Walk into virtually any urgent care clinic in the country and you're likely to be seen by a nurse practitioner or physician assistant — not a physician. According to the Urgent Care Association's annual industry report, NPs and PAs now account for the majority of providers working shifts at independent urgent care centers, with APP-led urgent care models growing rapidly as a cost-effective approach to acute ambulatory care (Urgent Care Association, 2024 Urgent Care Industry Report).
These clinicians are skilled, experienced, and in high demand. And a growing number of them are choosing not to accept permanent positions.
Instead, they're going locum.
The shift isn't accidental. It reflects a set of rational economic and professional decisions by clinicians who understand their market value — and have found that locum platforms and staffing partners now offer the infrastructure to make flexible APP careers genuinely sustainable.
The Structural Reality of Permanent Urgent Care Employment
To understand why NPs and PAs are choosing locum work, it helps to understand what permanent urgent care employment typically looks like.
Most full-time urgent care positions are structured as hourly or salaried W-2 roles with rigid schedules, limited autonomy over scope, and modest benefits packages relative to total compensation benchmarks. The AAPA's 2024 PA Professional Survey found that median PA compensation in urgent care/immediate care settings was approximately $120,000–$130,000 annually for full-time roles — competitive at face value, but often accompanied by strict productivity quotas, mandatory overtime during volume surges, and limited control over scheduling (AAPA, 2024 PA Professional Survey Summary Report).
The AANP's most recent National NP Practice Survey similarly found that NPs in primary care and urgent care settings report high rates of role-related dissatisfaction tied to administrative burden, lack of autonomy, and scheduling inflexibility — even as overall NP compensation has increased (AANP, 2024 National NP Practice Survey).
These structural conditions create fertile ground for locum work.
Why Locum Works Particularly Well for APPs in Urgent Care
Urgent care is one of the settings where locum placements work most naturally for NPs and PAs — and where the financial and lifestyle case for locum work is strongest.
1. Scope of Practice Is More Predictable
Hospital-based locum placements can be complicated for APPs because scope of practice agreements, supervision requirements, and collaborative practice structures vary significantly by facility. Urgent care is different. The clinical scope at most urgent care centers is predictable: acute injury, illness, minor procedures, point-of-care diagnostics. For NPs and PAs with urgent care experience, the clinical environment is familiar enough that the learning curve at a new site is minimal.
This predictability makes urgent care one of the most locum-friendly settings for APPs. Clinicians can integrate quickly, perform effectively from day one, and build the kind of track record that leads to repeat placements.
2. The Compensation Math Often Favors Locum Arrangements
Locum rates for NPs and PAs in urgent care have risen meaningfully over the past two years as clinic operators compete for a limited pool of experienced APP providers. In 2025, market locum rates for NPs and PAs in urgent care settings range from approximately $75–$115/hour depending on geography, experience, and shift timing (evenings and weekends carry differentials) — with rural and underserved markets often offering 15–25% premiums on top of baseline rates.
At $85/hour working 32 clinical hours per week for 46 weeks, a locum NP or PA earns approximately $125,000 in gross clinical income before expenses — and retains the ability to schedule down during peak life demands, eliminate non-clinical administrative obligations, and deduct legitimate business expenses that W-2 employees cannot.
As we detailed in our breakdown of urgent care compensation benchmarks for 2025, the gap between what locum APPs earn per hour and what permanent employees earn per equivalent clinical hour is meaningful — and it compounds over a career.
3. Administrative Overhead Is Dramatically Lower
One of the most underappreciated advantages of locum work for APPs is what it removes rather than what it adds. In permanent urgent care positions, NPs and PAs frequently carry responsibilities that have nothing to do with clinical care: performance reviews, committee meetings, mandatory all-staff trainings, EMR optimization projects, and the endless documentation of non-clinical activities that clinic management requires.
In locum arrangements, the scope of the engagement is the clinical work. Credentialing, scheduling infrastructure, and placement logistics are handled by the staffing partner or platform. The APP shows up, delivers clinical care, and leaves. This structural simplicity is itself a meaningful benefit for clinicians who entered healthcare to practice medicine, not to attend committee meetings.
