Locum advice

Started by sky778
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sky778

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10+ Year Member
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Hello - starting to entertain the idea of doing full time locum work. How do you guys negotiate locum rates? And when is the best time to negotiate? After I applied and got the position? Or set the rate when I apply?

On a side note - anyone used any of the locum courses offered online? (Velocity from Dr. Chaudhary or the other locum doc with the Lamborghini lol).

Appreciate the inputs.
 
It’s a loaded question you are asking

Please answer
1. What are your goals with Locums?
2. Are you planning on doing 100% Locum or prn 1099 Locums?
3. What is the travel distance you want to travel? Are you ok with traveling out of state ? Are you license in some non interstate medical company states like Virginia and California?

So once you answer these questions. You can start to ask about Locums rates
 
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aneftp said:
It’s a loaded question you are asking

Please answer
1. What are your goals with Locums?
2. Are you planning on doing 100% Locum or prn 1099 Locums?
3. What is the travel distance you want to travel? Are you ok with traveling out of state ? Are you license in some non interstate medical company states like Virginia and California?

So once you answer these questions. You can start to ask about Locums rates
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Decided to leave my current full time position and go full time locum. Goal of locum? I cant stand my current job and at this rate I’d burn out before I know it. So I want more income and more free time. Willing to travel out of state but prefer to be close to the pacific northwest. Open to other states as well.
 
So you are geographically limited.
sky778 said:
Decided to leave my current full time position and go full time locum. Goal of locum? I cant stand my current job and at this rate I’d burn out before I know it. So I want more income and more free time. Willing to travel out of state but prefer to be close to the pacific northwest. Open to other states as well.
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sky778 said:
Decided to leave my current full time position and go full time locum. Goal of locum? I cant stand my current job and at this rate I’d burn out before I know it. So I want more income and more free time. Willing to travel out of state but prefer to be close to the pacific northwest. Open to other states as well.
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PM me deets. I just went through locums in that area.
 
sky778 said:
Id say its a preference not limitation
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That’s fine. If you have no kids or a family. Or empty nesters. I recommend everyone do Locums these days. You get to confirm your schedule and make great money. Assuming you don’t want to work in high demand areas like Miami Florida where they pay sucks for w2 and for 1099
 
sky778 said:
And when is the best time to negotiate?
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When you have the most leverage. Basically any time they need you more than you need them. Once you have multiple options you can play them against each other. Like practice A better but practice B pays better, try to get A to match. You like practice C but practice D needs you, make practice D incentivize you becoming available.

The problem with negotiating is you will miss out on opportunities. Need to have a back up plan even if the back up plan is taking time off. I’ve had practices refuse to meet my demands only to call back a couple of days later and acquiesce.
 
aneftp said:
That’s fine. If you have no kids or a family. Or empty nesters. I recommend everyone do Locums these days. You get to confirm your schedule and make great money. Assuming you don’t want to work in high demand areas like Miami Florida where they pay sucks for w2 and for 1099
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You recommend everyone do locums vs W2?
 
Hey all- do you guys have a claims made or occurrence policy with your locums companies? I’ve always thought occurrence was better and more coverage…. A locums company im thinking of going with offered claims made - is that a problem for me if I stop working for them? What about tail coverage?
 
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amyl said:
Hey all- do you guys have a claims made or occurrence policy with your locums companies? I’ve always thought occurrence was better and more coverage…. A locums company im thinking of going with offered claims made - is that a problem for me if I stop working for them? What about rail coverage?
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Well you either need occurrence based or claims and a tail. Pretty simple, they need to provide one or the other.
 
