Is Locum Tenens Worth It? Recruiters Tell All

Locum tenens work offers physicians unparalleled freedom—higher pay, flexible schedules, and the chance to escape burnout. But behind the allure of temporary assignments lie real challenges: opaque agency fees, misrepresented job details, and the isolation of constantly changing workplaces.

In this article, we break down the unfiltered truths about locum tenens, drawing on insider insights from recruiters who’ve seen it all. You’ll learn:

• The top financial and logistical concerns doctors face—and how to avoid them
• Why some agencies prioritize profits over physicians (and how to spot them)
• The undeniable benefits that keep locums coming back
• How Era Locums is redefining the industry with transparency, ethics, and real partnerships

Whether you’re considering your first assignment or are a seasoned locum, this guide will help you navigate the system—and decide if it’s truly worth it for you.

Is Locum Tenens Worth It? Common Concerns and Pitfalls

While locum tenens offers undeniable perks, it’s not without its challenges. From opaque agency fees to unpredictable assignments, many physicians encounter frustrations that can make temporary work feel risky or unsustainable. Based on candid insights from recruiters, here’s a breakdown of the most common pain points—and how savvy locums can navigate them.

The Fees Charged by Locum Tenens Agencies

One of the most common frustrations physicians have with locum tenens work is the fee structure. Many recruiters admitted that large agencies take a significant cut of what facilities pay—sometimes as much as 40-50% of the total rate—without passing those earnings on to the doctor.

Doctors also report that overtime and seasonal rates (like holiday or surge pricing) often don’t make it into their paychecks, even though hospitals are billed at a premium. On top of that, some agencies tack on administrative fees, further reducing take-home pay.

However, not all agencies operate this way. We spoke with several Era recruiters who emphasized transparency and sharing their rates with physicians upfront. If a facility’s offer is too low, these recruiters will either negotiate for a better rate or advise the doctor to decline the assignment. This approach builds trust and ensures doctors feel fairly compensated for their work.

While agencies argue that their fees cover credentialing, malpractice insurance, and logistical support, many physicians feel the margins are unnecessarily high, especially when they’re the ones doing the actual work. For locums to be truly "worth it," doctors need to seek out transparent agencies, ask for rate details upfront, and negotiate if the numbers don’t add up.

Agencies Misrepresenting Needs & Qualifications

Trust is critical in locum tenens work—but some physicians find that agencies stretch the truth to fill positions quickly. Recruiters admitted that misrepresentation is a recurring issue, leaving doctors frustrated and stuck in assignments that don’t match what was promised.

Common problems include:

• Overstating a doctor’s qualifications to facilities, putting physicians in uncomfortable (or even risky) situations where they’re expected to handle cases beyond their expertise.
• Fabricating job details, like patient volume or support staff availability, only for doctors to arrive and find themselves overwhelmed.
• Inflating assignment lengths—some recruiters promise months of steady work, only for the assignment to end abruptly after a week or two.

One recruiter acknowledged that pressure to meet quotas leads some agencies to prioritize filling slots over ensuring a good fit. The result? Burned-out physicians who feel misled and hesitant to take future locum roles.

To avoid these pitfalls, doctors should:

✅ Ask for written confirmation of assignment details (patient load, expected duties, duration).
✅ Request to speak directly with the facility’s team before accepting.
✅ Work with agencies that have verified reviews—ones known for honesty, not just speed.

Transparency should go both ways. When agencies are upfront, physicians can make informed decisions—and locum work becomes sustainable for everyone involved.

Could not be happier with my experience with Era Locums! Kat, my recruiter, is an absolute pleasure to work with. She advocates on your behalf, she is responsive to your needs, and she is just a wonderful and genuine person you can trust. Era Locums is also very prompt with their payments, and they surprise you with adorable little gifts throughout the year on special holidays. It is definitely a company that sets itself apart from its peers. Physicians, join the team; you won’t regret working with Era Locums!

Dr. Aradia | Epilepsy Neurology

Silent Owners

Many physicians seek out smaller locum tenens agencies, hoping for a more personal, transparent experience—only to later discover that their "boutique" recruiter is actually owned by one of the large corporations they wanted to avoid.

Here’s how it happens:

• Big firms with questionable reputations quietly acquire smaller agencies, keeping the original branding intact. Doctors sign on, unaware of the parent company’s influence.
• Cost-cutting policies and opaque fee structures slowly trickle down, eroding the personalized service the smaller agency once offered.
• Physicians feel duped, especially if they left a major agency to escape high fees or misrepresentation—only to encounter the same issues under a different name.

One recruiter admitted that these acquisitions are rarely disclosed proactively, leaving doctors in the dark until problems arise.

How can physicians protect themselves?

🔍 Research the agency’s ownership—check LinkedIn, corporate websites, or industry databases. You can find an example of how a boutique agency describes itself here on Era Locums’ About page.
📝 Ask direct questions: "Has your agency been acquired in the last few years? Who owns your parent company?"
🗣 Talk to other locums doctors—peer reviews often reveal hidden ownership ties.

The takeaway? Smaller doesn’t always mean better—doctors need to dig deeper to ensure their agency’s values align with its actual practices.

