Locum Tenens: When Temporary Work Becomes a Career Strategy

For years, locum tenens work was easy to think of as something clinicians did temporarily. Maybe you picked up an assignment between permanent positions, filled a few weeks before starting a new job, or used occasional shifts to supplement your regular income.

But temporary work doesn’t necessarily mean temporary career strategy. For some experienced advanced practice providers, locum tenens offers something a traditional position may not: the ability to change how work fits into their lives without stepping away from clinical practice.

An NP, PA, CRNA, or other APP might use assignments to explore a new part of the country before relocating, create extended periods away from work, experience different practice environments, or continue seeing patients without committing to another long-term position. That doesn’t make locums an easier version of clinical practice. In some ways, it asks more of you. But for an APP at the right point in a career, the temporary nature of the work may be exactly what makes it appealing.

What Are You Really Looking to Change?

It’s easy to reduce the appeal of locum tenens to one word: flexibility. But flexibility can mean very different things depending on where you are in your career.

Perhaps you still enjoy practicing but no longer want every week of the year structured around the same employer’s schedule. Maybe you’re considering a move and would rather experience a healthcare market before relocating permanently. You may want to work intensively for a period and then take meaningful time away, or you may be approaching the later stages of your career and aren’t ready to stop practicing altogether.

Locums can also offer a way to experience healthcare organizations from the inside without immediately making a long-term commitment. That’s a very different decision from simply asking whether you want a permanent or temporary job.

The better question may be what you’re actually trying to gain more control over: your time, your location, your workload, or the amount of your life that revolves around a single employer.

You Get to Be New Again

One of the more interesting parts of locum tenens work is also one of its challenges: you may repeatedly become the new person in the room.

Experienced APPs spend years accumulating knowledge that extends well beyond medicine. They know who can solve a scheduling problem, how their organization’s EHR behaves, which specialist will return a call quickly, how referrals actually move through the system, and where to find the things nobody bothered putting in the orientation manual.

A locums assignment can take much of that institutional knowledge away. You may be learning a new EHR, meeting an unfamiliar clinical team, adapting to different workflows, and figuring out how an organization functions while simultaneously caring for patients. Because temporary clinicians are often brought in to address an immediate staffing need, there may also be an expectation that they become comfortable in the environment relatively quickly.

That makes adaptability more than a nice personality trait. It becomes part of the job. For an experienced clinician, however, there can be an upside. Years of practice may have given you a clearer sense of what is essential, what questions need to be asked immediately, and how to establish working relationships quickly. Instead of relying on familiarity with one organization, you’re relying more heavily on the clinical judgment and professional instincts you’ve built over time.

A Temporary Assignment Can Be a Career Experiment

Changing jobs is usually an all-or-nothing proposition. You leave one organization, accept another position, and hope what you learned during the interview process accurately reflects what working there will be like.

Locum tenens can create another possibility. An APP thinking about relocating might accept an assignment in the area first. Someone who has spent years in one type of healthcare organization might want exposure to a different practice environment. Another clinician may simply want to know whether a less permanent way of working suits them before restructuring an entire career around it.

Not every assignment will answer a major career question, and not every temporary role needs to lead somewhere else. An experience doesn’t have to become permanent to be professionally useful.

Working in different organizations can expose you to new workflows, patient populations, technologies, staffing models, and approaches to care. It can also clarify what you don’t want in your next permanent position, which can be just as valuable when deciding what comes next.

The Hourly Rate Doesn’t Tell You What You’ll Earn

Compensation is often one of the first things clinicians notice about locum tenens opportunities, particularly when an advertised hourly rate compares favorably with a permanent salary. But comparing the two isn’t as simple as multiplying an hourly rate by the number of hours you expect to work.

The details of locums arrangements vary. Depending on the staffing company and assignment, an APP may work as an employee or as an independent contractor. Benefits, retirement contributions, tax withholding, malpractice coverage, travel reimbursement, housing, licensing expenses, and other costs can therefore look very different from one opportunity to another.

There is also the time between assignments to consider. The ability to take several weeks off may be one of the reasons you want to work locums in the first place, but unpaid time still needs to be part of your financial planning.

