Physician Burnout and The Locum Tenens Sabbatical
/Physician Burnout and The Locum Tenens Sabbatical
Physician burnout is a very serious problem. According to a 2015 Medscape Physician Lifestyle Study, over 45% of practicing doctors admitted to feeling burnout, and what is even more scary, that stat was up 7% since the study done in 2013. If we extrapolate the data, that means we are somewhere close to 50% burnout as I write this article in 2018. Think about what that means for practicing doctors, it’s downright scary! For us as physicians it equates to decreased quality of life, increased risk of physician depression, higher rates of substance abuse, higher medical errors with associated malpractice cases and even increasing risks of physician suicide. For our patients, it leads to declining quality of care and for health systems it means a loss of productivity and physician attrition. Despite clear data to support this massive issue, it’s not looking like health systems are doing anything to make it better. Let’s all just put our heads in the sand and hope this issue goes away, right? Wrong. The situation isn’t getting any better with increasing physician shortages, workloads, and non-clinical demands. So how do physicians manage this level of stress and burnout?
In a recent article by The American Academy of Family Practice (AAFP), the five main causes of burnout were defined. To start, the clinical practice of medicine as a whole is stressful. We all have personal experience with sick and dying patients and their families, some specialties deal with this every hour of every day. In some scenarios the outcomes may even be out of our control, a situation that drives in more frustration and stress for the practicing doctor. Medical schools and residency programs have worked to increase education on stress, but as a whole, the “tough it out” mentality persists, despite its clear lack of effectiveness. The second cause of burnout relates to the management of your personal job. Such things as keeping track of wRVUs, compensation formulas, politics, and personal call rotations within your health system can sometimes feel like a second job. Managing your own practice? The situation gets even worse with declining reimbursements and increasing demands, leading to feelings of stress and depression that have nothing to do with patient care.
The third reason doctors are feeling run down relates to our lives outside of the patient rooms and our offices and focuses on our personal lives. In an ideal world, we would balance our time and energy equally between work and family, but as physicians we continue to say yes to more and more, our families suffering as a result. We all know the quote, “the worst thing about being on call q2 is missing half the cases”, but this false reality has led to abnormally high divorce rates and piles even more pressure on to doctors who value their lives outside of medicine. On a similar note, the fourth reason doctor’s burnout relates to the individual personalities that initially attracted us to medicine. “Perfectionist, workaholic, early to arrive, last to leave” were how I was decribed on my residency application, and these traits were considered necessary to get into that top tier training program. The idea that we can never show weakness or not know the correct answer is not only unreasonable but its detrimental to your health.
The last item driving burnout relates to our superiors and how their leadership skills develop an environment of stress. This one is outside of your control, but think closely about the milieu of your training program or first job, did it mold you to be similar to your ancestors? I’d be hard pressed to tell you that 6 years of surgical training in a high powered academic center made me a softer, more compassionate person to my junior residents. I wish I could tell you I was more gentle to them than others were to me, but it isn’t 100% true. Or perhaps you are out of training, 10 years into a career with quotas and metrics to meet in your practice or health system, do you take the time to advance the environment of your junior partners?
When we look critically at this problem, we find the issue is somewhat too large to fix easily, especially if you are immersed in the “don’t show weakness” environment every day. What’s the solution? Well, there are several things you can do in your own practice to combat stress, depression and burnout. We recommend all practicing physicians attempt some, if not all, of these items. Such things as automation of your EMR and order sets. Yes, there is upfront work in this, but studies have shown that doctors who take the time to efficiently build their templates will be rewarded in the long run. In addition, team building exercises with your physician and non-clinical colleagues can improve morale and comradery. Making your work a more enjoyable place can lessen the harsh blow of the medical work. Physicians can also start to say “No” more frequently and create more space for themselves. There has to be a better life balance and we have to start protecting ourselves and our families. What is more important, your daughters dance recital or that 5 o’clock meeting about the JAHCO visit in 9 months? With all this said and done, many doctors just can’t seem to disconnect from the stress and constant pull of their work. We all have heard the new trend in digital vacations, where you disconnect from your computer, ipad, and iphone for a week. It does miracles for many and made us wonder if a disconnect from your work for a short period may also have the same refreshing results. In that, the Locum Sabbatical was born.
