Healthcare Recruiting
Locum Tenens Career Guide 2026: Is It Right for You?
Locum tenens — temporary physician and APP staffing — generated over $4.5 billion in revenue in 2026 and involves more than 52,000 clinicians at any given time. For physicians and APPs willing to travel and manage administrative complexity, locum work offers the highest per-hour rates in medicine. This guide explains how locum tenens works, what you'll actually earn, and what to know before your first contract.
How Locum Tenens Works
A hospital or clinic with a coverage gap hires a temporary clinician through a staffing agency. The agency handles credentialing, malpractice coverage, housing, and travel. You provide clinical coverage. Contract lengths range from single-day coverage to ongoing multi-month engagements.
Who Does Locum Work?
- Early career: Physicians exploring practice settings or geographies before a permanent position. Common in primary care and emergency medicine.
- Mid-career: Physicians burned out by their current practice who want schedule control and variety.
- Late career / semi-retired: Physicians reducing workload without stopping clinical work.
Locum Compensation (2026)
| Specialty | Typical Day Rate | Typical Hourly |
|---|---|---|
| Emergency Medicine (MD/DO) | $2,800–$4,200 | $280–$380/hr |
| Psychiatry | $2,400–$3,600 | $240–$320/hr |
| Internal Medicine / Hospitalist | $2,200–$3,200 | $220–$290/hr |
| Family Medicine | $1,600–$2,400 | $150–$220/hr |
| CRNA | $1,800–$2,800 (8 hrs) | $170–$220/hr |
| Nurse Practitioner | $900–$1,500 | $90–$140/hr |
| Physician Assistant | $900–$1,400 | $90–$130/hr |
| Orthopedic Surgery | $3,500–$5,000 | $350–$500/hr |
Most contracts also include housing or per diem ($100–$200/day) and travel reimbursement, separate from the clinical rate.
Tax Home Requirement: Critical Administrative Detail
Non-taxable housing and meal stipends (which make locum contracts significantly more valuable) require a legitimate tax home — a permanent residence where you live, pay expenses, and return to regularly. Physicians who sell their home and travel exclusively on locum contracts risk having all stipends reclassified as taxable income, adding $30,000–$50,000 in unexpected tax liability. Work with a CPA specializing in locum/contractor healthcare taxes.
Malpractice Coverage
Locum agencies provide malpractice for work on agency assignments. Confirm before signing:
- Claims-made vs. occurrence: If the agency provides claims-made coverage, confirm tail policy coverage for claims after the contract ends.
- Permanent employer policy: Confirm your permanent employer allows moonlighting and doesn't require disclosure of locum assignments.
Agency Selection
Work with 2–3 agencies simultaneously (CompHealth, Staff Care, AMN Healthcare, Weatherby, Locum Leaders). Never give exclusivity. Evaluate recruiter quality, not brand name. Multiple agencies may have relationships with the same hospital.
Credentialing Reality
Every facility requires its own credentialing (60–90 days from application). Plan assignments 3–4 months ahead. Experienced locum physicians maintain active licenses and DEA registrations in 4–6 states for faster deployment.
Find locum assignments or source locum candidates at app.avahealth.co.
Related: Locum Physician Salary Guide, Travel Nursing Contract Guide, CRNA Career Guide, PA Career Guide.
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