Vlad Dzhashi, MD
So, you’re thinking about jumping into the locum tenens world as a physician assistant? Smart move! A locum tenens physician assistant is basically a provider who takes on temporary gigs at hospitals, clinics, medical groups, urgent care centers, and pretty much any healthcare facility that needs help.
Here’s the thing – if you’re a PA exploring locum tenens jobs, this career path can give you way more control over your life than you’ve probably ever had. We’re talking location freedom, schedule flexibility, assignment duration on your terms, and yes – better pay. Plus, you get to travel, experience different practice environments, and broaden your clinical skills without being stuck in one place forever.
Let me tell you about Caroline – she’s this experienced PA-C I interviewed who totally gets it. She’d been grinding through inpatient psychiatry, hospitalist medicine, and family practice when COVID hit. She took an assignment at a NYC field hospital and had this lightbulb moment – she could actually combine traveling with practicing medicine! After getting her state licenses sorted, she went full-time locum tenens and never looked back.
This guide’s gonna break down everything you need to know about PA jobs in the locum market – where to find the good stuff, how to spot a decent recruiter from the sketchy ones, what credentialing nightmares to expect, and how to actually build a career that won’t drive you crazy. And hey, even though I’m focusing on PAs here, most of this applies to nurse practitioners and other healthcare providers looking for temporary work too.
Read on or watch our interview below.
Benefits of Locum Tenens Work for PAs
Greater schedule control. This is the big one! As a locum tenens PA, you basically become the boss of your own calendar. Caroline told me she has almost complete control over when she works. Instead of begging for vacation days and waiting for some manager’s approval, she plans her trips first and then builds work around them. How’s that for living your best life?
Potential for competitive pay. Here’s where it gets interesting – locum work often pays way more per hour than permanent gigs. Now, don’t get too excited just yet because higher hourly doesn’t automatically mean more money in your pocket. You’ve gotta factor in taxes, health insurance, unpaid time off, and all those benefits you’re giving up.
Freedom to choose a location. Want to work in Alaska for the adventure? California for year-round opportunities? Some tiny rural town because you’re craving that slower pace and deeper patient connections? Locum work can get you there, my friend.
Travel and housing support. Depending on your contract (and trust me, read the fine print!), your agency might hook you up with flights, mileage, rental cars, hotels, or longer-term housing. Every policy’s different though, so nail down those reimbursement details before you say yes.
More variety in clinical practice. Working different hospitals and clinics means you’ll see new EMR systems, facility workflows, docs, patient populations, and medical approaches. Caroline found that treatment preferences actually differ from region to region – who knew? This stuff will make you a better provider, guaranteed.
Opportunities to serve underserved communities. Rural facilities are desperate for permanent healthcare providers, and Caroline found these assignments incredibly fulfilling. Patients were genuinely grateful, and the lower volume sometimes gave her more time with each person. She told me about this rural ED shift where she could actually focus on one stroke patient, get treatment going, coordinate with neurology, and arrange air transport without juggling ten other critical patients. Pretty cool, right?
A clear endpoint when a job sucks. Let’s be real – sometimes you get stuck with a terrible manager, awful workflow, or workplace drama. When you know there’s an end date, those problems feel way more manageable. You can stay focused on patient care without feeling trapped in permanent position hell.
What Kind of Locum PA Gigs Are Actually Out There?
Here’s the good news:
There are locum opportunities in pretty much every specialty you can think of. The bread and butter gigs include hospitalist coverage, emergency medicine, family practice, urgent care, critical care, surgical services, and outpatient primary care clinic work. If you’ve got the experience and the demand is there, you might even find opportunities in pediatrics, dermatology, oncology, cardiology, orthopedics, neurosurgery, and all sorts of subspecialties.
- How many patients will you typically see per shift?
- Is this inpatient or outpatient work?
- What procedures are you expected to do?
- Will you be flying solo or is there backup?
- Are you on call? Working weekends?
- Holidays?
- Overnight shifts?
The Big Players: Family Practice and Emergency Medicine
Family practice is probably your easiest entry point into locums work because clinics are constantly scrambling for help with routine visits, chronic disease management, same-day sick visits, and covering for providers who are out.
But here’s the reality check – Caroline noticed that family medicine assignments usually pay less than the procedure-heavy or big-money specialties. If you’ve got family practice experience, you might want to branch out into urgent care to boost your earning potential.
Emergency medicine and hospitalist roles?
There’s definitely demand, but you better understand exactly what they expect from you. Supporting an emergency physician might mean you’re seeing the less critical stuff while they handle the really sick patients.
What about solo coverage?
That’s a whole different ball game – you might need to be comfortable with intubations, chest tubes, central lines, and all sorts of emergency airway management.
