a locum contract for a year or more if both parties keep extending the agreement. That said, the average locum tenens assignment is often a few weeks to a few months in duration. 

Many physicians start with short stints and later take longer gigs once they find locations they like. Flexibility is the name of the game – you can arrange your locum schedule as you prefer. Some doctors do locum tenens just a few weeks a year, while others work continuously. Before accepting an assignment, you’ll know the expected time frame and can decide if it suits your schedule. Additionally, if you prefer short assignments (or conversely, long ones), let your recruiter know so they can match you accordingly.

How are locum tenens physicians paid?

Locum tenens physicians are typically paid an hourly or daily rate for their work, rather than an annual salary. The pay rate is agreed upon upfront for each assignment. For example, you might earn $150 per hour, or a flat $1,200 per 8-hour shift, etc. Overtime or on-call work may have additional pay as well. You’ll receive payment directly from the agency (or the facility) according to their pay schedule, usually via direct deposit​. Many agencies process payroll on a weekly or biweekly basis, so you don’t have to wait long after working to get paid. It’s important to track your hours/shifts (often via a timesheet signed by the facility) to ensure accurate payment.

As mentioned earlier, taxes are not deducted from locum tenens pay because you are an independent contractor, not an employee. You will be responsible for reporting that income and paying taxes yourself (federal, state, self-employment tax, etc.). Keep this in mind when budgeting – setting aside a portion of each paycheck for taxes is wise. On the plus side, being 1099 means you can deduct business-related expenses. Common deductions for locum physicians might include state licensing fees, travel costs (if not reimbursed), lodging (if you paid any), mileage on your personal car, scrubs or work supplies, and a home office if you use one for managing your locum work. These deductions can offset your taxable income significantly​. It’s highly recommended to work with a CPA familiar with physician contracting to maximize your take-home pay legally.

In terms of how lucrative locum tenens is, it varies by specialty and workload. Primary care and psychiatry locums might earn hundreds of dollars per day, whereas surgical or anesthesiology locums can earn significantly more. Overall, because locum rates factor in the lack of benefits, they tend to be higher than an equivalent employed rate. For many doctors, locum tenens pay ends up higher annually than a salaried position would, especially if you fill your schedule. Just remember to account for taxes and benefits costs when comparing. If managed well, locum tenens can be financially rewarding while providing you greater freedom over your time.

Do locum tenens physicians get benefits (health insurance, retirement, etc.)?

No, most locum tenens positions do not include traditional employee benefits like health insurance, dental, retirement plans, or paid leave. Since you’ll likely be working as an independent contractor, agencies generally do not provide these benefits to you (their client physicians). You are effectively your own boss/business, so you must arrange any benefits on your own. Here’s how physicians typically handle it:

• Health insurance: Locum doctors often purchase individual health insurance plans. You can buy coverage through the ACA marketplaces or private insurers. If you have a spouse with an employer plan, you might join that. Some professional associations also offer health plans for self-employed physicians. Factor the cost of premiums into your financial planning. The upside is that health insurance premiums may be tax-deductible as a self-employed person.

• Retirement savings: Without a hospital 401(k) or 403(b), you’ll need to set up your own retirement account. Options include an Individual 401(k) (solo 401k), SEP-IRA, or SIMPLE IRA, which have high contribution limits for self-employed folks. These let you save pretax income for retirement just like a workplace plan. Again, consult a financial advisor or accountant to choose the best vehicle. You’ll have the freedom to invest as you see fit for your future.

• Disability and life insurance: You might want to secure your own long-term disability insurance policy since you won’t have an employer plan. This protects your income if you get injured or ill and can’t work. Life insurance is similarly something to consider carrying independently if you have family/dependents.

• Malpractice insurance: This is provided for locum tenens assignments by the agency or facility, as discussed earlier. You should not need to pay for your own malpractice coverage while working locum tenens. Always verify this is the case. Virtually all agencies include it, covering claims made during your assignment (and providing tail coverage afterward). This is a valuable benefit that saves you a large expense.

