Locum Tenens FAQs: What Healthcare Employers Ask Us Most in 2026

Most hospitals and clinics don't turn to locum tenens because they read a whitepaper on flexible staffing models. They turn to it because a physician just quit, a maternity leave overlapped with a retirement, or a rural clinic can't recruit a permanent hire fast enough to keep the doors open.

Once employers are actually in that position, the same questions come up again and again. Here are the ones we hear most, answered plainly.

What is locum tenens staffing, exactly?

Locum tenens is Latin for "to hold the place of." In practice, it means a licensed physician or advanced practice provider fills in for a set period, anywhere from a few shifts to over a year, while a facility handles a gap in coverage. It's not a new concept. It's how hospitals have covered vacations, leaves, and open recs for decades. What's changed is how employers find and vet these providers.

For the fuller picture, including how the model breaks down by provider type and specialty, see our complete guide to navigating the locum tenens staffing landscape.

When does locum tenens make more sense than a permanent hire?

Three situations, mostly. A sudden departure that leaves a schedule with holes in it. A seasonal or predictable volume swing, like flu season in an ED. Or a role that's genuinely hard to fill permanently, often in a rural or underserved area where the candidate pool is thin.

Locum tenens isn't a replacement for a permanent hiring strategy. It's a way to keep the lights on while that strategy plays out.

How much does locum tenens actually cost?

More per hour than a permanent hire, usually. Less than an empty seat, almost always. An unfilled shift means diverted patients, overtime for existing staff, or a service line that has to close temporarily, and those costs rarely show up in a clean line item.

Rates depend on specialty, location, and urgency. What varies more than the rate itself is the markup. Traditional agencies often stack fees between the provider and the facility. Platforms that connect employers directly to credentialed clinicians tend to be more transparent about what you're actually paying for. We've broken down the full cost picture, including agency fees, travel, and administrative overhead, in what to know before employing locum tenens staffing.

How long does credentialing take?

Traditionally, 60 to 90 days, sometimes longer if a state license has to be issued from scratch. This is usually the single biggest bottleneck in getting a locum provider on-site.

It can move faster. Providers who already hold an active license in your state, or who are credentialed through a platform that keeps documentation current and ready to submit, can sometimes start in a couple of weeks. If credentialing speed matters to you, ask about it upfront rather than assuming it'll sort itself out. Our 10 tips for a smoother credentialing experience goes deeper on where the delays usually come from.

Who's on the hook for malpractice coverage?

In most arrangements, the staffing agency or platform carries occurrence-based malpractice insurance for the duration of the assignment, not the hiring facility. Ask for a certificate of insurance before the provider's first shift, and confirm the coverage type. Occurrence-based policies cover claims regardless of when they're filed, which matters more than people expect once a provider has moved on to their next assignment.

Don't take "we're covered" at face value. Get it in writing. Our licensing and credentialing resources cover what documentation to ask for before day one.

How do we know a locum provider is any good?

This is the question employers worry about most, and it's a fair one. Look for board certification status, verified work history, and references from prior facilities, not just from the staffing company placing them.

A useful signal: ask how the provider was vetted, not just that they were. Any staffing partner worth using should be able to walk you through their screening process without getting vague about it. We cover this in more detail in how to ensure quality care with locum tenens staffing.

What's the shortest and longest a locum assignment can run?

Assignments can be as short as a single weekend of ED coverage or run well past a year for a rural hospital still recruiting a permanent hire. Most fall somewhere between four and twelve weeks. The length should match the actual gap you're covering, not a standard contract template.

Can locum tenens cover an emergency, like a provider who quit with two weeks' notice?

Sometimes, yes, but it depends heavily on your state's licensing timeline and how fast privileging can move internally. If the provider already holds a license in your state, a placement in a matter of days isn't unrealistic. If a new state license is required, that timeline extends fast.

If you're in a genuine emergency, say so early and be specific about your real deadline. Staffing partners can often prioritize licensing and credentialing steps that would otherwise move at a normal pace, but only if they know it's urgent. If you're facing this right now, it's faster to talk it through directly than to keep reading FAQs.

Which specialties actually use locum tenens?

Emergency medicine and hospitalist roles lead by a wide margin, mostly because those departments can't function with an empty shift. Anesthesiology, psychiatry, and primary care follow closely. Radiology has grown quickly too, partly because teleradiology makes remote coverage genuinely practical rather than a workaround.

If a specialty has unpredictable demand or a chronic recruiting gap, there's a decent chance locum tenens already plays a role in it somewhere.

What's different about a platform versus a traditional staffing agency?

Traditional agencies typically act as an intermediary the whole way through: they source the provider, negotiate on both sides, and take a cut that isn't always visible to the hiring facility. That model isn't inherently bad, but it adds a layer between you and the person actually filling the shift.

A platform model, like the one DirectShifts runs, connects employers directly with credentialed providers. You see the rate, you see the credentials, and there's no second party negotiating in the middle. For employers who've been burned by markup surprises or slow communication with a traditional agency, that difference tends to matter more than it sounds like on paper. If you're actively comparing options, see how this plays out specifically against AMN Healthcare or OpenLoop.

What do locum tenens contracts typically include?

Rate and payment terms, assignment length, scope of duties, malpractice coverage terms, and cancellation or extension clauses. Travel and lodging, if applicable, are usually itemized separately rather than folded into the rate.

Read the cancellation terms closely. This is the section most likely to cause a dispute later, especially if a permanent hire comes through faster than expected and you need to end a locum assignment early. Our guide to streamlining the locum tenens staffing process covers contract management in more depth.

Can a locum assignment turn into a permanent hire?

Often, yes. It's called locum-to-perm, and it's common enough that many contracts build in a conversion path or a buyout fee if you want to hire the provider outright. It's also a low-risk way to evaluate fit before making a permanent offer. The provider gets a real look at your facility, and you get a real look at how they work, before either side commits long-term. Our notes on onboarding a locum tenens clinician touch on how to set an assignment up so a conversion, if it happens, goes smoothly.

If you're weighing locum tenens for the first time, or you've been burned by a slow or opaque staffing process before, we're happy to walk through what coverage would actually look like for your facility. No pressure, just a straight answer on timeline and cost.

For more on this topic, browse the full locum tenens resource hub.