If you end up working as an Emergency Medicine PA, Caroline’s advise is to be completely honest about what you can and can’t do. Since PA training varies so much, facilities can’t just assume every PA with emergency experience has the same skills.
For example, she turns down solo roles because she’s not comfortable doing certain advanced procedures like intubations and chest tubes on her own, but she’s found plenty of opportunities where there’s always an emergency physician around.s
How long are locum tenens assignments
A locum assignment could be anything from a weekend fill-in to more than a year-long commitment.
Some PAs pick up occasional shifts close to home, others string together multiple assignments into a full-time lifestyle. Sometimes facilities start with a short request and then keep extending if they like you and still need the help.
Short assignments give you flexibility but mean you’re constantly going through credentialing and learning new systems.
Longer gigs provide more income stability, let you actually learn how the place works, and give you time to build real relationships with the staff.
Multi-hospital systems can be gold mines because once you’re credentialed at the system level, you might get access to several different hospitals.
Finding locum tenens jobs: Agencies, Recruiters, and Going "Rogue"
Caroline’s initial strategy was pretty simple – start with where you want to work. Pick your dream destination, figure out how to get licensed there, and then start hunting for jobs once your license is in progress or approved. That’s how she tackled places like Alaska and Maine.
Or you can flip it around and start with the specialty instead of location. If you want consistent work, search nationwide and then compare what’s available in different states.
Being flexible usually means more opportunities, especially if you’re willing to work rural communities, less popular locations, nights, or weekends.
Important point here is: Don’t put all your eggs in one basket!
Agencies might know about jobs that you’ll never see anywhere else, but the networking may uncover a direct opportunity in the perfect location. You need to aim at the balanced approach.
Working with Agencies
Many locum agencies have their own job databases and established contracts with hospitals, health systems, clinics, and physician groups.
These opportunities might never show up on regular job sites. Once an agency understands your specialty, licensing, availability, and travel preferences, their recruiters can ping you when something matching comes available.
Agencies are always hunting for PAs and nurse practitioners for temporary openings across primary care, emergency medicine, hospital medicine, urgent care, critical care, and surgical specialties.
An agency with a strong advanced-practice division probably understands PA scope-of-practice rules and credentialing requirements better than some recruiter who mainly works with physicians.
A good recruiter makes all the difference by giving you the real scoop before you waste your time on application.
At minimum, they should explain:
- The facility and general location
- Required specialty experience
- Expected patient census
- Required procedures
- Shift length and number of shifts per month
- Physician backup and supervision structure
- Call, night, weekend, and overtime expectations
- Hourly pay and any call-back rate
- Travel and housing policies
- Licensing and credentialing timelines
- Malpractice insurance terms
- Cancellation and termination provisions
Note that a good locum tenens recruiter protects the relationship with both you and the facility.
The goal isn’t to “shove” your application into every opening – it’s to find assignments where you can practice safely and actually succeed
Another great point Caroline made and what she learned the hard way was not to complete applications with a bunch of agencies before finding a real opportunity.
Early on, she registered with multiple firms, filled out tons of paperwork, and burned out her references, but didn’t get a single assignment through those applications.
Now she recommends finding a specific job first and only then completing the agency’s paperwork.
Going Solo:
PAs who want to find their own assignments can network with former employers, supervising physicians, classmates, medical directors, and clinicians they meet while traveling. Direct opportunities might also pop up through hospital career pages, professional associations, specialty groups, social media communities, and general healthcare job boards.
Caroline found many of her assignments through social media and just talking to other clinicians. One of her favorite gigs in Maine started after she heard physicians talking about practicing there, got a Maine license, searched PA and APP social media groups, and contacted a medical director whose email was in a post. After a quick conversation and about three months of credentialing, she spent the summer working in Maine.
Independent searches might require more follow-up though. You might need to contact several facilities, track down the right hiring person, negotiate the contract, arrange malpractice insurance, and coordinate travel. It takes longer, but you might get access to a particular clinic, community, or schedule that agencies don’t offer.
Agency vs. Working Directly – What’s the Deal?
Both agency-managed and independent assignments can work great. The best choice depends on your priorities and how much administrative stuff you want to deal with.
– Agency-managed searches save time. The agency brings you vetted openings, handles facility communication, helps with licensing and credentialing, and might take care of travel and housing.
– Independent searches give you control. You manage outreach, screening, negotiation, and logistics but get more freedom to select arrangements and expenses.
– Independent contractor status isn’t guaranteed. Whether you’re legally an employee or contractor (W2 or 1099 for taxes) depends on the actual working relationship and applicable laws, not just what the contract says.
