Locum Tenens

How locum tenens works

A hospital or practice tells a locum agency it needs, for example, a hospitalist for seven-on, seven-off coverage for three months while it recruits a permanent physician. The agency presents available providers with the right specialty, board status and state license. Once the facility picks one, the agency coordinates licensing if needed, credentialing and privileging, malpractice coverage, travel and housing.

Most locum physicians are independent contractors paid a daily or hourly rate by the agency, which bills the facility a higher rate covering its fee, malpractice insurance and travel costs. Some health systems run internal locum pools of employed providers who rotate across their own facilities.

Why facilities use locums

• Covering a vacancy during a physician search that can take many months, especially in rural areas.
• Covering parental, medical and sabbatical leave.
• Keeping a service line open, such as an anesthesia department or an emergency department, when losing coverage would mean diverting patients.
• Seasonal demand, for example in areas with large winter populations.

The value is revenue and patient access protected. A department that cannot see patients for three months loses far more than a locum costs, which is why facilities accept the premium.

Credentialing and timelines

Speed is limited by paperwork, not by finding a provider. A provider needs an active license in the state where they will practice, and hospital privileges, which require primary-source verification of education, training, board certification, work history and malpractice history. This credentialing process commonly takes 60 to 120 days for a new provider at a new facility, though it can be shorter when the provider already holds the state license and the facility offers temporary privileges.

The Interstate Medical Licensure Compact gives eligible physicians an expedited path to licenses in participating states, which helps locums who work across state lines. Start credentialing the moment a coverage gap is foreseeable, not when it begins.

Locum tenens versus per diem

Both are flexible clinical staffing, but they cover different people and patterns. Locum tenens usually refers to physicians and advanced practice providers on assignments of a week to several months. Per diem staffing typically refers to nurses, therapists and techs picking up individual shifts as needed.

Common mistakes

• Treating locums as a long-term fix instead of a bridge while recruiting a permanent hire.
• Not orienting locums to the EHR and local protocols, which hurts productivity in the first weeks.
• Signing agency contracts without reading the conversion fee terms, which often charge a fee if the facility later hires the locum permanently.
• Leaving malpractice tail coverage unclear between the facility, agency and provider.