Lack of True “Vendor Neutrality”

Many hospitals and healthcare systems use Managed Service Providers (MSPs) or Vendor Management Systems (VMSs) to streamline locum tenens staffing. These platforms often claim to be "vendor neutral"—meaning they objectively match facilities with the best doctors, regardless of agency. But in reality, that neutrality isn’t always guaranteed.

Here’s what recruiters revealed:

• Preferred agency favoritism: Some MSPs/VMSs prioritize certain agencies (often those offering lower rates or kickbacks) over others, regardless of physician quality.
• Limited transparency: Doctors may be passed over for assignments without knowing why—sometimes because their agency isn’t in the MSP’s "inner circle."
• Biased algorithms: Even when placements are automated, the criteria can be skewed toward cost-cutting rather than finding the best fit for the facility or physician.

This lack of true neutrality hurts both doctors (who miss out on fair opportunities) and facilities (who may not get the most qualified candidates).

How can physicians navigate this?

✔ Ask agencies if they’re "preferred vendors" for the MSPs/VMSs they work with—this increases assignment opportunities.
✔ Work with multiple agencies to avoid being locked out by a biased system.
✔ Push for direct contracts when possible, bypassing third-party platforms altogether.

While MSPs/VMSs can simplify staffing, doctors should be aware of the politics behind the scenes—because "neutral" doesn’t always mean fair.

Feeling Isolated as a Locum Tenens

One of the biggest challenges of locum tenens work isn’t just the logistics—it’s the loneliness. Moving between facilities, adjusting to new teams, and lacking long-term colleagues can leave physicians feeling disconnected. But according to recruiters, it doesn’t have to be that way.

Here’s how agencies and facilities help combat isolation:

• Peer connections: Our recruiters told us that they intentionally introduce new locums to experienced providers, creating an instant support system. Some doctors even form lasting friendships through these introductions.
• Recruiters as confidants: "We’ve had providers call just to vent about their day or share a win," one recruiter shared. The best agencies act as both advocates and sounding boards.
• Facility culture matters: While most hospitals and clinics welcome locums warmly, recruiters keep a pulse on which ones don’t—and steer doctors away from unwelcoming environments.

Tips for staying connected:

💬 Ask your agency to connect you with other locums at your assignment—even a casual coffee chat can ease the transition.
🏥 Choose facilities with a reputation for inclusivity (your recruiter should know which ones these are).
📞 Don’t hesitate to reach out—agencies that truly care will celebrate your successes and troubleshoot tough days with you.

Locum life doesn’t mean going it alone. With the right agency and mindset, it can be a chance to build a network—not just a resume.

Benefits of Working in Locum Tenens

Locum tenens isn’t just a temporary fix—it’s a career path with real perks. Here’s why many physicians choose it:

• 💰 High rates: Locums often earn more than their full-time counterparts, with premium pay for last-minute, overtime, or high-demand assignments.
• ⏰ Job flexibility: Set your own schedule—work extra to save up, or take extended breaks between assignments without bureaucratic hurdles.
• 🔥 Burnout prevention: Escape toxic workplace politics, administrative burdens, and rigid hierarchies by stepping into short-term roles where your sole focus is patient care.
• ✈️ Opportunity to travel: Turn work into adventure—whether it’s a rural community in need, a bustling city hospital, or a destination with downtime for exploring.

For many doctors, locum tenens isn’t just a job—it’s a lifestyle upgrade.

How Much Do Locum Tenens Physicians Make?

According to ZipRecruiter, locum tenens physicians’ make $308,331 per year on average in the United States. Compare that to $149,049 a year on average for all physicians, and you can see why locum tenens has become an increasingly popular choice for many.  

How Much Do Locum Tenens Companies Make?

While rates can vary widely depending on the agency and the job, a rate of about 30% is generally considered fair for a locum tenens agency. Be mindful that some agencies charge additional fees for overtime, seasonal work, and administration, which can drive up rates significantly. 

One of the reasons that doctors prefer to work with Era Locums is fee transparency. We don’t mind sharing our rates for your role, and we’re happy to work with you to make sure you’re compensated fairly. We also don’t charge hidden fees.

The Era Locums Promise

At Era Locums, we believe locum tenens should work for physicians, not just agencies. That’s why we’ve built our entire model on transparency, partnership, and ethical growth—standards that set us apart in an industry often plagued by hidden fees and misrepresentation.

Here’s what you can expect:

• 🗒️ No surprises, ever: Clear compensation with zero hidden fees—physicians keep 100% of bonuses, and hospitals get straightforward billing.
• 🤝 Partnerships over transactions: No bait-and-switch tactics. We provide accurate details upfront and adjust assignments if they’re not working.
• 🔄 Flexibility without strings: If an assignment isn’t the right fit, we’ll find a solution—no pressure, no games.
• 🌱 Sustainable growth: We prioritize long-term trust over short-term profits, ensuring doctors and facilities thrive together.

We’re more than just recruiters—we’re advocates, connectors, and allies. Ready to learn about a new Era of Locums? [Read our complete commitment here.]