From Private Practice to Locums: Understanding Today’s Physician Career Options

A Changing Career Landscape for Physicians

Over the past 14 years as a full-time anesthesiologist, I’ve had a front-row seat to a shift in healthcare staffing that few of us could have predicted early in our careers.

When I was finishing residency, the path forward felt straightforward. You either continued your training through fellowship or entered the workforce through one of two routes: hospital employment or joining a private practice with a partnership track. Those were the options, and for many of us, the decision was clear.

Today, that simplicity is gone.

Physicians entering the workforce now have a third, increasingly popular option: locum tenens or per diem work. As a mentor to residents, I see this topic come up more than ever. It’s reshaping how early-career physicians think about flexibility, stability, and long-term career goals.

From Private Practice to Employment: A Broader Industry Shift

When I completed my training in 2012, I joined a large private anesthesiology group with a partnership track. It was a well-structured, mutually beneficial model, one where the hospital and physician group aligned closely in both incentives and outcomes.

However, by 2017, that model changed. The hospital dissolved the private group structure and transitioned physicians to direct employment. While our group ultimately secured strong contracts, the shift itself was telling, and it wasn’t unique.

Across the country, physician employment has steadily moved away from private practice. According to the American Medical Association, approximately 60% of physicians worked in private practices in 2012. By 2024, that number had dropped to just over 42%.

This trend continues to redefine how physicians think about autonomy, compensation, and long-term career planning.

The Pandemic’s Lasting Impact on Physician Staffing

Just a few years later, the COVID-19 pandemic accelerated changes that were already underway.

What followed was one of the most significant workforce disruptions in modern healthcare. Between burnout, early retirements, and what became known as the “Great Resignation,” healthcare systems across the country experienced unprecedented staffing shortages.

In our own group, we lost nearly one-third of our physicians in a short period of time—a loss we have yet to fully recover from. And again, this experience was far from isolated.

Estimates from the NIH suggest that between 117,000 and 200,000 physicians stepped away from the workforce during the height of the pandemic. The ripple effects of this exodus are still being felt today.

The Rise of Locums and Per Diem Opportunities

Out of this disruption, a new dynamic has emerged.

Healthcare systems (especially in suburban and rural areas) are facing ongoing staffing gaps. To meet demand, many organizations are offering highly competitive compensation packages, flexible schedules, and short-term contracts to attract talent.

This has contributed to the rapid growth of locum tenens and per diem opportunities. For many physicians, these roles offer clear advantages. Locums work provides flexibility, exposure to different clinical environments, and often higher compensation. It allows physicians to maintain greater control over their schedules while avoiding long-term contractual commitments.

At the same time, it’s not the right fit for everyone. Mobility, adaptability, and a willingness to navigate changing environments are essential to success in these roles.

What This Means for Today’s Physicians

The key takeaway is simple: physician career paths are no longer one-size-fits-all.

Whether you’re early in your career or more established, you now have more options than ever before. Each path—full-time employment, private practice, locums, or per diem—comes with its own set of trade-offs.

The most important step is understanding how these options align with your personal and professional goals:

• Are you prioritizing stability and long-term growth?
• Are you seeking flexibility and variety?
• Or are you looking for a balance between the two?

Today’s healthcare environment allows for all of the above—but making the right choice requires a clear understanding of the evolving landscape.

As healthcare continues to adapt to staffing shortages, demographic shifts, and changing physician expectations, flexibility will remain a defining factor in workforce models. Locums and per diem opportunities are no longer secondary options; they’re now a central part of the conversation around physician careers.

For physicians navigating this evolving market, staying informed is key. The more you understand these trends, the better position you are to make decisions that support both your career and your quality of life.

Whether you’re considering a transition or simply exploring what’s next, having the right partner makes all the difference. Explore current opportunities or connect with the Judge Healthcare team to start the conversation.

About the Author

Julian Castaneda, MD

Bogotá-born MD & Medical Director at The Judge Group. Board-Certified Anesthesiologist dedicated to clinical care, staffing, and healthcare innovation