Is Locum Tenens Right for You? A Decision Framework for APCs Considering Flexible Work

More nurse practitioners and physician assistants are weighing locum tenens against a permanent role. The reasons come up again and again. APCs point to higher hourly pay, greater control over their schedules, opportunities to work in new practice settings, and relief from the administrative burden that drives so much burnout. But locum work has trade-offs the pay rate won’t tell you about, and whether it’s a good move depends on your specialty, your finances, your licenses, and how much uncertainty you can handle. 

Here’s a way to think it through before you commit. 

Start with why you’re considering it 

Most APCs look at locum tenens for one of three reasons: money, flexibility, or a reset. Each points to a different version of the work. 

If income is the driver, locum rates usually run well above permanent-equivalent pay, and you control how much you work. If it’s flexibility, locum lets you cluster assignments, take months off, or work seasonally in ways a permanent job rarely allows. If it’s a reset (you’re burned out, second-guessing your specialty, or thinking about relocating), short assignments let you try different settings and places without a long commitment. 

Be honest about your real reason, because it changes which trade-offs you can live with. 

Know what you’ll actually take home 

The higher rate is only part of the picture. As a locum, you’re usually a 1099 contractor, which means no employer health insurance, no 401(k) match, no paid time off, and self-employment tax on top of your regular taxes. When you’re not on assignment, you’re not earning. 

Model a realistic year before you decide. Estimate the weeks you’ll really work, subtract the health coverage and retirement you’ll fund yourself, set aside roughly 25–30% for taxes, and account for gaps between assignments. Plenty of APCs still come out ahead, but the distance between the headline rate and your take-home pay is bigger than it looks. Keep a cash reserve that covers several months, since you won’t always control assignment timing. 

Check your license and credentialing readiness 

This is where a lot of APCs underestimate the friction. Locum work often means practicing across state lines, and every new state needs its own license plus credentialing at each facility. Credentialing can take 60 to 120 days, which directly affects how fast you can start earning. 

A few things to check: 

• Compact participation: The Nurse Licensure Compact (NLC) helps NPs in member states, but PA and NP licensure compacts are still uneven across the country. Know which states recognize your credentials fast and which don’t. 

• Scope-of-practice variation: Your autonomy as an APC changes from state to state. You may have full practice authority in one and physician supervision in another. That affects where you can work and how you’ll practice day to day. 

• Certification currency: Your DEA registration, board certification, life support certifications (BLS, ACLS, PALS), and specialty credentials all need to be current and, in some cases, state-specific. 

The more license-ready you are, or willing to become, the more assignments open up. A staffing partner that handles licensing and credentialing for you removes most of this burden, which is a real factor when you decide how to enter locum work. 

Match the work to your specialty 

Locum demand isn’t spread evenly. APCs in emergency medicine, hospitalist medicine, psychiatry and behavioral health, and surgical specialties tend to see steady, well-paid assignment flow. Primary care and urgent care APCs also find consistent work, often with more choice about location. 

If your specialty is narrower or more procedure-heavy, assignments may come less often or tie you to specific locations. That doesn’t rule out locum work, but it means your calendar depends more on your flexibility about where you’ll go. 

Gauge your tolerance for the unglamorous parts 

Locum life asks for adaptability. You’ll need to deal with unfamiliar EHRs, pick up new protocols fast, build rapport with staff who don’t know you, and travel or relocate temporarily. Some APCs find that energizing; others miss knowing their patients and their team. 

Ask yourself: Do you adapt quickly to new systems? Are you comfortable being the new person over and over? Can you handle travel and time away from home? Would losing long-term patient relationships wear on you? There’s no wrong answer, only a wrong answer for you. 

If you’re leaning yes 

The smartest first step is a conversation, not a leap. Talk with a recruiter who staffs your specialty, find out what assignments actually look like in your license states, and get a clear picture of how credentialing, travel, and pay would work for you. The right locum partner handles the logistics, including licensing, credentialing, housing, and malpractice coverage, so you can focus on practicing. 

Flexible work isn’t the right move for every APC. But for the right one, at the right time, it can be the change that makes the career sustainable again. 

Judge staffs locum tenens assignments for APCs across specialties nationwide, and handles the licensing, credentialing, housing, and malpractice coverage so you can focus on patient care. Reach out to a Judge recruiter to talk through what locum work would look like for your specialty and license states.