Maximize locum tenens income: 4 tips to make more and work less

Every hospitalist heard that locum tenens work pays better than permanent. Of course, I did, too, when I first started practicing. This was one of the reasons why I switched to the full-time locum tenens years ago.

Now, things have changed since then, and employed hospitalist salaries have been rising steadily over the years. It became obvious, then, that $150 per hour for locum tenens work doesn’t cut it anymore.

Think about it, as a locum tenens doctor, you don’t get any health insurance or a retirement plan. You also have to hustle to make sure you always have enough work months in advance.

So my pay rate should make up for all the extra effort I make.

The obvious solution could’ve been to take on more work.

But you see, I’m lazy. Not the kind of lazy person who watches TV all day, with a full bag of chips in the recliner chair.

No, I’m a different kind of lazy. I’d rather work smarter than harder.

I am too lazy to work 200+ shifts per month to get where I want to get financially. My goal is to be the highest paid hospitalist on my own terms.

In this article, I am going to reflect on my 5-years as a full-time independent hospitalist and share what I’ve learned about maximizing my locum tenens income.

1. Always negotiate

Unfortunately, a lot of hospitalists underestimate how much a slight payment increase will matter. For example, getting a $10 per hour increase can give you a $20,000 of extra income annually with a typical 7-on/7-off schedule.

Now, you don’t have to be a negotiation guru to get what you want. The actual process is actually pretty straightforward.

First, you need to realize that as a physician, your skills are in very high demand! This will make you more comfortable negotiating.

Second, you need to figure out how much other locum tenens doctors get paid in your area. So, talk to your colleagues practicing in the area. If that’s not an option, use an online calculator that can help you to get an estimate on where to start.

Third, learn as much as possible about your assignment when talking to the recruiter and leverage any “pain points” in your negotiation.

For hospitalists, for example, the more responsibilities (procedures, vent management), the higher patient census, the higher the patients’ acuity (open ICU), the less support (fewer subspecialties available) all mean a higher pay rate you can demand.

2. Look outside of large metro areas

Due to hospitalist shortages, the highest paying locum tenens gigs are often located away from large metro areas. Believe me, it’s tough to find anything even close to a decent pay in cities like New York, Los Angeles, or Chicago.

So don’t shy away from smaller cities and little towns. Some of them can give you steady work with great pay.

In my experience, the best set up is midsize hospitals that are 1 to 3 hours away from the city. They tend to have both good subspecialty support, and it’s easy to travel there if needed.

3. Consider working directly with the hospitals or hospitalist companies

Locum tenens agencies certainly have their benefits, but this is not the only option.

Sometimes it can really pay off to do your own research and contact facilities without a middleman.

It works especially well if you are a local doctor so that the hospital can save on accommodation, travel expenses, and the agency fees.

The main drawback is that you’ll potentially spend more time upfront to get them to respond.

4. Work with multiple agencies

If you decide to work with a staffing firm, make sure you contact multiple agencies. This way you’ll have access to more hospitals since every agency has its own unique geography.

After working with numerous locum tenens firms for some time, you’ll figure out the quality of their services and will stick with the one or few of them that pay and treat you better.


In many ways, being a locum tenens hospitalist provides you with the flexibility, and freedom for creating the best possible lifestyle.

Using the strategy that I shared today, you’ll be able to make the most of your work time and jumpstart your own locum tenens career.

“The LocumGuy” is a hospitalist and founder, The Locum Guy.

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