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amyl said:
Hey all- do you guys have a claims made or occurrence policy with your locums companies? I’ve always thought occurrence was better and more coverage…. A locums company im thinking of going with offered claims made - is that a problem for me if I stop working for them? What about tail coverage?
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Claims-made is fine as long as they perpetually keep renewing, which most locums companies do. I dont expect the big ones to default, and in the extremely rare chance it does, you can purchase the tail yourself, thought I would expect it to be around 50k.
dabears505 said:
You may have missed the window. Its definitely possible to be a full time locums, but seeing a little slowdown.
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Nah, locums businesses are going up, not down. 6-8% increase in locums business in 2026 vs 2025 based on first half of the year's projections from SIA.


sky778 said:
Can you elaborate more on that? Are you advising against full time locum?
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Depends on you. If you have no kids or attachments to things, then it makes perfect sense to grind out locums.
But I am finding out I like having post-call days and pre-call days, and sleeping in a house with my things in it rather than a hotel room.
I likely will transition out of locums to a full-time job once I find one that pays well enough and is in a good city.
 
Status Sciaticus said:
Staffing Industry Analysts. The data analysts and aggregators of the locums industry.
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We can take any data with a grain of salt. And I do believe the overall data being squirted out by chg healthcare about the global market

However the global market doesn’t mater to someone in say Jacksonville Florida or Miami Florida who really do not want to drive more than 30-45 min max. So data analyst always neglect important parts of Locums. Travel time. No one takes survey about commuting time.
 
Status Sciaticus said:
Claims-made is fine as long as they perpetually keep renewing, which most locums companies do. I dont expect the big ones to default, and in the extremely rare chance it does, you can purchase the tail yourself, thought I would expect it to be around 50k.

Nah, locums businesses are going up, not down. 6-8% increase in locums business in 2026 vs 2025 based on first half of the year's projections from SIA.



Depends on you. If you have no kids or attachments to things, then it makes perfect sense to grind out locums.
But I am finding out I like having post-call days and pre-call days, and sleeping in a house with my things in it rather than a hotel room.
I likely will transition out of locums to a full-time job once I find one that pays well enough and is in a good city.
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What you are really looking for is stability of 1 million dollar a year job with 10 weeks off plus pre and post call days off plus not working more than 40-45 hrs a week.

Now those jobs are extremely hard to find

Like I posted numerous time. The hybrids 20/26 weeks jobs for 500k (plus or minus with 40 hr work weeks are becoming very common but filled immediately once an opening occurs. Than it becomes a hustle how much money one can generate on those weeks and nights off

But it allows me to stay home.

But people are addicted to the tax advantages of being 1099. But if you are married. Making 500k w2 with employer tax deductions doesn’t really hit you hard in the tax range.

If you are single. You start feeling it around 240k agi so definitely feel the 35% tax hit. Vs being married and can gross around 600k w2 plus and not feel the 35% tax hit. So that’s where the hybrid 500k w2 job and married doesn’t really have a major tax hit. Make another 250-500k 1099 and write off half those 1099 earnings.
 
aneftp said:
What you are really looking for is stability of 1 million dollar a year job with 10 weeks off plus pre and post call days off plus not working more than 40-45 hrs a week.

Now those jobs are extremely hard to find

Like I posted numerous time. The hybrids 20/26 weeks jobs for 500k (plus or minus with 40 hr work weeks are becoming very common but filled immediately once an opening occurs. Than it becomes a hustle how much money one can generate on those weeks and nights off

But it allows me to stay home.

But people are addicted to the tax advantages of being 1099. But if you are married. Making 500k w2 with employer tax deductions doesn’t really hit you hard in the tax range.

If you are single. You start feeling it around 240k agi so definitely feel the 35% tax hit. Vs being married and can gross around 600k w2 plus and not feel the 35% tax hit. So that’s where the hybrid 500k w2 job and married doesn’t really have a major tax hit. Make another 250-500k 1099 and write off half those 1099 earnings.
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Yeah if I can find a 20 week job that pays 500k, I would take that as well. It would give me the other weeks to do pain and generate even more income.
 
aneftp said:
If you are single. You start feeling it around 240k agi so definitely feel the 35% tax hit. Vs being married and can gross around 600k w2 plus and not feel the 35% tax hit. So that’s where the hybrid 500k w2 job and married doesn’t really have a major tax hit. Make another 250-500k 1099 and write off half those 1099 earnings.
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This is the way.
 
sky778 said:
Can you elaborate more on that? Are you advising against full time locum?
Click to expand...

Having had a couple new grads just come through our place as locums, I am more convinced than ever that new grads should absolutely not do locums.

