Locum tenens pay trends: Who’s up and who’s down in 2021

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One reason many physicians turn to locum tenens is the great pay. Whether you’re working locums on the side or you’ve made it your full-time career, locum tenens physicians often earn more per hour than their employed counterparts. Here’s what locum tenens physicians are getting paid in several specialties and how locum tenens pay ranges changed from 2019 to 2021.

Factors affecting locum tenens pay

The COVID-19 pandemic affected physician compensation for many specialties, and locum tenens pay was no exception. Demand for locum tenens services dropped significantly in the summer of 2020.  Many hospitals cancelled or postponed non-emergent procedures, and nervous patients skipped preventative care and avoided emergency rooms.

In 2021, demand for locums has rebounded as healthcare facilities progress toward recovery. Many specialties are now in higher demand than ever, while others continue to struggle. As a result, some physician specialties are commanding higher locum tenens pay rates in 2021, while others are lower than they were pre-pandemic.  


This specialty went up in locum tenens compensation, from $110-$135 per hour in 2019 to $125-$150 in 2021. That said, there is low demand for these specialties. Locums assignments for allergists and immunologists are generally Monday-Friday during a typical office day of 8 am — 5 pm.


This specialty saw a big jump in locum tenens compensation, from $165-$200 per hour in 2019 to $238-$275 in 2021. One reason for the increase is an overall growing shortage of anesthesiologists. Even though demand fell for anesthesiologists in the early months of the pandemic, many facilities have resumed elective surgeries.

Anesthesiologists have also been in demand during the pandemic for their skills in other specialties such as critical care. Dr. Paul Langevin, who practices both anesthesia and critical care, took an assignment at a New Jersey hospital to help treat COVID patients needing intubation. “I was very fortunate because the hospital that I was in was superb,” he says. “They had a plan to meet the crisis, the financial capability to enact the plan, and executed it. At one point, I think we were at 148 intubated patients.”

Locums anesthesiologists are generally in high demand. A typical shift is 7 am — 4 pm, and assignments average 20 days.

Obstetrics & Gynecology (OB/GYN)

Locum tenens compensation for this specialty remained steady from 2019 to 2021, staying at around $100-$140 per hour for locums physicians. Typical locums hours are Monday-Friday from 8 am — 5 pm with call time. Average assignment length is three to six months. This specialty is in high demand.

Cardiac Surgery

This specialty went up in locum tenens compensation from $1,500-2,500 daily to $2,000-$2,500 daily from 2019 to 2021. This specialty is in high demand and faces an severe shortage. The typical locums schedule is a 24-hour call shift, shift work, and these are often available as long-term assignments.

Emergency Medicine

The pandemic negatively affected locum tenens pay for emergency medicine physicians, lowering it from $160-$300 per hour in 2019 to $100-$250 in 2021.

This may be related to the fact that many emergency departments cut back staffing to lower costs; 83% of hospitals reduced physicians’ hours during the pandemic due to low patient volume. Some emergency medicine residents coming out of training in 2021 have also reported it’s challenging to find a job right now.


This specialty went from $240-250 hourly in 2019 to $1,800-$2,000 daily in 2021.  During the early days of the pandemic, the pause on elective surgeries had a big impact on this specialty. Dr. Robert Brenner, a locums gastroenterologist, says that in spring 2020, many GIs weren’t working. “I was very fortunate,” Dr. Brenner says. “They shifted me over into straight hospital coverage,” keeping him employed through his locums assignments during the early days of the pandemic.

Other locums gastroenterologists said that even with the elective surgery ban in the early months of 2020, they were able to retain work. Dr. Duane Webb, a gastroenterologist, says they switched to doing lots of teleconferencing visits with patients, keeping him fully employed during that time.

A typical locums schedule is 8 am — 5 pm, or 7 on 7 off, with assignments averaging about two weeks in length.


This specialty went up from $1,200-$1,400 daily in 2019 to $1,400-$1,600 daily now. This tracks with other reports showing a significant physician shortage in this specialty coupled with high demand. For instance, the U.S. needs 11% more neurologists to meet patient demands, and by 2025, needs 19% more, according to the American Academy of Neurology.

Locum tenens neurology assignments are typically Monday to Friday from 8 am — 5 pm (with call) and average about a week in length.


This in-demand specialty went from $150-$200 hourly in 2019 to $180-$210 in 2021.

During the pandemic, more appointments were delivered via telehealth. Dr. Patrick Marsh, psychiatry, shifted to doing telehealth during the pandemic, and hopes more options for telehealth stay after the pandemic.

This specialty is facing a big shortage so is in high demand. A typical schedule is during office hours for three to six months.

Vascular Surgery

This specialty is experiencing a significant shortage, so pay for this field is rising. Locums pay went from $1,400-$2,000 per day in 2019 to $1,700-$2,200 daily in 2021.

Schedules for this high demand specialty are typical office hours and average a week in length.

Not seeing your specialty here? Check out our Trends by Specialty tool for locum tenens pay ranges for additional specialties.

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