4. Burnout Recovery and Prevention
The healthcare workforce data on APP burnout is sobering. A 2023 survey published in the Journal of the American Academy of Physician Associates found that PA burnout rates exceeded 50% across clinical settings, with urgent care and emergency medicine among the highest-stress environments (Sinsky C. et al., JAAPA 2023; see also Medscape's annual APP burnout series). NP burnout rates tracked similarly in AANP survey data.
For clinicians at or approaching burnout, locum work offers something permanent employment rarely does: a structural reset. The ability to dial down clinical hours during high-stress periods, choose assignments that align with preferred patient populations, and eliminate the non-clinical obligations that drive administrative fatigue can genuinely restore clinical engagement — not just manage it temporarily.
This is different from simply "reducing stress." Locum work changes the employment relationship in a way that gives APPs real leverage over their professional circumstances. Many clinicians who left permanent positions for locum work report that the flexibility itself — the knowledge that they can adjust their schedule when needed — reduces the baseline stress of clinical work even when the work itself is demanding.
Our post on work-life integration for locum clinicians covers practical strategies for structuring a locum practice that sustains rather than depletes.
The Financial Case in Detail
For NPs and PAs evaluating the locum option, the financial picture requires honest accounting on both sides.
What Locum Arrangements Add
Higher base rates. As noted above, locum hourly rates typically exceed the per-hour equivalent of permanent salaries for comparable clinical work.
Expanded tax deductions. As 1099 independent contractors, locum APPs can deduct professional expenses that W-2 employees cannot: malpractice insurance (when not facility-covered), licensing fees, CME costs, travel and lodging for out-of-area assignments, and home office costs for administrative work. Healthcare-focused CPAs routinely help locum APPs structure these deductions to materially reduce effective tax rates.
Retirement savings optionality. Self-employed clinicians can contribute up to $69,000 annually to a Solo 401(k) or SEP IRA under 2024 IRS limits — roughly triple the maximum employee contribution to a 403(b) or 401(k). For mid-career APPs in peak earning years, the retirement savings differential over a decade can be substantial (IRS Publication 560, Retirement Plans for Small Business).
What Locum Arrangements Require
Benefits self-funding. Permanent employment packages for NPs and PAs typically include health insurance, malpractice tail coverage, disability insurance, and retirement matching — benefits that collectively represent $20,000–$40,000 in additional compensation. In locum arrangements, the APP funds these independently. This doesn't make locum work financially inferior, but it's a real cost that must be modeled honestly when comparing offers.
Tax management discipline. 1099 income requires quarterly estimated tax payments, meticulous expense documentation, and annual reconciliation. Many locum APPs find that working with a healthcare-focused accountant in their first year pays for itself — and that the administrative overhead becomes manageable with systems in place.
Licensing and credentialing lead time. Working across multiple states requires maintaining multiple licenses. Even with PA and NP compact arrangements, building a licensure footprint takes time and carries ongoing maintenance costs.
For a deeper look at how to navigate the financial side of locum work, the locum tenens guide for nurse practitioners covers NP-specific compensation structures, scope considerations, and state compact updates in detail.
What's Driving Increased Locum Adoption Among APPs in 2025
Several converging factors are making locum work more accessible and appealing for NPs and PAs than it was five years ago.
The NP and PA Workforce Has Matured
The NP workforce has grown significantly over the past decade — the Bureau of Labor Statistics projects it will be one of the fastest-growing occupations through 2032, with over 385,000 NPs currently practicing in the U.S. (BLS, Occupational Outlook Handbook: Nurse Practitioners). The PA workforce similarly stands at over 168,000 active practitioners (NCCPA, Statistical Profile of Certified PAs).
This growth means there are now large cohorts of experienced APPs with 5–15 years of post-training practice — clinicians who have the credentialing history, clinical confidence, and professional networks to navigate locum work successfully. Early in a career, the case for permanent employment is often stronger: mentorship, benefits, structured professional development. A decade in, the value proposition shifts.
Compact Licensure Has Simplified Multi-State Practice
The NLC (Nurse Licensure Compact) and PALC (PA Licensure Compact) have materially reduced the administrative burden of multi-state practice. As of 2025, 41 states participate in the NLC, allowing NPs practicing in a compact state to hold a multistate license that authorizes practice in other compact states without additional applications (NCSBN, Nurse Licensure Compact). The PA compact, more recently ratified, is expanding membership steadily.
