How to hire a locum tenens hospitalist

Why does locum coverage take so long to arrange?

Because the medical compact is widely misunderstood. It is an expedited route to obtaining several separate state licenses, not a portable single license. Every state still issues, renews and regulates its own. A physician licensed in four states cannot simply work in a fifth.

Add hospital privileging, which runs on its own committee calendar regardless of how urgently you need the shift covered, and you have the real timeline. Any agency quoting a two-week start without asking about your privileging cycle has not thought about it.

What does it cost?

Locum hospitalists are commonly paid $150–$200 per hour, with the national average near $158 and daily rates around $1,800. Facility cost is higher once you include malpractice coverage, licensure, credentialing support, travel and lodging.

Locums is usually quoted per day or per shift rather than per hour, and the rate is highly sensitive to notice. A shift needed next week does not price like a rotation booked in March. Detail on rate structure is on our staffing cost page.

When is locum coverage the right answer?

• A gap between a departure and a permanent hire — so the service line does not close while you search
• Parental, medical or sabbatical leave — predictable, and best booked months ahead
• Census surge or seasonal volume
• Protecting your employed physicians from burnout — the cheapest locum contract is still cheaper than replacing a hospitalist who quit from being over-scheduled
• Trialling before a permanent offer — locum-to-perm is common and low risk

What has to be in place before a physician can work a shift?

• Active license in your state
• DEA registration, plus state controlled-substance registration where required
• Hospital privileges, granted through your medical staff process
• Malpractice coverage, normally carried by the agency with tail as applicable
• Payer enrollment where the assignment involves billing
• NPDB query, references and OIG/SAM exclusion screening

The item that most often derails a start date is privileging, not licensure. Tell your agency your committee calendar at intake.

Should you use locums or a permanent search?

Both, usually. Locums stabilizes the schedule immediately; the permanent search then runs on merit rather than desperation. Hiring a permanent hospitalist while short-staffed is how facilities end up with a bad twelve-month hire.

Demand supports planning ahead rather than reacting: the locum tenens market is projected at roughly $13.5 billion in 2026, with around 80% of healthcare organizations maintaining or increasing their use. Physician shortage projections run as high as 86,000 by 2036. The physicians you want are booked in advance.

What goes wrong most often?

• Privileging started too late. Begin it in parallel with licensure, never after.
• Scope not defined. Admissions, rounding volume, ICU responsibility, procedures and code coverage all need stating up front.
• EMR not disclosed. Familiarity meaningfully affects the first week.
• Booking too late. Known leave should be covered months ahead, not weeks.