Agency support advantages might include:
- Faster access to open roles and established facility relationships
- Assistance with licensing applications and credentialing paperwork
- Coordination of flights, rental cars, hotels, and longer-term housing
- Support when payroll, onboarding, scheduling, or facility issues come up
- Agency-provided malpractice insurance
Possible agency drawbacks include:
- Some agencies have limited specialty coverage or terrible communication
- Compensation might be less transparent when the agency won’t explain the complete pay package
- The agency might control travel arrangements or impose strict reimbursement procedures
- Contracts might contain restrictive cancellation, noncompete, or conversion language
- You have less direct contact with the facility during negotiation
Caroline’s direct assignments gave her more freedom to pick destinations and arrange her own travel and lodging, but some paid less than agency opportunities.
She found that agencies could sometimes offer more money because they worked with facilities that had bigger staffing budgets, but the reimbursement and expense process was more complicated.
PA's Licensing, Credentialing, and Working in Multiple States
Here’s the truth:
Getting multiple state licensing is crucial for building a locums career for Physician Assistants!
Start with states where you actually want to work, then think about available jobs, average licensing time, application cost, supervision rules, prescribing requirements, and how often facilities recruit your specialty.
Caroline initially looked for Tennessee hospitalist positions but realized her geographic and specialty combo was too narrow. She expanded into states like California, Alaska, Pennsylvania, and New York and eventually maintained 11 state licenses.
The good news is many locum agencies cover or reimburse licensing fees when the application connects to a confirmed assignment, but don’t forget to request that policy in writing.
In the near future, the licensing can becoma a whole lot easier for PAs since here’s a new Licensure Compact legislation. But it’s still in the works and it’s not available yet as of August 2026. So for now, PAs still have to go through the each state’s medical board to apply for new licenses.
To stay organized and keep track of you multiple licenses, you can create a spreadsheet that includes:
- License number and state
- Original issue and expiration dates
- Renewal deadline
- CME requirements
- Supervisory or collaboration documents
- Controlled-substance and prescribing registrations
- Application receipts for reimbursement
- Login information for the state licensing portal
Managing Credentialing Chaos
Credentialing usually takes 60 to 90 days, but it could be shorter or way longer. The timeline depends on the facility, state license status, medical staff meeting schedule, background history, payer enrollment, references, and how fast you submit complete information.
Some facilities can speed things up significantly by issuing temporary or locums privileges which might only take a few weeks. Also, outpatient facilities like clinics typically have shorter credentialing timeframes.
Of course, the credentialing process can take a LOT longer if you don’t reply to those pesky credentialing emails fast.
So make sure you’re on top of it!
It’s a good idea to save and keep commonly requested document for credentialing applications include:
Malpractice Insurance for Locum tenens Pa's
Most agencies provide malpractice insurance for PA-s, but I don’t want to you to assume it’s there unless you confirm this in writing.
Typical locums malpractice insurance is claims-made coverage but some agencies do offer occurrence policies. Note that if you get claims-made coverage you’ll need to have an extended reporting period or “tail coverage”. As to the coverage limit, it’s also pretty standard and should cover $1m/3m at the minimum.
Before working with an agency , confirm: If the coverage is claims-made or occurrence
Locums Pa's Salary/pay rates
W-2 vs. 1099
You tax status as a locums PAc affect multiple things including your locums salary.
As a W-2 employee, your employer (i.e. agency) withholds income, Social Security, and Medicare taxes. If you are classified as an independent contractor , you are self-employed, generally receive Form 1099-NEC, and may need to make quarterly estimated tax payments.
Your tax form alone does not determine your legal classification. The IRS looks at the actual working relationship, including behavioral control, financial control, and the relationship between the parties.
Most of Caroline’s locum income has been paid on a 1099 basis. She values the flexibility but handles her own taxes, retirement contributions, health insurance, accounting, and cash flow. If you do not want those responsibilities, you should ask agencies if they can offer W-2 employment and benefits.
Another point is that California is even more strict about worker classification. That is one reason some agencies place California clinicians on W-2 or avoid the state alltogether.
When talking to your recruiter , confirm:
And remember!
For tax questions, it’s a good idea to talk with a qualified tax professional rather than relying on your recruiter or something you saw online.
What salary can you expect for locums work?
For emergency medicine and hospitalist assignments, Caroline has often targeted about $100 to $110 per hour, sometimes more. These numbers reflect her experience, not a universal market rate.
Workload matters. A rural 12-hour shift with only a few patients may pay less than a busy emergency department. At $105 per hour, a 12-hour shift pays $1,260 before taxes and expenses.
Pay rate for High-Demand PA specilaties
They defeinitely pay more because they want specialized skills. Caroline’s seen critical care PA postings asking for central line and chest tube skills paying over $150 an hour, while some cardiothoracic or vascular surgery gigs were advertised above $200 an hour.
Compare the Full Pay Package!
