5 Tips for Becoming a Successful Locums Hospitalist

Over 52,000 physicians—around 7% of the total workforce—work as locum hospitalists in the United States, according to the 2023 State of Locum Tenens Report. This number is expected to increase by 14% in 2024.

If you’re thinking about taking up work as a locums tenens hospitalist, read on to learn what the term means, the pros and cons of taking up the role, and five tips for success.

Key Takeaways

Over 52,000 physicians work as locum hospitalists, with expected growth in 2024.
Locum hospitalists fill temporary roles, often in rural or underserved areas.
Benefits include tax deductions, high pay, and reduced risk of burnout.
Challenges include frequent travel, complex taxes, and confusing insurance options.

Table of Contents

Who Is a Locum Hospitalist?

A locum tenens hospitalist is a hospitalist physician who fills in for full-time hospitalists in healthcare facilities, usually on a short-term or contract basis (e.g., cover shifts, physician vacations, or staffing shortages). They’re typically hired through a locum tenens agency.

While they do work in large urban hospitals, most locum hospitalists are found in rural medical centers, where there may be a greater need for temporary staffing due to fewer available healthcare providers. Facilities that hire locum hospitalists include:

Rehabilitation centers
Long-term acute care hospitals
Veterans Affairs (VA) hospitals
Community hospitals

Locum hospitalists diagnose and treat patients, coordinate care with other medical professionals, ensure patients receive continuous care, and may even travel to care for patients in far-off areas.

Pros and Cons of Becoming a Locum Hospitalist

Here are some pros and cons of working as a locum hospitalist:

Pros

1. Your Expenses Are Tax-Deductible

Locum tenens work involves frequent traveling, especially if you’re working in rural medical centers. Airplane tickets, car rental, insurance fees, and other travel costs can add up.

The good news is that all of your business-related expenses are tax-deductible and may even be reimbursed by the healthcare facility or locum tenens agency you’re working for.

2. You Get a High Pay Rate

Due to the shortage of hospitalists in many areas and the temporary nature of locum contracts, you’ll often get a higher hourly rate compared to physicians working full-time.

You may also get access to partial benefits and bonuses when working in high-demand areas or during peak times. This can help you earn much more.

3. You Experience Low Burnout

You have the freedom to work where and when you want. This means if you don’t want to work during the night, you can do that. You can also set up a seven-on, seven-off schedule—you work for a week and take a week off.

This ability to control your schedule and take breaks between assignments can lower your risk of physician burnout, which is when you lose the ability to empathize with patients. According to CHG’s Client Awareness and Perceptions Study, 42% of the surveyed healthcare providers thought of the locum work role as a solution to burnout.

Source

Cons

1. Regular Travel

If you don’t like traveling, have family obligations keeping you rooted in your state, or can’t go through the loss of income that inevitably comes with shifting states and applying for licenses, working as a locum hospitalist may not be for you.

Much of the time, these physicians have to travel to different cities, states, and even overseas to get the best, highest-paying assignments.

2. Frequent Tax Filing

When you work a permanent W-2 job, your state and federal taxes are withheld from your paycheck throughout the year. That’s not the case when working as a locum hospitalist.

Locum hospitalists are considered self-employed and, thus are classified as 1099 independent contractors. They have to keep track of all their expenses to ensure they file taxes correctly and on time.

3. Confusing Insurance Options

As a 1099 independent contractor, you typically have to review deductibles, co-pays, co-insurance, in-network and out-of-network, out-of-pocket maximums, and all other insurance conditions to create a plan that’s right for your situation.

While you may find pre-configured health insurance plans, they might come with conditions you may not be comfortable with.

The good news is that you have the freedom to select a health insurance plan that’s affordable, covers dental and vision, and can be reconfigured every year. You can also reduce your taxes if you select the right life insurance policy.

5 Tips for Becoming a Successful Locum Hospitalist

You need to do your homework before getting into locum tenens! Here are five considerations to keep in mind:

1. Define What You Want

The first step is to find out why you’re interested in locum tenens and understand your own preferences. Are you interested in short-term assignments or long-term ones? Do you want to move to a new part of the country every few months? Do you want to stay in your current city?

You want to know your exact expectations so you can choose the right locum hospitalist job. Otherwise, you might find yourself dissatisfied.

2. Try to Be Flexible

If you want your pick of locum assignments, you need to be flexible with your work setting and scheduling expectations. If you’re willing to work only in your city, you may not get access to a vibrant job market. But if you can and are open to working in rural areas or midsize cities, you won’t have to worry about a shortage.

Flexibility here also means generalization and openness to working in different specialties. Many locum tenens jobs require ICU coverage and experience, so if you understand how to perform procedures like arterial lines, central lines, and lumbar puncture, you become more marketable.

3. Start Early

It takes an average of 180 days to fill a primary care physician locum tenens role, and the wait is even longer for surgeons—around 277 days on average, according to a report from the Association for Advancing Physician and Provider Recruitment (AAPPR).

This means you need to start your job search and applications early, usually during your residency or fellowship. Your potential employer may require references, state licenses, DEA, and credentialing—which can take months to over a year.

4. Choose the Right Locum Tenens Agency

A locum agency doesn’t just get you hospitalist assignments—they also walk you through the required processes for getting state licenses (which can be complex) and understand what paperwork to get together for licensing and credentialing.

This process can take months and good locum tenens hospitalist jobs are taken up fast. This means it’s a good idea to start a discussion with a locum agency as much as a year to eight months before you finish your training.

5. Talk to a Financial Expert

As a locum hospitalist, you’re a 1099 independent contractor, so your taxes won’t be deducted every month. Instead, you’ll have to pay quarterly estimated tax payments. You’ll also have to figure out your insurance deductibles and negotiate terms in your favor.

This can be time-consuming, cut into the time you spend working locum tenens, and be generally difficult if you don’t have a business background. You may run into accounting errors, incorrect tax filings, and other filing-related issues.

A tax advisor can help you figure out how to navigate your tax filings, structure investments for long-term growth, find the right type of insurance coverage for your situation, and ensure financial stability—even when you’re taking a break from locum assignments.

They could also help you write off many business expenses like meals, business travel, continuing medical education (CME), and home office expenses, saving you thousands in taxes.

Let Physicians Thrive Help You on Your Locum Journey

If you’re looking to take up a locum tenens job, start early, know what you want, and work with the right people, such as a financial advisor. They’ll help you understand your locum contract, plan your taxes, and even plan for retirement.

That’s where Physicians Thrive comes in.

With over 20,000 contracts negotiated to date, our contract advisors help you negotiate a more fair contract to help you earn more. We also help you find ways to keep more of your compensation, so you can invest in a secure future for yourself

Reach out to us today to get started!