The term sabbatical typical refers to a teacher or professor taking time away from their profession after they have put in a certain amount of years to study or travel. Typically, a teacher would receive one year of sabbatical for every seven years of work! Now we aren’t advocating that everyone needs a full year off to combat their stress and prevent burnout, but when we think critically about the idea it makes a lot of sense. Physicians are teachers in the purest sense, to both their patients, colleagues, and families. We recognize the need for continued medical education and most of our specialties have requirements for licensing that mandate certain credits or hours every year. So why do many doctors take the easy way out and sign up for quick last-minute CME courses and tests, or even worse, fake their CMEs to avoid penalty? Shouldn’t we be dedicating more time to educating ourselves and protecting our health? The clear answer is yes.
A locum tenens sabbatical may be the sweet spot for many doctors looking for a life rebalance, allowing for maintenance of clinical experience while increasing dedication to family and self. In addition, it eliminates some of the major barriers to entry into the locum tenens world by preserving the benefits that are still associated with your permanent job. Most physicians choosing a 3, 6 or 12-month locums sabbatical will find that although they may sacrifice their prior salary, the locums contracted rates will most likely be higher than the 50% MGMA averages. We aren’t saying that we can guarantee that everyone will break even or even be allowed to do a sabbatical but choosing a location and practice structure can bring the return for your time higher while allowing you the needed time to focus on your well-being. The real benefit to a sabbatical relates to maintenance of benefits. Short term locums sabbaticals are often well received by health systems and large groups, as the cost and headache of replacing a doctor who leaves because of burnout is much greater than allowing an establish physician to take a needed break. The chief medical officer you work with knows all too well that to find, hire, train and market a new doctor will cost much more than allowing you to take a locum tenens sabbatical and maintain your existing benefits and return to the position as a stronger person. Most will allow you to keep your health, malpractice and group disability insurance through your existing company for the time you are away. Full transparency here, some of your health systems or practices will not be on board with the idea of a locums sabbatical, especially those in highly competitive areas or specialties. In addition, if you are feeling burnout, chances are your partners or colleagues are as well. We understand they may feel upset or even anger about the idea of you taking a position away for several months and perceive you as dumping more work on them. In some situations, your prior practice may consider a locum tenens swap. You may be able to negotiate a locums replacement for yourself at a similar rate, making the work impact and finances minimal to your colleagues. However, with this said, we need to remember who comes first, it’s you and your health, and this replacement work may be best left to your employer to handle. Lastly, your current position may allow you to take a locums sabbatical but require you to find your own benefits for the time you are away. Most commonly, the prior employer will not allow you to utilize their malpractice as technically you are not representing them in this work, and you will need to secure malpractice for the locum tenens assignment.
The last benefit to a locum tenens sabbatical, one designed to give you the mental health break you need from your current situation, relates to the major issue at hand. Perhaps you didn’t realize that the position you have is not suited for your personality but were unaware while in the thick of things. A locums assignment in a location or practice you are (or should be!) considering may allow you the opportunity to see what else is out there before making a permanent move from your current stressful position. Always wanted to live closer to family? Maybe you take a locums sabbatical near them and see if this improves your happiness. Living in Michigan and dreaming of the Florida sun? We know those cold winters can add to your stress and perhaps a few months in nice weather will give you the perspective to know what is right for you.
Physician burnout is a problem for our country and industry, but more importantly, it’s a serious issue for our health. Utilizing the concept of a locum tenens sabbatical may allow more physicians the much needed break from the stressful position and provide the opportunity for a little self-care. On a short term basis, it may be easier and more beneficial then you expect, but the details need to be worked out to maximize your individual situation.
~The Locums Life~
Locum Tenens & Physician Burnout: FAQ Section
1) What is locum tenens work for physicians?