A good hourly rate can get your attention fast. But before you say yes, do the math on the whole assignment.
Sometimes the $105-per-hour job is better than the $115-per-hour job because the first one guarantees your shifts, pays for housing, and does not leave you holding the bill if the schedule changes.
When you compare offers, check:
- Hourly or daily rate
- Guaranteed shifts and hours
- Overtime and differentials (e.g. Holidays)
- Call and call-back pay
- Travel and housing
- Health and retirement benefits
- Orientation pay
- Cancellation terms
The workload counts too!
A quiet rural hospital where you see a handful of patients during a 12-hour shift is a different job than a busy ED where you might see 16 or more.
At $105 an hour, that 12-hour shift pays $1,260 before taxes and expenses. You need to know what you are signing up for before deciding whether that number is good.
Ask Questions Before Agreeing to the Pay rate/Salary:
Do not throw out a number before you understand the job.
How many patients will you see? Are you doing procedures? Nights? Weekends? Call? Will a physician be on-site? Are you covering one facility or three?
Get those answers FIRST.
Then you can negotiate based on the actual work instead of guessing.
Caroline also recommends speaking up when the job changes after you agree to it. If the hospital suddenly wants you to work your day off, drive to another facility, or take extra shifts, ask for more money.
She has negotiated bonuses for coming in on scheduled days off. She has also asked for extra compensation when covering another location meant additional driving.
You can keep the conversation simple:
“I can cover that extra shift. Is there any additional compensation available since it wasn’t part of my original schedule?”
Or:
“I’m happy to help at the second location, but it adds quite a bit of driving. Can we adjust the rate or add a travel payment?”
You do not need to make it awkward. Ask the question and let them answer.
Caroline has caught both underpayments and overpayments by comparing her records with her checks. A basic spreadsheet works fine. Record the date, hours worked, rate, reimbursements, expected pay, and actual pay.
If you live close to the hospital, bring that up too. The agency may not need to pay for flights, hotels, or a rental car. Ask if there is room for a higher hourly rate or a completion bonus instead.
They may say no, but at least you’ve asked…
Phyician Assistant locums agreement/Contract
Read your contract and confirmation letter/term sheet. Yes, the WHOLE thing.
Pay attention to guaranteed hours, overtime, call pay, cancellation rules, termination notice, travel limits, malpractice coverage, licensing costs, noncompete language, conversion terms, additional facilities, and whether orientation is paid.
For complicated contracts, consider having an attorney familiar with healthcare staffing or locum work review the agreement.
traveling Physician assistant: tips
Travel can get pretty messy when nobody explains the rules.
Before you book anything, find out whether the agency books it or you do. If you pay first and get reimbursed later, get the limits in writing.
Ask about hotel limits, rental cars, mileage, parking, baggage fees, receipt deadlines, and travel time.
Pay attention to housing dates too.
Say you work Monday, Wednesday, and Friday. Is the hotel covered Tuesday and Thursday night? Do not assume it is.
And what happens if the hospital cancels after your flight and hotel are booked? You want that answer before you spend the money.
Before you travel, confirm that your privileges, license requirements, occupational health clearance, malpractice coverage, EMR access, badge, payroll setup, and schedule are complete.
If your recruiter says everything “should be ready,” ask for actual confirmation.
You do not want to fly across the country and find out you cannot see patients because one approval is still sitting in someone’s inbox.
Building a Locums Career You Can Actually Maintain
Caroline gave several great tips on how to make sure your locums careers last a very long time.
1 -“A good recruiter can make your life much easier.”
You want someone who gives you accurate information, responds when there is a problem, and sends you jobs that actually fit what you are looking for.
Caroline would rather have a few solid recruiter relationships than a huge contact list filled with people sending random assignments.
2 – “You must have cash reserves!”
She recommends keeping four to six months of expenses saved before leaving a permanent position for full-time locum work.
Credentialing gets delayed. Assignments get canceled. Sometimes you may go several weeks without working. Savings give you more freedom to turn down a bad offer instead of accepting it because you need the next check.
3 – “Look for work that can keep going!”
Caroline also prefers assignments with ongoing needs when she can find them. Credentialing takes time, so getting approved at a health system with several hospitals can give you more options.
At one system, her first hospital hired a permanent PA. Instead of losing the work completely, Caroline moved to another facility in the same system without repeating the entire credentialing process.
That kind of setup can give you steadier work with a lot less paperwork.
4 – “and finally…Watch your schedule.”
When the hourly rate is good, it gets very easy to keep saying yes.
One more shift…One more weekend…One more trip…
Eventually, the travel and night work can catch up with you big time!
Leave yourself recovery days.
Protect time for exercise, family, friends, appointments, and whatever else you want your life to have.