Before comparing a locums opportunity with a permanent job, look beyond the rate and determine what the arrangement actually includes. Find out who pays for travel and housing, whether malpractice insurance is provided, whether benefits are available, how taxes will be handled, and which expenses remain yours.

The attractive number at the top of the offer only becomes meaningful once you understand everything surrounding it.

Geography Creates Opportunity—and Paperwork

The ability to practice in different parts of the country is one of the features that makes locum tenens appealing, but an APP’s professional credentials don’t automatically allow them to practice everywhere they want to go.

Licensure, scope-of-practice requirements, prescribing authority, credentialing, privileging, and other requirements can vary by profession, state, and facility. Staffing companies may provide assistance with licensing and credentialing, but that doesn’t eliminate the need to understand what will be required before accepting an assignment.

Timing matters, too. A promising opportunity doesn’t necessarily mean you can begin working next week. Facility credentialing and obtaining authorization to practice in another state can add time between finding an appealing assignment and actually beginning it.

For APPs interested in making multistate work a regular part of their careers, understanding the licensing landscape becomes part of career planning rather than an administrative detail.

Flexibility Works Both Ways

There’s another side of locum tenens that deserves more attention. You may have greater freedom to choose when and where you work, but the organization is hiring temporary help because it has a need.

A clinician may be covering a vacancy, supporting a busy service, filling in during someone’s leave, or helping an organization maintain patient access while it searches for permanent staff. That can mean walking into a practice during a period of transition.

Before accepting an assignment, it’s worth understanding why the position is open, what the current staffing situation looks like, what patient volume you will inherit, what support will be available, and exactly what the organization expects you to accomplish while you’re there.

Flexibility shouldn’t mean accepting ambiguity. A good locums opportunity should make the fundamentals clear before you arrive, including your schedule, clinical responsibilities, call expectations, practice locations, support structure, and who you can turn to when questions arise.

Continuity May Matter More to You Than You Realize

Not every APP will enjoy moving between assignments. Some of the most satisfying parts of clinical practice come from relationships that develop over time.

You watch a patient improve. You know the family history before opening the chart. Colleagues learn how you practice, and you learn how they work. Eventually, a group of people becomes your team rather than simply the people scheduled alongside you.

Locum tenens can change that experience. Depending on the length and type of assignment, you may leave just as you’re becoming comfortable with the organization. You may not see what happens to patients months later. And although you can build strong professional relationships quickly, they aren’t the same as spending years practicing alongside the same colleagues.

For some clinicians, that’s a reasonable trade for greater control over their schedule. For others, continuity is one of the things they value most about medicine. You may not know how important it is to you until you seriously consider working without it.

Locums Doesn’t Have to Be an All-or-Nothing Career Choice

Perhaps one of the biggest misconceptions about locum tenens is that you have to become a full-time “locums provider.” In reality, temporary work can play different roles at different stages of a career.

An occasional assignment may supplement a permanent position if your employment agreement and schedule allow it. A period of locums work can bridge two stages of your career. It can be something you try once and decide isn’t for you, something you do periodically, or something that becomes your preferred way to practice for several years. Later in a career, it may also provide a way to continue seeing patients while working less than a traditional permanent position requires.

That makes the decision less intimidating. You don’t necessarily have to decide whether locum tenens is the way you want to spend the rest of your career. You only have to decide whether a particular assignment—and this way of working—makes sense for what you want next.

The Temporary Nature of the Work May Be the Point

For much of a healthcare career, permanence is treated as the goal. Find the right organization, establish yourself, build relationships, and stay. There is real value in that kind of stability, but there can also be value in reaching a point in your career when you no longer need every professional decision to lead to something permanent.

Locum tenens won’t eliminate the difficult parts of clinical practice. It introduces its own uncertainties, administrative demands, and tradeoffs. What it can offer is another way to remain a practicing clinician while changing some of the assumptions about how a clinical career is supposed to look.

For an experienced APP who still wants the patient care but wants something different from the job surrounding it, that may be worth exploring.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.