Locum tenens (often shortened to “locums”) is temporary physician staffing—typically filling coverage gaps at hospitals, clinics, or health systems. Assignments can range from a few shifts to several months, and may be local or travel-based. Many physicians use locum tenens as a way to regain control over schedule, reduce administrative burden, or explore different practice settings while maintaining clinical work.
2) How do you pronounce and spell “locum tenens”?
“Locum tenens” is Latin, commonly pronounced LOH-kum TEN-enz. The correct spelling is locum tenens (not “locus tenens,” “locums tenens,” or “locum tenants”). For SEO, it can help to include variations people search: “locums,” “locum tenens physician,” and “locum tenens jobs.”
3) Why do physicians choose locum tenens in the first place?
Physicians choose locum tenens for a handful of consistent reasons:
Schedule flexibility (choose when and how much to work)
Higher earning potential in many markets and specialties
Reduced nonclinical load (less committee work, fewer meetings)
Practice variety (new settings, different patient populations)
Time off between assignments for recovery, family, travel, or health
A bridge between roles (after leaving a position or before starting one)
4) Is locum tenens good for physician burnout?
It can be—especially for doctors burned out by administrative overload, EHR inbox volume, and rigid schedules. Locum tenens can reduce exposure to institutional politics and give physicians more autonomy over workload. That said, locums can also create new stressors (travel fatigue, onboarding chaos, unfamiliar systems). It’s often best seen as a tool: used strategically, locums can support burnout recovery; used reactively without boundaries, it can worsen burnout.
5) How does locum tenens help prevent burnout?
Locum tenens can help prevent burnout by shifting the physician’s experience from “trapped in a system” to “choosing an assignment.” Common protective factors include:
Control over shifts and call
Ability to decline unsafe workloads
Clear start/stop dates
Time off built into your schedule
Less long-term administrative responsibility
Reduced organizational friction
6) Can locum tenens cause burnout too?
Yes. Burnout can still happen if you:
Take assignments with excessive call or unclear expectations
Accept a site with poor staffing or unsafe patient volumes
Don’t build recovery time between blocks of work
Travel constantly without a sustainable routine
Get stuck in repetitive “fix the system” roles where you’re asked to plug chronic gaps
The key is recognizing that locums doesn’t automatically equal “easy.” It’s flexible—but it requires boundaries.
7) What’s the difference between locum tenens and per diem?
Both can be flexible, but:
Locum tenens typically means you’re brought in through a staffing process (often an agency) to fill a defined coverage need. It may include travel, housing, and multi-week commitments.
Per diem often refers to local, as-needed shifts in a facility’s internal pool or a local group. It’s usually more casual and less travel-oriented.
8) How is locum tenens different from being a 1099 independent contractor?
Many locum tenens physicians are paid as 1099 contractors, but not all. Some assignments are W-2 through an agency or staffing entity. The practical difference:
1099: you manage taxes, retirement contributions, and some insurance decisions yourself.
W-2: taxes are withheld; benefits may be limited but the paperwork is simpler.
For burnout prevention, the better model is the one that reduces your cognitive load and supports your desired lifestyle—not just the one that pays more.
9) What types of physicians do locum tenens work?
Nearly every specialty uses locum tenens, including:
Hospital-based fields (anesthesiology, emergency medicine, hospital medicine)
Surgical subspecialties (general surgery, orthopedics, urology, OB/GYN)
Outpatient specialties (family medicine, psychiatry, dermatology)
High-need specialties in rural areas and critical access hospitals
10) Is locum tenens a good option for mid-career physicians feeling burned out?
Often, yes. Mid-career doctors may be at peak administrative burden and leadership expectations. Locums can provide an “off-ramp” from full-time employment while preserving income and clinical identity. Many physicians find relief in returning to clinical work with fewer institutional obligations—if they choose assignments wisely.
11) Is locum tenens good for early-career physicians?
It can be, especially for those who want geographic mobility, debt payoff acceleration, or the chance to sample different practice types. Early-career physicians should be cautious about:
Underestimating onboarding complexity
Taking on high-acuity call without adequate support
Not building a mentorship or peer network
12) Is locum tenens good for late-career physicians or semi-retirement?
