10 Best States for Locum Tenens in 2025

Locum tenens is projected to grow by 5% in 2025 as the demand for care increases in every state across the U.S. But as with any career, this isn’t just about goals and growth, it’s about finding the places that take you where you want to be. 

With a healthcare labor market that’s ever-changing, we’re always on the lookout for how locums physicians are moving. Previously, we’ve written about where Cardiologists and Orthopedic Surgeons are moving to find more competitive pay and stronger support for career longevity. But today we’re focusing on the overall market for locum physicians. 

Moving to a new state is a big decision that brings many questions like “what’s the malpractice climate like?” and “yes, the salary might be higher, but can it keep up with the cost of living?” As the job market heats up again for fall, we have the data about where physicians are moving and some of the factors you might want to consider for your next assignment.

We built the top 10 best states for locum tenens list with insights about the 2025 healthcare job market and data from Era experts. Whether you’re looking for a place with solid cost-of-living, a fulfilling career in service, or an environment with better pay and stronger malpractice protections, we’ve got something for everyone.

Let’s check it out.

A note on data: Employment rates, location quotients, and salaries come from the Bureau of Labor Statistics. Salaries are based on full time employment data. Locums work may be higher. 

Best States for Locum Tenens

• Oregon
• Maryland
• Massachusetts
• Tennessee
• Indiana
• Delaware
• Arkansas
• Texas
• North Carolina
• Pennsylvania

1. Oregon

• Best for: Gorgeous natural scenery, moderate cost beyond Portland. Balanced laws, stable premiums.
• Average salary: $288,930
• Average hourly wage: ~$350/hr 
• Location quotient: 2.0
• Locum Tenens Jobs in Oregon

Oregon stands out for its exceptionally high location quotient (LQ) in overall physician demand and job opportunities, especially in rural HPSAs. With OHSU anchoring its academic landscape, locum tenens doctors in Oregon can provide exceptional care while benefiting from its progressive healthcare infrastructure. Hourly rates are strong, and the malpractice climate is stable and balanced, reducing stress for temporary providers.

The cost of living is manageable outside of Portland, and Oregon’s outdoors lifestyle, craggy coastlines, mountains, and stunning national parks, offer something for every nature lover. However, heavy regulatory oversight and variable weather in certain regions (especially in winter) may be drawbacks for some. If it’s your first time in rural locums, you might face some logistical challenges that require concierge support.

2. Maryland

• Best for: Near D.C., solid infrastructure. Well‑established physician protections, tort-friendly.
• Average salary: $210,950
• Average hourly wage: ~$300–$320/hr
• Location quotient: 1.7
• Locum Tenens Jobs in Maryland

Maryland is the crown jewel of academic and clinical locum opportunities. With Johns Hopkins and the University of Maryland Medical Center nearby, physicians can work within elite institutions while serving a diverse, high-volume population. The location quotient for several specialties (internal medicine and pathology) is significantly above average, showing a demand in both urban and suburban regions. Its proximity to Washington, D.C. also opens doors for federal, nonprofit and research-focused engagements.

But, Maryland’s cost of living, especially near Baltimore and D.C., can be relatively high. While its malpractice environment is generally physician-friendly, bureaucracy and traffic are challenges to navigate, especially for locum tenens professionals seeking efficiency and autonomy.

3. Massachusetts

• Best for: Harvard, MGH, UMass are top schools. Cultural hub, but $$. Moderate state malpractice environment.
• Average salary: $229,980
• Average hourly wage: $320–$340/hr
• Location quotient: 1.6
• Locum Tenens Jobs in Massachusetts

Massachusetts is simply world-class when it comes to locum tenens. Academic affiliations with Harvard, MGH, and UMass, make it an ideal state for physicians interested in cutting-edge care, teaching, or research roles. With a high LQ and rising demand in specialties like dermatology and psychiatry, providers can find steady assignments and high hourly compensation. The malpractice environment is moderate and stable, which is great for contractors in both short and long-term roles.

