Although locum tenens in medicine has a rich history dating back to the 1970s, many misconceptions and questions continue to foster apprehension in those considering this alternative form of practice. While some view locum tenens providers as unstable wanderers who may have difficulty holding traditional permanent employment, many, such as myself, have taken this intentional path in search of independence and freedom.

From a busy metropolitan hospital in California to a clinic in the desert of New Mexico, locum tenens has allowed me to see the world at my own pace—all while practicing the medicine I love, free from constraints. A niche in medicine focused on bringing care to underserved communities, locum tenens provides a world of freedom to those who practice medicine. As health care deserts grow and the commercialization of large medical systems forces many to contemplate their careers in an increasingly complicated and productivity-focused sector, locum tenens helps to prioritize autonomy, flexibility, and—most of all—purpose for health care providers, while helping patients who need it most.

Traditional practice vs. independent contracting

Distinct from traditional jobs, a locum tenens worker chooses their schedule, location, and scope of practice while enjoying financial incentives superior to that of a standard employee. While all locum tenens are independent contractors, not all independent contractors are locum tenens. Unlike a solo practitioner, locum tenens may turn to staffing agencies to provide assistance in covering travel, licensing, and malpractice while fending off administrative tasks, allowing providers to focus on what matters most: the patient.

In seeking help to dispel my preconceived notions and find guidance for this road less traveled, I turned to multiple resources such as CompHealth’s Physicians Guide to Working as an Independent Contractor to trailblaze a path toward a brighter future.

Paying off debt and building a nest egg—all at once

For many, the increased salary that comes from working locum tenens can provide an avenue for earlier loan repayment, establishment of a nest egg, and retirement opportunities unavailable in the mainstream job market. As a 1099 employee, one can work with a financial advisor or accountant to plan for variable income. By setting aside funds for estimated taxes, focusing on deductions for work-related expenses, and investigating various tax shelters, earning potential can be maximized and leveraged toward decreasing future financial stressors.

Additionally, retirement opportunities such as a solo 401(k) or SEP IRA provide more generous limits for investment, accelerating wealth accumulation and potentially allowing for earlier retirement. By taking advantage of a higher income and saving aggressively, I was able to pay off $315K in student debt, invest an equal amount, and enjoy the perks of financial sovereignty at ten times the speed of my colleagues.

Locums as a career, not just a placeholder

When I started working locum tenens, many people—including my mother—warned I would quickly grow tired of what they considered a career gap filler. In reality, I have built lifelong connections and found myself returning day after day to many facilities where I’ve been welcomed as one of their own. From birthday parties and potlucks to karaoke and hiking, I’ve become deeply invested in these communities.

With the right structure and timing, it’s been possible to spend months molding into each area I work, leading to an ever-evolving career that, ironically, has stability in what has traditionally been considered a life of instability.

For some specialties and providers, it is common to have solitary or brief encounters with patients, but for those in primary care or subspecialties focused on chronic needs, continuity of care defines who we are and why we practice medicine. While this may seem beyond the control of a locum tenens worker, I have found that my presence leads to improved collegiality and community involvement, not disruption.

Through intentionality and passion, I’ve helped stabilize areas in dire need. There is something special about walking through a town near the U.S.–Mexico border and hearing a proud father shout, “Hey! That’s my baby’s doctor!” It is about who the locum tenens is, not where they are.

From novice to expert—the five A’s of success

Historically, successful physicians exhibit three consistent traits: ability, availability, and affability. For those seeking greatness in locum tenens, I would add two more: adaptability and aggressiveness (in proactively identifying opportunities).

• Keeping an open mind while pursuing the right roles provides exponential growth and helps ensure success.
• Organizing financial records, credentials, certifications, an updated CV, references, and a well-planned schedule are critical.
• Reading contracts carefully, listening to those around you, and prioritizing wellness are essential.

Each system is different, but locum tenens teaches quickly that medicine is medicine—and even new acquaintances can become vital support.

A reflection on locum tenens, a reflection on finding purpose

For many, locum tenens is an elusive world full of unknowns. For me, it brought me back to a question I first asked more than a decade ago: Why do you want to be a doctor? Locum tenens returned me to the heart of medicine, refocusing my energy on the patient in front of me, free from bureaucracy and burnout.

The financial freedom I’ve gained has shifted me from living to work, to working to live—years ahead of schedule. I’ve seen the world, deepened my love for this country, and learned that no matter where you go, people just want to be cared for.

These experiences have sharpened my clinical skills and propelled me forward—even leading me to re-enter fellowship with renewed clarity and passion. In a world where medicine can lose its meaning, locum tenens gave it back to me.

This essay is cited in the KevinMD records on physician careers and physician personal finance.

Trevor Cabrera is a pediatrician.