Yes—locums can be a strong “glide path” into retirement. Physicians often reduce burnout by working fewer weeks per year, selecting lower-stress assignments, and avoiding call-heavy roles.
13) What are common burnout triggers in traditional employed roles that locums can reduce?
Common triggers include:
Endless EHR inbox and patient portal messages
Productivity pressure without adequate staffing
Committee work, mandatory meetings, and bureaucracy
Lack of autonomy in scheduling
Misalignment between leadership and frontline reality
“Always on” culture with unclear boundaries
Locums can reduce or eliminate some of these—especially the politics and long-term administrative commitments.
14) What new stressors do locum tenens physicians face?
Locums-specific stressors include:
Travel and time away from home
Credentialing delays and paperwork
Learning new EHRs and workflows repeatedly
Inconsistent staff support or unclear site expectations
Social isolation in new environments
Being treated as “temporary,” which can affect teamwork
15) How do I know if locum tenens is right for my burnout situation?
Locums may be a good fit if you:
Want control over schedule and workload
Need a “reset” without leaving medicine
Prefer defined commitments and time off
Can tolerate some uncertainty and travel (or choose local roles)
It may be less ideal if you:
Crave deep community roots at one institution
Find change and novelty draining
Prefer stable teams and long-term continuity
16) How can I use locum tenens as part of a burnout recovery plan?
A sustainable approach looks like:
Start with a short assignment to test fit (2–6 weeks)
Choose a setting with predictable hours and low surprise call
Build in recovery blocks (e.g., 1–2 weeks off between assignments)
Track workload and wellbeing metrics (sleep, exercise, irritability, dread level)
Scale up only after you’ve found a rhythm
17) What is the biggest mistake physicians make when starting locums for burnout?
Taking the first available job without fully defining:
Hours, call, and patient volume
Support staff availability
EHR and onboarding plan
Exactly what “coverage” means (clinic only? clinic + OR? nights? weekends?)
Burnout recovery requires reducing uncertainty—not increasing it.
18) How can I avoid “locums treadmill” burnout?
Set non-negotiables:
Maximum call frequency
Maximum weekly hours
Minimum days off between blocks
No last-minute schedule expansions
A hard rule to decline assignments with vague expectations
Locums should serve your life. If your calendar starts serving the next contract, you’re back in burnout territory.
19) What questions should I ask before accepting a locum tenens assignment?
Ask these early:
What are the exact dates, hours, and shift expectations?
How many patients per day / cases per day?
What is the call schedule and response time?
Who covers backup call?
What support staff exists (APPs, nurses, techs, MA coverage)?
Which EHR is used? Is training provided?
What does “full scope” mean for this role?
What are the top reasons the facility needs locums?
Who is my clinical lead and escalation path?
20) How do I assess whether a site is “burnout-safe”?
Look for signs of operational maturity:
Clear scheduling and predictable workload
Stable nursing and support staffing
Transparent call expectations
Respect for physician boundaries
Organized credentialing and onboarding
A plan for integration (not “show up and figure it out”)
21) What should be in a locum tenens contract to protect against burnout?
Key protections include:
Defined hours and call expectations
Rate clarity (hourly, shift, call-back, overtime)
Cancellation terms and guaranteed minimums (when possible)
Coverage expectations defined (clinic vs procedures vs admissions)
Travel and lodging terms
Malpractice details (occurrence vs claims-made and tail coverage)
Documentation time expectations (inbox/portal responsibilities)
22) Do locum tenens physicians have to do prior authorizations and inbox messages?
This varies by site. Many locums roles reduce inbox and admin work, but not always. Ask:
Who handles portal messages?
Who handles refills and prior auth?
Is there APP or RN triage?
What is expected after hours?
23) What is the best locum tenens schedule to reduce burnout?
A common sustainable pattern:
Work 1–2 weeks on, then 1 week off
orWork 2–3 weeks per month consistently
The best schedule is one that supports recovery cycles: sleep, exercise, family time, and decompression.
