By T.J. Porter, WCI Contributor
Locum tenens, Latin for “one holding a place,” refers to doctors who fill in for other physicians when they're unavailable. Physicians working as locum tenens work as temporary staff in areas that are underserved—such as rural locations—or to fill in when a hospital has staff on vacation, leave, or an open position that has been difficult to fill. Working as a locum tenens offers several advantages for physicians who don’t mind the uncertainty involved, but it’s important to consider the pros and cons before committing.
How Does Working as a Locum Tenens Work?
If you want to work as a locum tenens, it means a slightly different career path than the typical physician. Rather than being employed by a hospital or opening your own practice, you’ll need to find opportunities to work as a locum tenens. You can either work to find gigs on your own or work with a locum tenens agency to find hospitals in need of locum tenens.
Once you find an opportunity and get hired, you’ll need to complete any required credentialing for your assignment and travel to the new location. Some agencies will assist with finding accommodations and transportation while others will leave you on your own.
Once you arrive, you’ll work the job like any other physician. Depending on the reason for hiring a locum tenens, you may know the gig’s end date. Once the assignment ends, you’ll start the process over again, finding a new place to work and travel to the new job.
More information here:
How to Get Locums Work Without a Locums Agency
Benefits of Locum Tenens
Working locum tenens has a number of advantages that can make it appealing to some physicians.
Flexibility
If you get a traditional job at a hospital or start a practice, you’ll likely wind up working a pretty set schedule. You’ll get some vacation time each year, but you will otherwise be expected to show up to work most days.
When you work as a locum tenens, assignments can last anywhere from days to months. You can take an assignment that lasts a few months, take a month off to relax, find another role that lasts a few weeks, take a few days off, and so on. You have much more flexibility and the opportunity to choose when you work and take longer periods of time off.
Higher Income
In some cases, especially if you have an in-demand specialty, you can command a higher rate of pay as a locum tenens. Hospitals hiring locum tenens are often looking to fill an urgent need and are willing to pay a premium to do it.
Travel
There are locum tenens assignments all over the United States, from Alaska to Hawaii and from Florida to Maine. If you want to experience different parts of the country before settling down in one place for the long term, working as a locum tenens gives you the chance to travel.
Learn New Skills and Experience New Environments
Every locum tenens assignment will be different. One might have you working in a small community health center while another could have you working in a huge city hospital. Working as a locum tenens means having the chance to choose assignments in different types of settings, letting you learn the pros and cons of different environments.
You’ll also work alongside a huge variety of people, and you may have the opportunity to pick up new skills that you can use to advance your career.
Drawbacks of Locum Tenens
Working as a locum tenens isn’t for everyone, so you have to consider the drawbacks before you commit.
Lack of Stability
The nature of working as a locum tenens is that nothing is permanent. Your assignment may last just a few days or it may last for months, but you know that eventually you’ll have to leave and find a new assignment.
If you don’t feel comfortable with constantly looking for new assignments and traveling to new areas for work, working as a locum tenens probably isn’t for you.
Onboarding Headaches
Every time you start a new assignment, you’ll need to onboard. That means filling out a huge amount of paperwork, possibly applying for licenses in a new state, learning how to work with a new EMR, and so on.
If you’re not adaptable to new ways of doing things or if mountains of paperwork give you a headache, this could make starting new assignments a major chore.
Lack of Benefits
When you work as a locum tenens, you’re not an employee of a hospital. That means that you’re responsible for handling things like retirement planning, health insurance, dental insurance, and so on.
Agency Cuts
Many, if not most, locum tenens find new assignments through an agency. If you get a locums tenens assignment through an agency, you’ll have to pay that agency a cut of your income, which eats into your earnings.
More information here:
How Can I Make My Terrible Doctor Job Less Terrible?: Auntie Marge Explains It All
When in Your Career to Work as a Locum Tenens
You can work as a locum tenens at any point in your career. Many physicians make a career as a locum tenens, spending the majority or all of their working years traveling to new assignments.
However, working as a locum tenens is often most popular among doctors who have just finished their residencies and forthose who are nearing the end of their careers.
Post-residency, many physicians have yet to put down roots or figure out where they really want to settle down. Working as a locum tenens gives new doctors the chance to travel the country, earn a high level of income, and learn more about what they’re looking for in a more permanent position.
Working as a locum tenens can also be appealing as you near the end of your career. If you’ve set up a strong financial base for yourself, you might consider working only a few assignments a year while taking off large amounts of time. You have the option to work as much or as little as you want and to be picky with where you want to work.
The Bottom Line
Locum tenens travel the country, and sometimes the world, working temporary positions at hospitals and healthcare centers. If you have flexibility, don’t mind the uncertainty of constantly looking for new assignments, and like the idea of travel, locum tenens might be right for you.
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A common issue that has come up for locum tenens physicians is whether a business license or business tax receipt is required to work as an independent contractor. Does this requirement depend on the state or county where you’re physically working, or on your home state where you reside?
For example, if you live in one state but never actually practice there, and instead take locums assignments in another state while being paid on a 1099 basis, do you need to obtain a business license in your home state, the assignment state, or both?
This has become a more complicated issue recently, and many physicians may not even realize it applies to them. Similarly, for telemedicine work (such as with MDLIVE or Teladoc), earning 1099 income may trigger the need for a special business permit depending on the jurisdiction. What’s the real answer here?
Great question. I’m not sure I know the “real answer”. It may be not just state dependent, but city/county dependent. The general answer if you ask any state or city is that you have to register. Meanwhile, I don’t think it really gets enforced anywhere, so even if the answer is you have to get the license, if nobody gets in trouble for not having it, do you really have to?
My city says this:
https://sandy.utah.gov/271/Apply-for-a-Business-License
Lots of advice, but NONE as to whether an independent contractor needs one. It’s basically left up to you to decide if you’re “operating a business.” Technically, being an IC is operating a business though.
https://sandy.utah.gov/267/Business-Licensing
In Sandy City Ordinance 5-1-1, it states that it is unlawful for any person to engage in business within the City limits without first having obtained a business license. A separate license shall be required for each type of business and for each place of business. Licenses are renewable annually and are not transferable from one owner to another or to any other location other than the one indicated on the license. If you are planning to take over the ownership of an existing business or move an existing business to a new location, please allow up to 20 days to process an application.
What is a business license?
A business license is city permission to operate a legal business within the boundaries of the issuing government body. In Sandy City Ordinance May 1, 2013, the term “business” shall include all activities engaged in or caused to be engaged in with the object of gain or economic profit.
Not sure what your city says. Probably something similar. So I guess the real answer is get the license. Luckily it’s usually pretty cheap.
The base fee for a Sandy City commercial business license is $140, plus a $40 inspection fee and a Disproportionate Regulatory Service fee. These are the main costs to consider when applying for a business license in Sandy City, Utah.
Not sure we’ve ever bothered for WCI given we have no location customers come to, we sell nothing face to face etc. But we probably should after reading this. Thanks a lot for asking this question.