There’s always a but- and this one is important. Massachusetts’ high cost of living and complex healthcare ecosystem. Boston, specifically, has housing and transportation challenges. High patient volumes and pressure in top-tier institutions make this a state for physicians with deep academic and clinical experience.

4. Tennessee

• Best for: Vanderbilt and UT systems present locum opportunities.No state income tax, affordable, solid malpractice reforms.
• Average salary: $297,780
• Average hourly wage: $350–$370/hr
• Location quotient: 1.8
• Locum Tenens Jobs in Tennessee

Tennessee is a strong contender for locum tenens work, combining high demand, top-tier compensation, and a solid malpractice climate. With no state income tax and relatively low living expenses, take-home pay here stretches as far as the Great Smoky Mountains. Institutions like Vanderbilt and the UT medical system provide excellent academic touchpoints, while a high percentage of the state’s rural areas are considered HPSAs, increasing the demand for providers.

The flip side? The rural-heavy distribution of locum work may require extensive travel and flexibility. Limited public transportation and inconsistent access to advanced technology in more remote settings are offset by the income potential and the low cost of living. Together, these make Tennessee a smart choice for well-positioned practitioners.

5. Indiana

• Best for: Affordable housing, strong tort reforms. Steady locum availability in rural and urban areas.
• Average salary: $323,030
• Average hourly wage: $300–$330/hr
• Location quotient: 1.5
• Locum Tenens Jobs in Indiana

Indiana offers a stable locum job market with demand in both urban and rural settings. Locum physicians working here benefit from relatively high salaries and a solid legal environment that includes strong tort reform and low malpractice insurance costs. The Indiana University Health system is a hub for teaching and research, making it attractive to locum physicians seeking academic engagement.

Food for thought: Indiana’s lifestyle appeal is for those interested in small town life rather than coastal amenities or metropolitan buzz. Additionally, harsh winters in northern areas could be a deterrent depending on assignment timing. 

6. Delaware

• Best for: Close to Philly/Baltimore.Moderate malpractice costs, surgeon demand rising, highest pay in US.
• Average salary: $225,650
• Average hourly wage: $380–$400/hr
• Location quotient: 1.7
• Locum Tenens Jobs in Delaware

Delaware ranks first in locum pay, offering ~149% of the national median compensation, with high demand in cardiology, dermatology, and pediatrics. So why is it in the middle of this list and not at the top? Because the state is a study in contrasts. Its compact size means providers can enjoy short commute times while being close to major metro areas like Philadelphia and Baltimore. But this also means job opportunities are concentrated in just a few health systems, and those seeking a wide variety of practice environments might find it limiting. Additionally, while close to major cities, Delaware itself may feel more suburban and less dynamic for those more interested in city life.

7. Arkansas

• Best for: Rural focus; low cost of living. 
• Average salary: $221,690
• Average hourly wage: $330–$350/hr
• Location quotient: 1.8
• Locum Tenens Jobs in Arkansas

Arkansas has a high demand for family medicine and general practitioners, driven by its rural healthcare shortages and policy changes. Locum tenens roles receive generous pay, about 131% of the national average, and assignments often come with housing and travel coverage due to HPSA status. For those seeking hands-on, meaningful care, Arkansas offers high-impact work and a chance for a meaningful career. 

That said, the rural nature of most assignments can present logistical and cultural challenges. Providers may experience limited technological infrastructure, fewer specialists for referrals, and longer on-call rotations. But for those comfortable in community settings, Arkansas offers rewarding work and significant earning potential.

8. Texas

• Best for: No income tax, varied urban/rural mix. Good malpractice environment for most specialties with caps.
• Average salary: $239,840
• Average hourly wage: $325–$350/hr
• Location quotient: 1.5
• Locum Tenens Jobs in Texas

Texas offers a vast and varied locum landscape, from underserved rural regions to booming urban hospital systems. The lack of state income tax and competitive compensation, especially in specialties like pediatric surgery and emergency medicine, make it financially attractive. Tort reform and legal caps have created a somewhat favorable malpractice climate, easing liability concerns for most locum doctors.