24) Can locum tenens increase work-life balance?
Yes—if you design it intentionally. The trap is using locums flexibility to say yes to everything. Work-life balance happens when you treat time off as scheduled, not as leftover.
25) How does locum tenens affect professional identity and meaning?
Some physicians feel a boost: they return to clinical medicine without the bureaucratic drag. Others feel disconnected because they’re not “part of the team.” If meaning and belonging are core needs for you, choose assignments that emphasize collegiality and stable teams, or consider part-time employment plus selective locums.
26) Does traveling for locums contribute to burnout?
It can. Travel adds “hidden workload”: airports, rental cars, meals, sleep disruption. Many physicians reduce this by:
Choosing local or regional assignments
Working longer blocks with fewer travel days
Building consistent routines on the road (same hotel chain, gym plan, meal prep)
27) How do locum tenens physicians maintain healthy routines while traveling?
Burnout prevention is routine protection:
Choose lodging with a kitchen and gym access
Pack a predictable nutrition kit
Create a “first-night” sleep routine
Use time-zone-friendly scheduling when possible
Plan one restorative activity per off-day (walk, sauna, training, reading)
28) What are signs my locum tenens workload is unsustainable?
Red flags include:
Dreading shifts and feeling trapped again
Increased irritability, cynicism, emotional numbness
Sleep disruption that persists beyond travel
Recurrent headaches, GI symptoms, or mood changes
More errors or near-misses
Losing your recovery time to charting
29) Can locum tenens help physicians recover after leaving a toxic job?
Yes. Locums can provide income and clinical continuity while you heal and reassess. A short, well-chosen assignment can restore confidence—especially if it’s a stable environment with good support.
30) How do I explain locum tenens on my CV?
List assignments under a single header like “Locum Tenens Physician” and include:
Facility types (community hospital, academic affiliate, rural critical access)
Scope (inpatient, outpatient, procedural)
Dates and responsibilities
This presents a cohesive narrative rather than a scattered job history.
31) Does locum tenens look bad to future employers?
Generally no—especially now that temporary staffing is common. Employers may ask why you chose locums; a strong answer is:
“I wanted flexibility while evaluating my next long-term role.”
“I used locums to focus on clinical practice while reducing administrative strain.”
“I explored different practice models to find the best fit.”
32) What’s the best way to transition from full-time employment to locum tenens?
Practical steps:
Build a 3–6 month runway (cash buffer)
Clarify your must-haves: schedule, income, geography, call limits
Start with one short assignment
Keep your licensing and credentialing organized
Decide if you want local locums or travel-based roles
33) How do licensing and credentialing affect burnout?
Credentialing can be stressful and time-consuming. To reduce friction:
Keep a “credentialing packet” (licenses, CME, immunizations, references, case logs)
Maintain a master CV and timeline of work history
Track expiration dates early
Choose assignments with efficient credentialing support
34) How quickly can a physician start locum tenens work?
It depends on specialty, state licensing, and facility credentialing timelines. Some physicians start quickly if already licensed and credentialed in a system; others take longer. Burnout tip: treat credentialing as a project with a checklist—reduce uncertainty by getting organized.
35) What is physician burnout, clinically speaking?
Burnout is typically characterized by three elements:
Emotional exhaustion
Depersonalization/cynicism
Reduced sense of accomplishment
Locums can reduce contributors (loss of control, admin overload), but it won’t fully address burnout if deeper issues like depression, moral injury, or trauma are present—those may need additional support.
36) What is “moral injury,” and how does it relate to locums?
Moral injury is the distress from being unable to deliver the care you know patients deserve due to systemic constraints (staffing, policies, productivity pressure). Locums can help by allowing you to leave environments that generate moral injury and select better-aligned sites—but moral injury can still occur anywhere with poor systems.
37) Can locum tenens help with compassion fatigue?
Potentially. Compassion fatigue improves when:
You have adequate rest and support
You’re not overloaded
You can emotionally recover between intense clinical exposures
Locums schedules can be built to allow recovery time, but high-acuity assignments without support can worsen it.
