Locum Tenens: A New (Old) Way to Earn Extra Money in Medicine

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The advantages of locum tenens are many—the flexibility to work whenever and wherever you want, the freedom from many bureaucratic and administrative responsibilities, the excitement of new locations, the gift of real time off.
No surprise, then, that a growing number of physicians are taking advantage of this lifestyle. A survey last year of several hundred healthcare facility managers found that over 90 percent of them use locum doctors. And there are now an estimated 44,000 physicians—about 6 percent of active doctors in the U.S.—working locum tenens nationwide.

But other doctors who might be tempted by the opportunities that locum tenens affords may be stopped by outdated ideas—that locum tenens is only for retired doctors, for instance—or worried about the effect that this way of practicing medicine will have on their income. The fact is that locum tenens is appealing to younger and younger doctors. And doctors of all ages are turning to locum tenens not only for the freedom and flexibility, but also to supplement their income with part-time locums work. . . or to actually make more money as locums than in permanent, full-time positions.

For younger doctors, not surprisingly given the burden of med school loans, money is a motivating factor. “I can tell you that one paycheck of locums work is more than I make in three months of fellowship, and it’s only a weekend. It really pays off,” says Dr. Bassam Rimawi, an obstetrician/gynecologist.

“There was a time when locum tenens were primarily late-career or retired physicians. No longer,” says Melissa Byington, President of the National Association of Locum Tenens Organizations (NALTO). “Increasingly we’re seeing docs working locums straight out of residency.” And Byington adds that mid-career doctors are finding the lifestyle and income benefits of locum tenens attractive, too.

More Money, More Freedom

“About 40 percent of the physicians who work locum tenens fall between the ages of 36 and 49. These doctors are working locums for a few different reasons,” she explains. For some of the doctors it’s a stopgap between permanent jobs. But there are also many doctors who do locums as a financial supplement to their full-time jobs. “When it’s time to pay for kids’ braces or a wedding or a trip, they’ll pick up extra shifts on the weekends or over their vacation days. Not only are they earning the income without the overhead costs of their own practice, but they also find that they get to do something pretty refreshing: practice medicine without the headaches.”

And yes, plenty of older physicians still work locum tenens.  And while the money is, of course, a plus, Byington says, “It’s not uncommon for these doctors to choose their assignments based on geography. Some like to take jobs near their kids or grandkids, for instance. Others like to work in places close to travel destinations. One of our family medicine doctors takes assignments in southern Utah because he and his wife can visit any of the five surrounding national parks on the weekends.”

Some doctors opt to make locum tenens their sole way of practicing, replacing full-time, permanent positions. Many others choose part-time locum tenens to boost income. Even occasional locum tenens assignments can have a significant impact on income, offsetting stock market fluctuation effects on a retirement fund, making home renovations or tuition bills easily affordable, or enabling doctors and their families to plan extra special vacations.

Val Jones, MD, a physician blogger who has worked locum tenens, wrote, “If you don’t mind travel and are a fairly adaptable individual… then you can expect to make at least 33 percent more in salary working as a locum (with professional liability insurance, housing and travel included). In addition, you have no administrative or teaching responsibilities, coding/billing hassles, or staff management issues. You’re paid an hourly rate for a minimum number of hours, with overtime negotiable. You get to see different parts of the country, and can control where you go and how much you work (think summers in Sonoma, winters in Florida. . . not a bad lifestyle choice).”

As a way to supplement income from a permanent position, or as a completely new way to practice with more freedom, locum tenens is a career option for physicians to consider. “Locum tenens is not for everyone. You need to be flexible. You need to be interested in trying new things and meeting new people and learning new EHRs,” says Byington. “But if you’re willing to try, it could help you reimagine what’s possible in your career.”