While the lack of employer benefits is a downside to locum tenens, many physicians find that the significantly higher pay rates often compensate for these costs. You essentially have more cash in hand, part of which you allocate to buying benefits of your choice. Additionally, you have full ownership and portability of your benefits – for example, the retirement account you set up stays with you forever, not tied to an employer. For doctors who value independence, this arrangement can be preferable to a traditional benefits package. It does, however, require diligence in managing your personal finances and insurance needs.

Who covers the malpractice insurance for locum tenens doctors?

Malpractice insurance for locum tenens physicians is typically provided by either the staffing agency or the facility hiring you—at no cost to the physician.

How It Works:

• Agency-provided coverage: Most locum tenens staffing agencies maintain an umbrella malpractice insurance policy covering all their providers. You’ll be added as a named insured for each assignment.
  • Example: Wapiti Medical Staffing provides A-rated malpractice insurance with:
    • Coverage limits: $1M per claim / $3M annual aggregate
    • Claims-made policy with tail coverage (coverage continues after the assignment ends)
• Facility-provided coverage: Occasionally, hospitals might cover locums under their self-insurance. Regardless, you shouldn’t pay for coverage yourself.

Key Points for Physicians:

1. Cost savings: You avoid the expense of personal malpractice insurance.
   Documentation: Keep a copy of your certificate of insurance provided during credentialing.
2. Coverage type clarification: Confirm if the policy is:
   • Occurrence-based: Covers incidents during the policy period, even if claims arise later.
   • Claims-made with tail: Covers incidents occurring during your assignment and claims made after the assignment ends. (Most common for agencies.)

Before Starting an Assignment:

• Confirm in writing that malpractice coverage is provided.
• Ensure coverage explicitly includes the services you’ll perform.

If you pursue locum assignments independently (not via an agency), you’ll need to negotiate coverage directly or purchase your own policy.

When working with a reputable locum tenens agency, malpractice insurance is typically guaranteed, allowing you to focus solely on patient care without worrying about personal liability risks.

Yes—while locum tenens positions are temporary by nature, they can often evolve into permanent roles. This pathway, commonly known as “locum-to-perm,” provides advantages for both physicians and healthcare facilities.

How Locum-to-Perm Typically Works:

1. Trial period:
   • Hospitals or clinics may initially hire you as a locum to evaluate fit.
   • Physicians can similarly assess whether the facility or community suits their long-term goals.
2. Mutual interest:
   • If both parties agree the fit is excellent, a permanent job offer may follow.
3. Facilitating the transition:
   • The staffing agency usually assists in the transition, coordinating with the facility to hire you directly after contractual obligations are satisfied.
   • Agencies may have specific procedures or placement fees, but these are generally handled by the facility, not the physician.

Benefits of the Locum-to-Perm Model:

• “Try before you buy”: Gain exposure to various settings and teams before committing.
• Flexibility:
  • You are never obligated to transition into a permanent role.
  • Some physicians enjoy staying locum for continued freedom and flexibility.

Things to Consider:

• Confirm any transition-related details with your staffing agency (placement fees, contract duration requirements, etc.).
• Staffing agencies, including Wapiti, often provide permanent placement services, making it easy to shift from temporary to permanent when you’re ready.

Locum tenens can absolutely open doors to permanent positions—if that’s your goal. It offers a practical way to discover your ideal workplace or simply enjoy the freedom of temporary assignments until you’re ready for something more permanent.

Locum tenens offers physicians professional freedom, flexibility, and adventure by allowing them to take short-term assignments while maintaining their income and clinical practice. From partnering with staffing agencies and credentialing to traveling for assignments and receiving compensation, the locum tenens model provides physicians with substantial control over their schedules and lifestyles.

To explore locum opportunities, partner with a trusted staffing agency such as Wapiti Medical Staffing. We handle all logistics, including licensing, travel, and malpractice coverage, allowing you to focus on patient care.