LocumDoctorReady.com is the trusted independent resource for physicians working locum tenens assignments. We cover hourly pay rates by specialty, 1099 tax strategy, malpractice insurance (occurrence vs. claims-made), state licensing through the IMLC compact, hospital credentialing timelines, housing stipends, and the clinical gear every locum physician should own.
Locum tenens physicians typically earn $150–$350/hour depending on specialty and location. Emergency medicine and hospitalist shifts commonly pay $200–$300/hour. Psychiatry commands $200–$300/hour due to chronic national shortage. Rural, critical access, and frontier hospitals add a 10–30% premium over comparable urban rates. Your staffing agency takes a 20–35% margin — always negotiate your 1099 rate directly.
As a 1099 independent contractor you keep more gross income — but you manage quarterly estimated taxes, self-employment tax (15.3% on the first $168,600 of net income in 2024), tail malpractice coverage, and multi-state medical licensing. This site provides clear, specific answers to all of it: no agency marketing, no fluff.
Locum tenens physicians earn $150–$350/hour depending on specialty, location, and shift type. Emergency medicine and hospitalist locums: $200–$300/hour. Primary care and family medicine: $150–$220/hour. Psychiatry: $200–$300/hour. Rural and critical access sites add a 10–30% premium. Agencies take a 20–35% cut — negotiate your net rate directly.
No taxes are withheld on 1099 income. You owe self-employment tax (15.3% on the first $168,600 of net income) plus federal income tax. Set aside 30–35% of gross. Max a SEP-IRA (up to $69,000 in 2024) or solo 401(k) to cut your taxable income significantly. Deduct mileage ($0.67/mile), licensing fees, CME, equipment, home office, and health insurance premiums. Pay quarterly estimated taxes in April, June, September, and January to avoid IRS penalties.
Most established agencies provide either occurrence-based or claims-made malpractice coverage. Occurrence policies need no tail. Claims-made requires a tail policy when coverage ends — confirm whether your agency pays for it automatically (most major ones do). Tail coverage costs roughly 1.5–2× the annual premium. If you work with multiple agencies or independently, buy your own occurrence policy.
Hospital privileging takes 60–120 days from application submission. Start immediately after signing your contract. The Interstate Medical Licensure Compact (IMLC) allows licensed physicians to obtain licenses in 40+ member states — typically 30–60 days per state at $700–$1,000 per state fee. Traditional out-of-compact state licensing takes 3–6 months.
Contracts range from single shifts to 12+ months. Most run 4–13 weeks. Longer contracts include furnished housing, round-trip travel, and a competitive rate. Short-term fills pay a higher per-shift premium but require more travel. Agencies always prefer longer commitments — use that as negotiating leverage.
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