Still, everything’s bigger in Texas. And that means locum experiences can vary dramatically between regions. Roles in cities are competitive and center on high-volume care. Meanwhile, rural areas don’t always have the support staff or specialty care they need. Flexibility and adaptability are key here. But there’s ample room for physicians to find opportunities for professional growth in the Lone Star state.

9. North Carolina

• Best for: Duke, UNC as major hubs. Affordable housing, strong urban amenities. Balanced malpractice laws and growing rural need.
• Average salary: $218,010 
• Average hourly wage: $300–$330/hr
• Location quotient: 1.4
• Locum Tenens Jobs in North Carolina

North Carolina is an increasingly popular state for locum tenens because of its balanced cost of living, growing physician demand, and strong academic presence (Duke and UNC Medical Center). Locum physicians can find solid opportunities in both urban and rural communities, giving them a broad scope of practice. The malpractice environment is stable, and compensation, while not the highest, is competitive given the overall quality of life.

The main drawback is that urban assignments can be competitive, and rural ones may require quite a few hours on the road. In some areas, reimbursement rates remain lower than in neighboring states. Still, for locum doctors seeking professional diversity with location flexibility, North Carolina offers a good mix of work and lifestyle perks.

10. Pennsylvania

• Best for: a diverse mix of academic access, solid pay, and community-focused care.
• Average salary: $360,000
• Average hourly wage: ~$180–275/hr
• Location quotient: 1.8
• Locum Tenens Jobs in Pennsylvania

Pennsylvania is a well-traveled destination for locum tenens physicians, with an above-average location quotient (~1.85) indicating high demand across specialties like internal medicine. The state is home to top-tier academic institutions such as the University of Pennsylvania, UPMC, and Jefferson Health, offering opportunities to practice in top-tier facilities or contribute to teaching and research. Urban centers like Philadelphia and Pittsburgh offer rich cultural experiences, while rural areas hold high-impact assignments.

Something to keep in mind: Pennsylvania’s healthcare market is highly regionalized, so competition in urban hospitals can be steep. Cost of living varies. It’s affordable in many areas, but higher near Philadelphia’s suburbs. While the malpractice environment is moderate and generally manageable for locums, for some specialties it’s not as favorable as in tort-reformed states like Texas or Indiana. It’s also a big state, so you’ll need to budget more time for travel between rural and urban assignments. 

How We Chose the Best States for Locum Tenens

Curating a list of the top states for locum tenens physicians requires balancing quantitative data with qualitative factors that impact career satisfaction and quality of life. Our method focused on four key pillars:

1. Compensation & Job Market: We analyzed average salaries, hourly wages, and employment data to identify states where locum tenens are competitively compensated. Location quotients helped determine market saturation—whether a state has higher demand (quotient >1) or fewer opportunities (quotient <1) relative to national averages.
2. Hospital Systems & Academic Opportunities: States with nationally ranked medical schools scored higher, as these institutions offer career growth, research opportunities, and cutting-edge practice environments.
3. Quality of Life & Cost of Living: We considered taxes, housing affordability, and lifestyle perks (e.g., outdoor recreation, urban amenities). States with no-to-low income tax (Texas and Indiana) or high salary-to-cost-of-living ratios (Delaware and Tennessee) gained competitive footing.
4. Legislation & Practice Environment: Malpractice climates, physician-friendly tort reforms, and state healthcare policies were factored in. 

Salary and employment numbers were critical to our understanding of the state of the job market, but we also incorporated insights from physician recruiters and regional trends (e.g., aging populations in rural areas and competitive metro environments) to ensure our recommendations reflect real-world desirability. The result is a carefully assembled list designed to both reflect current patterns and support you as you make decisions about your locum tenens journey.

Let Us Help You Find Your Next Locum Tenens Role

While you’re keeping an eye out for a change of pace or better earning potential, Era Locums is helping to connect skilled physicians with top opportunities nationwide. From leading academic institutions to high-demand community facilities, discover positions that align with your goals, offer competitive pay, flexible schedules, and dedicated support. 

Your ideal practice setting is just a click away.