The Rise of the Part-Time Doctor

Dr. Franklyn Rocha-Cabrero, a 37-year-old neurologist, went into gig work soon after completing his training, detouring from the traditional track of joining a medical practice or hospital system.

He typically takes at least 10 out of every 30 days off. And he earns an hourly rate that is usually 30% to 40% more than a hospital-staff physician would, he says.

About 50,000 doctors, or 7% of the U.S. physician workforce not including foreign medical-school graduates, now practice medicine via temporary assignments, according to medical-staffing company CHG Healthcare. That is a nearly 90% increase from 2015.

Like traveling nurses, many of these doctors are tapping into booming demand for their services, especially at labor-starved community hospitals around the U.S. Primary-care doctors are the most sought after, according to CHG Healthcare data. So are specialists such as cardiologists, pulmonologists, surgeons and oncologists.

Rocha-Cabrero finished his residency in Miami in 2021, where he says he often juggled more than 20 critically ill patients during night shifts. Next came a neurophysiology fellowship at the University of California-Irvine, where he worked 60 to 80 hours a week, much of it on paperwork. His supervisors’ schedules were just as grueling.

“I didn’t want to be a part of that cycle," he says.

He hit the road instead. A month’s work now might include a week at a hospital in Salinas, Calif., diagnosing epilepsy and other nervous-system disorders, then five to eight days of telemedicine appointments from his home in Long Beach or a stint at another California community or academic hospital.

“It’s kind of a roller coaster," he says of his itinerant work life. Yet, “I’m able to do so many more things to take care of my physical and mental health that I wasn’t able to do before."

Doctors and staffing agencies say working temporary hospital gigs typically can pay 30% to 50% more than what a full-time hospital staff doctor would earn—and sometimes more, depending on the specialty and location. An obstetrician-gynecologist can earn $140 an hour, while an emergency-medicine doctor can make as much as $300 an hour, according to Locumstory.com, a resource site for temp-working physicians. That said, they are often on the hook for financing their retirement and other benefits.

Many doctors say longer hours and bigger patient loads—especially during the pandemic—have pushed them to shift out of more traditional medical careers. In a 2023 survey of more than 9,100 physicians, a majority described themselves as burned out, up from 42% in 2018. Nearly a quarter of those doctors said they had quit jobs or sold a practice as a result, according to healthcare website Medscape, which conducted the study.

Dr. Ripal Patel, 42, an emergency physician who lives in Houston, says corporate medicine’s increased focus on physician productivity contributed to his decision to switch to gig work. He recalls taking extra time for a more-complicated chest tube procedure several years ago, after which a medical director noted his patient count had slowed for part of the day.

“You’re so naive going out into the healthcare world," Patel says. “You really have no idea because you’re focused on medicine and not on the business and the finance and the billing."

A former colleague suggested he consider locum tenens, Latin for “placeholder" and the term the healthcare industry uses to describe temporary-gig physicians. In an average month, he works 12 shifts across multiple facilities based in Texas, Nebraska and New Mexico. As a contractor, he says, he avoids much of the bureaucratic pressures and productivity metrics that many hospital faculty doctors face.

“I don’t think I could do anything else now," says Patel, who estimates he earns up to 1.5 to two times what traditional emergency physicians make. He has since started his own locum tenens practice, so that he and colleagues can contract directly with hospitals seeking temp doctors, instead of through a third-party agency.

The temp-work approach comes with its own challenges—for the doctors, and the hospitals and patients who increasingly rely on them. Temp doctors have to fulfill credentialing and licensing requirements for each new state or facility they practice in. They typically get malpractice coverage through the temp agencies they work with, but the risk of being sued can vary greatly from state to state.

The practice also requires getting up to speed in a new workplace quickly—repeatedly—says Dr. Miechia Esco, a vascular surgeon who has been a full-time locum tenens physician for nearly a decade.

“In many instances, you may be the only one out of the facility," she says. “That requires deep knowledge and the flexibility of being able to quickly adapt."

Some medical professionals also worry that greater reliance on temporary doctors can be disruptive to patients, especially in fields where continuity of care is important, such as oncology or obstetrics.

“On Friday, you got Dr. Jones, but on Saturday, you get the locum. Maybe they didn’t get a good sign out from Dr. Jones. Maybe they have to start from scratch because they aren’t really clear on what’s going on," says Dr. Gail Gazelle, a physician coach and assistant professor at Harvard Medical School.

Still, gig-working physicians are often what allows community hospitals, particularly in rural areas, to provide basic services and continual care, hospital administrators argue.

“You want to keep the doors open," says Christy Bray Ricks, vice president of provider talent for Ardent Health Services, which owns and operates hospitals across the country.

And some doctors who’ve switched to temporary work say patients often fare better with a doctor who can focus entirely on providing care. Rocha-Cabrero says that is now his main focus, rather than the meetings and administrative work that come with a full-time hospital job.

“Instead of paperwork and checklists, I can focus on things that matter," he says.