Not good for them, not good for us.

We aren't going to take any more new grads from locums agencies.
 
pgg said:
Having had a couple new grads just come through our place as locums, I am more convinced than ever that new grads should absolutely not do locums.

Not good for them, not good for us.

We aren't going to take any more new grads from locums agencies.
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I completely agree. New grads want the early career cash but aren’t ready to navigate being a hire hit man.

Just the demeanor I see.

I see some on the Locums circuit (the ones with less than 3 years). It’s a 50-50 shot who is good or not good.
 
narcotics999 said:
That is aggressive. 25K per week for W2. I can't get 25K as a locum.
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There are 17 weeks a year jobs (13 hr x 7 days) paying 550k. 35 weeks off. The pain docs doing it do pain clinic in the am

So they finish pain clinic 4-5pm. And roll to their second night float job at 6pm to take over call.
 
aneftp said:
I completely agree. New grads want the early career cash but aren’t ready to navigate being a hire hit man.

Just the demeanor I see.

I see some on the Locums circuit (the ones with less than 3 years). It’s a 50-50 shot who is good or not good.
Click to expand...

You're absolutely right - you never know if you get one that'll be OK, or if you'll get an inefficient and excessively conservative cancel machine.

If they were a new partner-track person, or a fellow employee who'd be there more than a couple months, you'd mentor and guide them. They've made a commitment to your group, the group has made a commitment to them, and there's powerful incentive to help them succeed. And honestly, with some help, just about any new grad can navigate the steep part of the learning curve and become good.

I feel (a little) bad about letting the guy we've got now kind of flounder but neither I nor any of my partners really have the time to guide a person who'll be gone in a couple months. He's not a bad guy. He's not even particularly weak. He's just not navigating the gray areas well.

From the new grad's perspective, you really ought to have a first job someplace where the people give a **** about you and have personal/economic incentives to ensure you succeed.

One of the worst things about the death of most private practices is that new grads now basically have to choose between locums, academics, AMC/PE, or hospital employment. Of those, only academics is really set up to help out the newbies.
 
pgg said:
God that sounds miserable
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Crnas on call with them. They sleep 5 plus hours 4/5 out of 7 nights.

Although the facility is trying to have residents instead of Crnas cover ob on weekends. (To save money on Crnas). That will make their lives really miserable.
 
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coffeebythelake said:
Eh I get messages every day about locum,
There is one right now they contacted me about for generalalist 10x5s paying 450/hr with full travel and malpractice
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Yes but it involves travel.

I’ve been very fortunate the last several years to not have to travel and still average barley 7 figures with 12-14 weeks off and sleep at home with my hybrid w2 job plus 1099 gigs combined.

But things may change in 2027 for me. The gigs I like may dry up in the next 3-4 months. They are getting more desperate local Locums willing to work for non continuous beeper pay on call. I mean. Good the local Locums . Go make that $2000/2400 beeper plus hours worked on weekends and weekday nights at $1000/beeper pay 12 hr rate plus hours.

I’d put my phone on do not disturb and sleep on well at night not making $1000/1200 a night rather than be on the hook for a call back.
 
aneftp said:
Yes but it involves travel.

I’ve been very fortunate the last several years to not have to travel and still average barley 7 figures with 12-14 weeks off and sleep at home with my hybrid w2 job plus 1099 gigs combined.

But things may change in 2027 for me. The gigs I like may dry up in the next 3-4 months. They are getting more desperate local Locums willing to work for non continuous beeper pay on call. I mean. Good the local Locums . Go make that $2000/2400 beeper plus hours worked on weekends and weekday nights at $1000/beeper pay 12 hr rate plus hours.

I’d put my phone on do not disturb and sleep on well at night not making $1000/1200 a night rather than be on the hook for a call back.
Click to expand...

Do you mean your previous gigs paid continuously for all call hours, but now they’re switching to $1,000 for weekday nights or $2,000–$2,400 for weekends, plus additional pay for hours worked?

Are there still locum jobs paying $350–$400/hour for the entire 24-hour shift, even when overnight call is relatively quiet?
 
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