Locum tenens pay: how to compare it to a salaried offer

A public anchor, not a locum rate

BLS Occupational Outlook Handbook reports median pay for physicians and surgeons of $275,930 per year in the figures Saile uses. This is an occupational reference point only. BLS does not publish locum rates, and Saile does not quote locum rates. Do not divide the median into a temporary-work rate and present the result as a benchmark for a locum assignment.

NPs and PAs should not use the physician and surgeon figure as their own occupational wage measure. The clinician state pay hub provides the existing BLS-based pages for those roles. Whatever role you are comparing, the public wage source cannot tell you the temporary assignment’s guaranteed work, expense coverage or cancellation terms. Those details belong in the proposed agreement.

Convert the quoted rate into comparable work

For an hourly quote, multiply the rate by the paid hours attached to the work you expect to perform. For a daily quote, multiply the daily rate by worked days. If you start with an hourly rate and a count of worked days, you also need the paid hours within those days; a day count alone is not an hourly-pay calculation.

Compare the resulting gross work payment with the salaried offer only after describing the work behind each. A salary may cover an ongoing schedule and responsibilities that differ from a temporary assignment. Record whether the locum proposal guarantees work, how changes are handled and what the payment unit includes. Do not treat an assumed full schedule as promised income.

Keep call and additional clinical responsibilities visible during this conversion. Ask whether the quote covers availability, clinical hours, a defined daily assignment or another arrangement. If those units are unclear, resolve them before doing the comparison. Arithmetic can organize known terms, but it cannot supply missing contract commitments.

Identify what is not included in the rate

• Benefits: ask what, if anything, is offered under the arrangement.
• PTO: establish whether non-worked time is paid rather than assuming a salaried leave benefit.
• CME: clarify both education expenses and time away from work.
• Malpractice: identify the coverage arrangement and responsibility when the assignment ends.
• Licensing: determine which expenses are covered and which remain yours.
• Travel and lodging: request the specific coverage and reimbursement terms.

These are items to investigate because a locum rate may not include them. This guide does not assume they are always excluded or always paid separately. An agreement may address them in different ways, so list the actual terms instead of subtracting invented costs from the quote.

Travel and lodging deserve explicit treatment when the work is away from home. Ask who arranges them, what documentation is needed and whether changes in the assignment affect coverage. Similarly, do not assume that the presence of malpractice coverage settles every question about the policy or obligations after the work ends.

Employment and tax status require their own review

Ask whether the proposed arrangement is described as 1099 or W-2 work, and review the documents rather than relying only on an informal label. Tax and self-employment considerations can affect how you evaluate gross payment, but the result depends on your circumstances. Ask your tax advisor about those considerations; this guide does not estimate taxes or net income.

Keep gross compensation separate from your personal tax analysis. A larger quoted rate is not automatically a larger take-home result, and a benefit should not be assigned an assumed cash value without understanding its terms. Bring the actual proposal and expense responsibilities to the advisor so the discussion reflects the arrangement you are considering.

Readiness affects the work you can actually accept

Credentialing and privileging lead times vary by facility. Ask the facility what it needs, who coordinates the review and how the planned work relates to approval. This page provides no timeline and does not promise that an assignment can begin before the required processes are complete.

State licensure is a separate part of readiness. The licensing hub explains the physician IMLC pathway and where to confirm state requirements. The IMLC applies to physicians, not NPs or PAs; those clinicians should use their relevant licensing authority. Confirm requirements for the proposed practice location rather than assuming temporary work bypasses them.

• State licensure and the physician IMLC

Finish with a written, like-for-like comparison

Summarize the paid work, guaranteed commitments, covered expenses and unresolved questions for each proposal. Keep the public wage anchor in a separate context column instead of making it the expected locum payment. A facility can support this comparison by spelling out assignment units and responsibilities without claiming that the rate reproduces a public annual wage.

When the proposals remain different, describe the difference rather than forcing a precise verdict. Ask for the missing information and use professional advice for tax, legal or insurance questions. An honest comparison can identify uncertainty while still helping you decide which terms need attention.

Sources and scope

• BLS Occupational Outlook Handbook: Physicians and Surgeons
• BLS Occupational Employment and Wage Statistics

The public reports linked here provide the source context described above. Offer-specific terms must be confirmed with the employer. General information, not legal, tax or insurance advice.