For urgent care locum work specifically — where assignments are often regionally clustered rather than nationally dispersed — these compact arrangements eliminate a significant administrative barrier that historically made multi-state locum practice more costly and time-consuming.
Modern Platforms Have Made the Logistics Manageable
Perhaps the most significant change driving APP locum adoption is structural: the infrastructure for locum practice has improved dramatically. Platforms like Rediworks handle credentialing portability, transparent rate matching, and scheduling coordination in ways that traditional agency models did not. APPs who previously would have needed to manage their own placement relationships, negotiate rates without market data, and navigate fragmented credentialing across multiple facilities can now do this through a single platform interface.
This matters because the administrative friction of locum practice — not the clinical work — has historically been the primary deterrent for APPs considering the transition. Reduce that friction, and the calculus changes.
What Urgent Care Operators Should Know
The trend toward locum work among experienced NPs and PAs has direct implications for urgent care operators. Experienced APPs who prefer locum arrangements are not leaving the workforce — they're entering the locum market, and they want to work with facilities that make the experience efficient and reliable.
Facilities that build relationships with high-quality locum APPs — through transparent platforms, prompt onboarding, and consistent repeat placements — access a talent pool that full-time employment alone cannot reliably attract. The NP and PA who turned down a permanent offer because she wanted scheduling flexibility will often take a well-structured locum relationship with a facility she trusts.
This is the structural opportunity for urgent care operators: not to fight the trend toward flexible work, but to build staffing models that work with it. Operators who can offer pre-credentialed, well-compensated locum APP placements through efficient platforms gain access to experienced clinicians who might otherwise be unavailable through traditional recruitment.
The Clinicians Who Locum Work Is Best For
Locum work suits NPs and PAs who are:
- Clinically experienced — comfortable operating effectively in new environments without intensive onboarding
- Administratively organized — able to manage licensing, taxes, and credentialing as ongoing business functions
- Clear about their goals — whether that's income maximization, schedule flexibility, geographic exploration, or burnout recovery
- Comfortable with variability — clinically and logistically, locum practice involves more uncertainty than permanent employment
It tends to work less well for APPs who are early in their careers and benefit from mentorship-rich environments, or who need the financial predictability of a biweekly paycheck and employer-funded benefits.
Neither profile is better. They're different. The relevant question is which one describes you accurately.
If you're an NP or PA considering locum work in urgent care, Rediworks offers a platform built specifically for the way experienced APP clinicians want to practice: transparent market-rate matching, portable credentialing, and scheduling that fits your life. Join the waitlist to get early access to placements in Colorado and beyond.
Sources and References
- American Association of Nurse Practitioners (AANP). 2024 National NP Practice Survey. https://www.aanp.org/research/aanp-surveys
- American Academy of Physician Associates (AAPA). 2024 PA Professional Survey Summary Report. https://www.aapa.org/research/
- Bureau of Labor Statistics. Occupational Outlook Handbook: Nurse Practitioners, Midwives, and Physician Assistants. https://www.bls.gov/ooh/healthcare/nurse-practitioners.htm
- Internal Revenue Service. Publication 560: Retirement Plans for Small Business. https://www.irs.gov/publications/p560
- Medscape. Nurse Practitioner & PA Burnout & Lifestyle Report 2023. https://www.medscape.com/slideshow/2023-lifestyle-burnout-6016328
- National Council of State Boards of Nursing (NCSBN). Nurse Licensure Compact. https://www.ncsbn.org/nurse-licensure-compact.page
- National Commission on Certification of Physician Assistants (NCCPA). Statistical Profile of Certified PAs, 2024. https://www.nccpa.net/data-and-trends/statistical-profiles-of-certified-pas/
- Urgent Care Association (UCA). 2024 Urgent Care Industry Report. https://www.ucaoa.org/
- Sinsky C. et al. PA burnout rates across clinical settings. Journal of the American Academy of Physician Associates, 2023. https://journals.lww.com/jaapa/
Compensation figures reflect 2025 market data compiled from industry surveys and platform placement data. Individual compensation varies by geography, specialty, experience level, and assignment type. This post is educational and does not constitute legal, tax, or financial advice — consult qualified professionals for advice specific to your situation.