A decade ago, locum tenens was often treated as a fallback — what you did between permanent jobs, or what a rural hospital called when no one else was available. That framing has become obsolete.
Locum tenens is now a deliberate career strategy for tens of thousands of U.S. physicians. It is a frontline workforce solution for facilities managing supply gaps that permanent hiring pipelines cannot close. And it is growing: the locum tenens market reached an estimated $6.5 billion in 2024, up from roughly $4 billion five years prior.
The question worth asking is why — and what the structural forces shaping this growth mean for where the industry goes next.
What "Locum Tenens" Actually Means
The term is Latin: locum tenens means "one who holds a place." It entered clinical usage in the United Kingdom in the 18th century, where it described physicians temporarily covering for absent colleagues.
In modern American healthcare, the definition has expanded considerably. A locum physician today might:
- Cover a permanent vacancy for three months while a facility recruits
- Provide surge capacity at an urgent care center during peak flu season
- Fill a long-term role at a rural hospital that cannot attract permanent staff
- Build a full independent practice across multiple facilities without a permanent employer
What these arrangements share is structure: a physician engages with a facility through a short- or medium-term contract, typically as an independent contractor, and provides clinical services on agreed terms. The work is the same. The employment relationship is different.
The Shortage That Isn't Going Away
The most direct driver of locum tenens growth is a physician supply problem that has been building for decades and is now arriving at scale.
The Association of American Medical Colleges projects a shortfall of up to 86,000 physicians by 2036. The drivers are predictable: an aging population with higher chronic disease burden, medical school class sizes that have not kept pace with demand growth, and an aging physician workforce itself — more than a third of currently practicing physicians are over 55.
Primary care and emergency medicine bear a disproportionate share of the shortage. Urgent care, which now handles a significant fraction of episodic care in the United States, sits at the intersection of both. 42% of urgent care physician searches went unfilled at the end of 2024 — a figure that underscores why facilities are increasingly treating locum coverage as a permanent operational strategy rather than a gap-fill.
Locum tenens does not solve the underlying shortage. But it solves the distribution problem: matching available physicians to facilities that need coverage, on timescales that permanent recruitment cannot match.
Physician Burnout Has Changed the Calculus
The shortage of available physician hours is not only a supply problem — it is also a utilization problem. Physician burnout, well-documented across specialties following the COVID-19 pandemic, has accelerated early retirement and driven meaningful numbers of physicians to reduce their clinical hours.
The 2024 Medscape Physician Burnout & Depression Report found that 49% of physicians report burnout — up substantially from pre-pandemic baselines. Burnout rates are highest in emergency medicine, primary care, and hospitalist medicine: exactly the settings where locum demand is most acute.
Here the locum model offers something permanent employment typically cannot: control over schedule and workload. Locum physicians choose when they work, where they work, and how much they work. They can take extended time off between assignments without jeopardizing their position. They can exit a difficult facility relationship without navigating corporate HR processes.
For a physician whose burnout is rooted in loss of autonomy — which Medscape's data consistently identifies as the leading driver — locum work addresses the cause rather than the symptom.
Why Facilities Have Shifted Their Stance
Until recently, many health system administrators viewed locum physicians with skepticism: higher cost, lower continuity, difficult to integrate. That view has softened considerably, for reasons that are mostly arithmetic.
The cost of a locum physician — typically $200–$300/hour in emergency medicine and urgent care — is high relative to a permanent hourly equivalent. But the cost of an unfilled shift is higher still: reduced patient capacity, increased wait times, potential diversion, and downstream revenue loss. For facilities operating at high utilization, an unfilled shift is rarely a cost-free event.
More importantly, the permanent recruitment timeline has lengthened. Physician recruitment, credentialing, and onboarding — assuming a successful search — typically runs four to six months from first contact. In a tight supply environment, some permanent searches extend to a year or more. Locum arrangements provide coverage on a timeline measured in weeks.
The math has changed. Locum physicians now fill coverage gaps that facilities cannot close through any other mechanism. The administrative calculus has shifted accordingly.
The Geographic Dimension
Physician distribution in the United States is not uniform. Metropolitan and suburban markets attract the bulk of permanent clinical talent, for reasons ranging from academic affiliation to spousal employment to school quality. Rural and underserved areas face chronic understaffing that structural incentives have not meaningfully addressed.
Locum tenens operates as a redistribution mechanism. A physician based in Denver can cover shifts in rural Wyoming or western Kansas without relocating. A hospitalist in Atlanta can work a two-week rotation at a critical-access hospital in the Mississippi Delta. The flexibility of the engagement model makes geographic mobility possible in ways that permanent employment does not.
This is not incidental to the model's social function. Rural hospitals serve communities with no other local options. When the alternative to locum coverage is a closed unit or diversion to a facility two hours away, the value of flexible physician deployment is not measured in billing rates.
The Technology Gap
Despite the growth of locum tenens as a market, the operational infrastructure supporting it has developed unevenly. Traditional staffing agencies — which intermediated most locum placements for decades — have not fundamentally modernized their processes.
Credentialing remains largely paper-based and manually managed. Physician onboarding for a new facility typically requires assembling the same documentation package repeatedly, even for facilities within the same health system. Licensing across states — increasingly important as physicians take assignments in multiple markets — is fragmented and administratively burdensome.
On the facility side, coverage gap visibility is reactive rather than proactive. Administrators discover openings when a physician gives notice, often beginning a search only then. The agency model is opaque: facilities often do not know how much the physician they are working with is being paid, or why rates differ between similar engagements.
These frictions create real costs. They extend the time between a coverage need and a physician filling it. They add administrative overhead that makes short-duration assignments economically marginal. And they create information asymmetries that benefit intermediaries more than the physicians and facilities doing the actual work.
What's Coming Next
The structural forces driving locum tenens growth are not temporary. The physician shortage will deepen through the 2030s. Burnout rates are unlikely to improve substantially without changes in how clinical work is structured. The geographic distribution problem will persist as long as the incentive structure for permanent placement remains unchanged.
What is changing is the technology infrastructure around the model.
Platforms that automate credentialing, consolidate multi-state licensing, provide real-time market rate transparency, and intelligently match physicians with facilities — replacing the relationship-brokered opacity of traditional staffing with algorithmic precision — are beginning to close the operational gap that legacy staffing firms have left open. For a market that processed $6.5 billion in placements in 2024, the efficiency gains available to AI-native platform participants are substantial.
For physicians, the implication is straightforward: the administrative burden of locum work — the part that has historically made it feel like a second job on top of the clinical one — is becoming solvable. As it does, the model becomes attractive to a wider range of physicians, including those who would not previously have considered it because of operational complexity.
For facilities, the implication is similar: the 25–40% premium that reactive, last-minute agency placements have historically commanded can be substantially reduced when matching and credentialing are automated through a technology platform — turning emergency coverage scrambles into planned, proactive staffing operations.
The rise of locum tenens is not a trend that will reverse. It is a structural shift in how physician labor is organized — one that reflects permanent changes in supply, demand, and physician preference. The market infrastructure is now catching up.
Rediworks is building the platform that closes this gap — connecting urgent care centers and physicians directly, with automated credentialing and transparent pricing. If you're a physician interested in locum work in Colorado, join the waitlist to get early access.