9 Secrets to Success for Family Physicians Going Locum Tenens

Dreading another day of back-to-back patients, mountains of paperwork, and that sinking feeling you’ll be charting again until midnight? You’re not alone. Family physicians everywhere are drowning in administrative duties while their patient care time shrinks. Meanwhile, you’re not taking care of yourself, and family moments are slipping away.

There’s a better way to practice medicine. Locum tenens offers family doctors a path to reclaim their time, reduce stress, and refocus on what matters — patients, themselves, and their families. This alternative practice model delivers flexible scheduling, competitive pay, and freedom from administrative burdens that weigh down traditional practices. The locum tenens model fits all stages of a physician’s career, whether you want to work more hours to pay down student loans or fewer to improve your lifestyle.

Understanding the fundamentals of locum tenens — Latin for “to hold the place of” — opens doors to a more fulfilling career. These temporary positions allow you to practice in diverse settings, from bustling hospitals to rural clinics, while focusing on patient care without the administrative headaches of permanent positions.

Ready to explore what it takes to make this transition? Here are nine insider secrets to help you smoothly shift from private practice to a successful locum tenens career.

1. Get Ready for Tax Changes: Employee to Business Owner

When you jump into locum work, you’ll face a change in how you handle your paychecks and taxes. Instead of receiving a W-2 with taxes already taken out, you’ll get 1099 income where nothing is withheld. That means you’re responsible for setting aside money for federal and state taxes, Social Security, and Medicare.

This switch catches many doctors off guard. Most of us aren’t taught business finances in medical school! But don’t worry – with a bit of planning, you can actually keep more of what you earn compared to traditional practice.

Most successful locum docs work with a CPA who specializes in healthcare professionals. They’ll help you set up quarterly tax payments, track deductible expenses, and possibly establish an S-Corp or LLC to optimize your tax situation.

Switching to locum work changes how you get paid and taxed. You’ll move from getting a regular paycheck where taxes are taken out to being your own boss who handles taxes yourself. This might feel scary at first, but it can actually put more money in your pocket if you plan ahead.

Here’s the good part: locum work usually pays more per hour than regular practice jobs. The catch? You’ll need to take care of your own benefits and set aside money for taxes that used to be handled for you.

Here’s What This Typically Means For You:

• Mark your calendar for quarterly tax payments (January 15, April 15, June 15, September 15)
• Set aside 30-35% of income for taxes
• Track deductible expenses (travel between assignments, home office, medical equipment)
• Secure your own health insurance through the marketplace or professional associations
• Set up a dedicated checking account just for taxes

Many physicians discover that with proper guidance, these financial aspects become a benefit rather than a burden. The key is preparation and organization before your first assignment.

Action Step: Consult with a CPA experienced with physician independent contractors before accepting your first locum position.

2. The Agency Advantage: Finding Your Perfect Partner

Many physicians initially try finding locum opportunities independently, only to become overwhelmed by credentialing paperwork, contract negotiations, and travel logistics. What started as an escape from administrative burdens quickly turns into a different kind of paperwork nightmare.

A good locum tenens agency eliminates these headaches. The right partner handles credentialing, negotiates competitive rates, arranges travel and housing, and provides clear details about schedules and expectations.

What to Look for in an Agency:

• Specialized expertise in family medicine placements
• Transparency about compensation and their commission
• Verifiable references from other family physicians (always check!)
• Clear communication about patient volumes and EMR systems
• Comprehensive support for travel, housing, and malpractice coverage

Don’t settle for the first agency you contact. Most experienced locum physicians maintain relationships with 2-3 trusted recruiters who understand their specific preferences and career goals. Think of it as “dating” before finding your perfect match.

Action Step: Interview at least three locum agencies about their family medicine placements in your preferred regions. Always request to speak with other physicians they’ve placed as references.

3. Licensing Strategy: Maximizing Your Mobility

If you’ve practiced in one state for years, you’ll need additional state licenses to access the best locum opportunities. The good news? Most agencies cover or reimburse these licensing expenses as part of their service.

The smartest approach for new locum physicians is targeting states in the Interstate Medical Licensure Compact. This agreement allows you to complete one application for multiple participating states, dramatically reducing paperwork and processing time.

Strategic Licensing Timeline Tips:

• Compact-participating states: Begin 3-4 months before the desired start date
• Non-Compact states: Allow 6-12 months for processing
• All applications: Ensure each document page is correctly numbered and initialed

Getting Organized:

• Create a digital folder with essential credentials (medical school diploma, residency certificates, board certifications, CME certificates)
• Work with your agency to identify states matching your specialty preferences
• Let your agency handle the administrative aspects of applications

Most successful locum physicians find that having licenses in 3-5 strategic states provides plenty of assignment options without unnecessary paperwork or expense.

