Locum tenens work lets a clinician choose shifts instead of holding a fixed schedule. The clinical work is the same as in a permanent job. What changes is everything around it: pay is hourly, licenses and credential files have to be in place before you can accept a shift, and the taxes and benefits an employer used to handle may become yours.
This guide covers those logistics for clinicians who work, or want to work, in urgent care.
What locum tenens means
The phrase is Latin for "to hold the place." A locum tenens clinician works temporarily at a facility that needs coverage: a staff member on leave, a seasonal rise in patient volume, a position open during a search. In urgent care, locum work is usually booked by the shift or in blocks of shifts.
Urgent care suits locum tenens work for a structural reason. A clinic isn't a hospital, so there's no hospital privileging committee in the timeline between applying and working. The clinic still verifies your credentials, but the process has fewer steps.
Who does locum tenens work in urgent care
Urgent care clinics staff shifts with several roles, and locum tenens work exists for each of them:
- Physicians (MD and DO)
- Nurse practitioners (NPs) and physician assistants (PAs)
- Certified registered nurse anesthetists (CRNAs)
- Registered nurses (RNs)
- Medical assistants (MAs)
The requirements differ by role. A physician's file includes medical school, residency and a DEA registration, and a medical assistant's doesn't. Where this guide describes a requirement, it says which roles it applies to.
Why clinicians choose locum tenens work
The reasons depend on what a permanent job isn't giving you.
Schedule control. You pick the shifts. Taking three weeks off doesn't require approval, because you simply don't book shifts for those weeks.
A second income. Clinicians often start locum work alongside a permanent job, with a weekend shift or two a month. Check your employment agreement first, since some restrict outside clinical work or include a non-compete.
A way to test a change. Working shifts at several clinics shows you how they run before you commit to any of them. Our guide on moving from permanent to locum work and back covers that path.
A lighter schedule. A clinician who wants fewer clinical hours can set that number without negotiating part-time status with an employer.
The cost of that control is predictability. Income varies with the shifts you book, and nobody else is responsible for keeping your calendar full.
How locum tenens pay works
Locum pay is an hourly rate for a scheduled shift. To compare it with a salary, convert the salary to an hourly figure, count only the hours you'd work as a locum (no paid vacation, holidays or sick days), and add the value of the benefits your employer pays for. Our guide to how locum tenens physician pay works walks through that arithmetic, and the method applies to every role.
How the income is taxed depends on how the work is classified, which varies by arrangement. Some locum work is paid as wages with tax withheld. Some is paid as self-employment income with nothing withheld. In that case you owe a 15.3% self-employment tax covering both halves of Social Security and Medicare, and you pay tax during the year through estimated payments across four payment periods.
Benefits follow the same split. A permanent job typically comes with health insurance, retirement contributions and paid time off. In most locum arrangements you fund those yourself, so their cost belongs in any comparison of offers.
This is a general explanation and not tax advice. State rules differ, and an accountant who works with clinicians can apply them to your situation. The locum taxes guide has more detail.
Licensing for locum tenens clinicians
You need a license in the state where the clinic is. Working locum shifts in a second state means meeting that state's licensing rules, and the route depends on your role.
Physicians. The Interstate Medical Licensure Compact lets an eligible physician apply for licenses in several member states through one application. It doesn't create a single multistate license. Each state still issues its own.
Registered nurses. The Nurse Licensure Compact lets an RN who lives in a compact state hold one multistate license that's valid in every other compact state. It covers RN and LPN/VN licenses only.
Nurse practitioners and CRNAs. The Nurse Licensure Compact doesn't extend to advanced practice licenses. A separate APRN Compact exists on paper, but it takes effect only after seven states enact it, and that hasn't happened. An NP or CRNA working in a second state needs that state's advanced practice license.
Physician assistants. The PA Licensure Compact has been enacted by enough states to form its commission, but compact privileges aren't available yet. Once they are, a PA will apply for a separate privilege in each member state. Until then, a PA needs a license from each state.
Medical assistants. Requirements for MAs are set by states and employers and vary widely, so check the rules for the state where you plan to work.
State licensing takes time, and the timeline is the board's, not yours. If you want to work in a second state, apply before you need the shifts. Our licensing guide goes further.
DEA registration for prescribers
This applies to clinicians who prescribe controlled substances. A DEA registration is state-specific: a separate registration is required in each state where you prescribe, and a registration based on one state's license doesn't authorize prescribing in another. Practitioner registrations run on a three-year period, so the renewal date belongs on your calendar with your license renewals.
Credentialing for locum tenens work
Credentialing is the facility or agency confirming that your license, training and history are what you say they are. What's requested depends on your role, but a typical file includes:
- Your current state license or certification
- Proof of training and, where it applies, board or national certification
- DEA registration, for prescribers
- Work history, with any gaps explained
- Malpractice coverage and claims history, where it applies to your role
- Professional references
- Life support certifications the clinic requires
A file moves at the speed of its slowest item. A state board can confirm a license the same day, while an employment verification waits in a former employer's HR inbox, and the file stays open until that comes back. Having every document current and in one place before you apply is the part of the timeline you control.
In the traditional model you build this file again for each agency. The credentialing guide explains the checks in more detail.
Malpractice coverage for locum tenens shifts
Malpractice coverage for locum work is arranged in different ways. An agency may provide it, a facility may extend its policy to you, or you may carry your own. Ask which applies before your first shift, and get the answer in writing.
The type of policy matters as much as who provides it. An occurrence policy covers an incident that happened while the policy was in force, whenever the claim is filed. A claims-made policy covers a claim only if it's filed while the policy is active. When a claims-made policy ends, claims filed afterward aren't covered unless extended reporting coverage, known as tail coverage, is in place.
For a locum clinician the question is who pays for the tail when a claims-made arrangement ends. This is a general description of how policies work, and the terms of your actual coverage are in the policy. The malpractice guide covers more.
How to find locum tenens shifts
There are two main routes to locum tenens work.
Staffing agencies. A traditional agency assigns you a recruiter, who presents openings, coordinates credentialing and often arranges travel and housing for assignments away from home. For a clinician who wants to work in another part of the country and have someone else handle the logistics, that service is worth having. The trade-off is that you see the shifts and rates the recruiter brings you, when they bring them.
Self-service marketplaces. A marketplace lists shifts and lets you apply directly. You see what's available without waiting for a call, and you handle your own travel. This fits clinicians who want to pick up shifts near where they live or already hold a license.
Whichever route you take, read the agreement before you accept a shift. Our guide to locum tenens contract terms lists the clauses to look at and the questions to ask.
Is locum tenens work stable enough?
Locum tenens income is as steady as your bookings. A clinician with one clinic and no backup has the same concentration risk as any business with one customer. Working with several clinics, and going back to the ones that run well, spreads that risk and makes your calendar easier to fill.
If you're leaving a permanent job for locum work, start the licensing and credentialing paperwork while you're still employed. The administrative lead time is unpaid, and it's easier to absorb with a paycheck still arriving.
Locum work fits clinicians who are comfortable walking into a new clinic, organized about paperwork and able to live with a variable month. It fits less well if you want a long-term patient panel or need the same deposit every two weeks.
Your first locum tenens shift
Once your file is complete, the first shift is mostly a matter of logistics: where to park, how to log in to the EMR, who to ask when something isn't where you expect it. Our walkthrough of what to expect on a first locum tenens assignment covers the days before and the shift itself.
Rediworks is a self-service marketplace for urgent care shifts. You upload your documents to a credential wallet once and reuse them at every Rediworks facility, and each listing shows the rate, location, shift length and facility before you apply. Sign up to see shifts.