38) Should I do locums if I’m already severely burned out?
It depends on severity. If you’re in a state of profound exhaustion, insomnia, anxiety, or depression, the first step may be rest and treatment, not a new assignment. Locums can be part of the return-to-work plan—but start light, with clear boundaries and supportive environments.
39) How can I negotiate a locum tenens assignment to reduce burnout risk?
Negotiate for:
Fewer nights/call shifts
Clear patient caps or realistic clinic templates
Protected admin time for charting
Predictable days off
Onboarding and EHR training time
Even small changes can have an outsized effect on stress.
40) What are the best locum tenens jobs for burned-out physicians?
Typically lower burnout risk:
Day shifts only, no call
Stable outpatient settings with good staff
Hospitalist roles with strong team coverage and reasonable census
Assignments in facilities known for organization and support
Higher risk:“Just show up” coverage
Chronic understaffing sites
Vague expectations, high call burden, high turnover
41) How do locum tenens physicians manage relationships and family life?
The best approach is transparency and scheduling:
Plan assignments in predictable blocks
Protect family calendar commitments
Consider local/regional locums to minimize travel
Make “recovery time” real time—don’t backfill it with extra shifts
42) What about loneliness and isolation as a locums physician?
This is real, especially for travel-based work. Countermeasures:
Choose longer assignments where relationships can form
Connect with peers at the site intentionally (lunch, quick check-ins)
Maintain a consistent social routine at home
Consider part-time local work to preserve community
43) How do I maintain quality of care in a new system as a locums physician?
Do three things:
Ask for the site’s preferred pathways and escalation contacts
Build a small “local playbook” early (consult norms, admission criteria, key phone numbers)
Be humble about differences in workflow and communicate early
Reducing uncertainty reduces stress and improves safety.
44) Does locum tenens reduce EHR burden?
Often, yes—but it’s not guaranteed. Some sites still expect inbox coverage. Ask specifically about:
Portal messages and refill workflows
Chart completion expectations
EHR training time
Use of scribes, dictation tools, or templates
45) How do taxes and financial planning relate to burnout in locum tenens?
Financial stress is a burnout amplifier. A clean system helps:
Set aside money for taxes automatically (especially for 1099)
Use a simple bookkeeping workflow
Track income per assignment and true hourly rate (including travel time)
Build a steady baseline schedule so you’re not chasing income in panic mode
46) Is locum tenens a long-term career or a short-term fix?
Both. Some physicians do locums for a season to recover and reset; others make it their primary model because it matches their lifestyle. The sustainable version has:
Predictable blocks
Guardrails on workload
A recovery plan built into the year
47) How do I avoid “scope creep” during a locum assignment?
Scope creep is when “just clinic” becomes clinic + procedures + call + extra admin. Prevent it by:
Getting scope in writing before you start
Clarifying what happens when staffing changes
Having a polite script to decline new duties: “I can help within the agreed coverage parameters.”
48) What are the best self-care strategies for locum tenens physicians dealing with burnout?
The best “self-care” is system design:
Sleep protection (consistent bedtime routines)
Exercise that is realistic while traveling
Nutrition defaults (simple, repeatable meals)
Decompression rituals after shifts
Therapy or coaching when needed
Peer support (other locums doctors can be a lifeline)
49) How can physicians prevent burnout before it starts in locum tenens work?
Prevention is easier than recovery:
Choose assignments with high support, not just high pay
Underbook your calendar initially
Take the first 2–4 weeks to calibrate your workload limits
Track warning signs and adjust early
50) What is the bottom line on locum tenens and physician burnout?
Locum tenens can be a powerful antidote to burnout when it restores control, reduces admin burden, and creates structured time for recovery. But it’s not a magic switch—burnout can follow you if you bring the same overwork patterns into a new setting. The highest-value approach is to use locums intentionally: pick stable environments, define boundaries, protect rest, and treat your wellbeing like a clinical outcome worth managing.