Action Step: Meet with your locum agency to develop a licensing strategy focused on states that align with your specialty, preferences, and the Interstate Medical Licensure Compact where possible.

4. Clinical Adaptability: Mastering New Systems Quickly

After years with the same EHR system, many physicians experience genuine anxiety when confronted with unfamiliar platforms at locum assignments. The questions running through your mind are real: “Can I find my way around this system fast enough? What if I miss documenting something crucial because I can’t find the right screen?”

Making matters more challenging, most facilities give you just a quick tour before throwing you into patient care. Your success depends on how quickly you can adjust to different systems, workflows, and protocols at each new assignment.

Proven Adaptation Strategies:

• Request access to EHR training modules before your assignment begins
• Arrive a day early when possible to shadow another physician
• Create a personal “onboarding checklist” for each new facility
• Identify the most essential EHR functions first (orders, documentation, prescribing)
• Build relationships with nursing staff who know helpful workarounds
• Maintain a digital or physical notebook of facility-specific protocols

While the first few days at any new assignment involve a learning curve, experienced locum physicians report that their adaptability improves dramatically with each placement. What initially feels disorienting soon becomes an invigorating professional challenge that keeps skills sharp.

Action Step: Create your own “New Facility Cheat Sheet” with key questions about the EHR system, common workflows, and essential protocols to ask during your first-day orientation at each assignment.

5. Facility Variety: Finding Your Perfect Match

Locum work opens doors to healthcare settings you might never experience in a traditional role. Family physicians can move between bustling hospitals, neighborhood clinics, and established private practices—each with a unique culture.

Hospital assignments drop you into fast-moving environments where you'll work with specialists from every discipline. The pace can be energizing, and you'll handle medical challenges that might never walk through a clinic door. Switch to a community health center, and you'll experience medicine at a different tempo, with chances to build deeper connections with patients and their families.

This sampling of different settings helps you discover where you truly belong. Maybe you'll find you love the adrenaline and teamwork of hospital medicine. Or perhaps you'll realize you do your best work in the continuity of a clinic setting. With locum work, you get to test-drive these environments before committing to any single path.

6. Schedule Freedom: Your Time, Your Way

Picture yourself watching your daughter’s entire dance recital without your phone buzzing with patient messages. Or planning a two-week mountain getaway without negotiating with colleagues for coverage. After years of putting work first, locum assignments flip the script—you decide when to work, not your practice.

Many doctors build their locum schedules around what truly matters—saving time for family celebrations, favorite seasons in certain places, and personal passions. This deliberate approach to planning changes how you experience both your career and home life.

What you gain:

• Mark your calendar with can’t-miss personal events before accepting any assignments
• Create your own work pattern (two weeks on/two weeks off, summer work/winter break)
• Pick locations that match your travel wishes or where family members live
• Take more or fewer assignments based on your savings goals and energy levels
• Say goodbye to being on call and weekend work

This freedom does have some trade-offs. Job opportunities sometimes appear without warning or get filled before you can respond, potentially creating income gaps or requiring flexibility with your plans. To manage this: look 3-6 months ahead when scheduling and build relationships with several different recruitment agencies to maximize your choices.

Next step: Create a calendar for the upcoming year with all your non-negotiable personal events and ideal working times clearly marked. Then, rather than just chasing the highest-paying opportunities, seek out positions that complement your life priorities

7. Assignment Detective Work: Avoiding Problem Placements

Not all locum assignments are created equal. What looks perfect on paper can hide serious issues—understaffing, unrealistic patient volumes, or dysfunctional workplace cultures. Nothing is more disheartening than escaping private practice only to land in an even worse situation.

Experienced locum physicians have learned to investigate potential assignments thoroughly before committing. This due diligence separates consistently positive experiences from frustrating ones.

Red Flag Detection Questions:

• Why exactly does the facility need locum coverage? (Listen carefully—high turnover or unexplained provider departures are warning signs)
• What’s the actual patient volume per day? (Get specific numbers, not vague ranges)
• Which support staff will be available to you? (Nurses, MAs, front desk)
• Who handles after-hours calls and emergencies?
• What specific procedures are you expected to perform?
• How do current providers rate the EHR system and workflow?

Always request to speak with other physicians who have worked at the facility. Their insights often reveal issues that facilities won’t volunteer. With experience, you’ll develop a personal checklist of must-haves and deal-breakers that makes evaluation more efficient.

Action Step: Create a standardized “assignment evaluation form” with your most important questions, and maintain detailed notes on each facility to build your own database of preferred locations.

8. Building Relationships and Networking: The Key to Long-term Success

Building relationships and networking are essential for family medicine physicians seeking long-term success in locum tenens careers. Every new assignment introduces you to potential allies and mentors who can shape your future. The doctor sharing orientation tips, the nurse who shows you the unwritten workflow rules, the practice manager impressed by your adaptability—each connection matters.

Temporary assignments create a unique chance to expand your professional circle beyond what's possible in a single practice. Your reputation travels through these connections, often leading to unexpected opportunities. "We worked with Dr. Lee at Memorial and she was fantastic" carries weight when facilities are making hiring decisions.

These relationships also serve as your professional lifeline. Fellow physicians become trusted resources for clinical questions, career advice, and job leads. Administrators who see your value may create positions specifically for your return. By investing time in genuine connections at each assignment, you transform a series of temporary jobs into a sustainable, rewarding career path

9. Professional Identity Shift: From Practice Builder to Clinical Expert

Family physicians who have built their identity around being “the family doctor” in their community face emotional challenges when transitioning to locum work. Patients have known them by name, trusted their advice, and been under their care for years. Walking away from these relationships feels like abandoning a core part of their professional self.

“Who am I as a physician if not the doctor who knows my patients’ entire families and histories?” many wonder. “Will I find the same satisfaction in caring for patients I might never see again?”

What most discover surprises them. Without the pressure of building and maintaining a practice, they can focus entirely on the clinical medicine they love. They find satisfaction in being the physician who can step in during critical staffing shortages, bringing expertise and calm to facilities in need.

Professional Adjustments:

• Redefine success around clinical excellence rather than practice building
• Find satisfaction in helping facilities and communities in need
• Appreciate the freedom from politics and personalities of a single practice
• Discover your adaptable clinical core that transcends specific practice settings
• Build a professional identity around your versatility and expertise

Transitioning from community fixture to clinical pinch-hitter isn’t easy, but many physicians find it liberating. Without the weight of practice on their shoulders, they reconnect with the fundamental joy of practicing good medicine.

Action Step: Before beginning locum work, reflect on what aspects of patient care bring you the most satisfaction independent of long-term relationships, and look for assignments that emphasize these elements.

Your 6-Month Transition Plan: From Practice to Freedom

Few physicians who leap locum work ever return to traditional practice models. The freedom, flexibility, and pure joy of practicing medicine without administrative burdens make locum work so appealing that most physicians never return to traditional roles. Though changing your entire career model feels overwhelming initially, following a clear roadmap can have you working on your own terms within half a year.

6 Months Before Transition:

• Meet with a financial advisor who understands physician independent contractors
• Research and prepare for quarterly tax payment requirements
• Begin exploring locum agencies that specialize in family medicine placements
• Start licensing applications, prioritizing Interstate Compact states
• Investigate malpractice tail coverage needs from your current position

3 Months Before Transition:

• Interview multiple locum agencies and thoroughly check their references
• Select your primary agency and build a relationship with your dedicated recruiter
• Create a digital portfolio with all credentials, certificates and references
• Secure appropriate health insurance coverage
• Develop a thoughtful communication plan for your current patients

1 Month Before Transition:

• Finalize arrangements with your chosen agency
• Block your calendar with non-negotiable personal time
• Begin reviewing specific assignment opportunities
• Establish a separate business account for tax withholding
• Create your personal facility onboarding checklist
• Confirm professional liability coverage details

First Three Months in Locum Practice:

• Start with shorter assignments (1-2 weeks) to build confidence
• Arrive a day early whenever possible to orient yourself
• Keep detailed notes on each assignment to refine your preferences
• Schedule regular strategy sessions with your recruiter
• Connect with other locum physicians for support and advice
• Fine-tune your financial systems based on real-world experience

Consider a gradual transition by reducing private practice hours while taking occasional weekend locum assignments or using vacation time to test a short-term placement before fully committing.

With thoughtful preparation, locum tenens work offers the professional satisfaction and work-life balance that initially drew you to medicine. As one physician put it: “I finally feel like I’m practicing medicine again, not just managing a business.”

Ready to reclaim your medical career?

Download the StaffDNA app and explore locum tenens opportunities that align with your preferences.