Telemedicine vs. Locum Tenens for Doctors: The Complete Guide to Getting Started, Pay Structures, Pros/Cons, and How to Choose
/Telemedicine vs. Locum Tenens for Doctors: The Complete Guide to Getting Started, Pay Structures, Pros/Cons, and How to Choose
Medicine is changing fast. Two of the biggest “alternative” practice models—telemedicine and locum tenens—have shifted from side gigs to legitimate, career-defining paths for many clinicians. Some physicians use them to rebuild autonomy after burnout. Others use them to pay off debt faster, regain geographic flexibility, explore new practice settings, or create multiple income streams.
This guide is designed to be a practical “everything you need to know” overview for doctors considering telemedicine, locum tenens, or a hybrid of both. We’ll cover: how each model works, getting started, credentialing and licensing realities, what day-to-day life feels like, and—importantly—pay structures, contracts, taxes, malpractice, and red flags.
Part 1 — Definitions and How These Models Actually Work
What is Telemedicine Work for Physicians?
Telemedicine (telehealth) is clinical care delivered remotely using video, phone, secure messaging, or asynchronous tools. Telemedicine can be:
Synchronous: real-time video or phone visits
Asynchronous: e-visits, patient portal messaging, remote review of data, store-and-forward (e.g., dermatology photo review), or digital triage
Remote patient monitoring (RPM): monitoring devices + clinician oversight, often with periodic video follow-ups
Virtual urgent care: episodic care, often high volume
Virtual specialty clinics: longitudinal care for specialty patients, scheduled follow-ups, stable panels
Telemedicine work can be:
W-2 employed (hospital system, health plan, virtual clinic)
1099 independent contractor (telehealth company or staffing network)
Per diem (shifts, nights, weekends)
Hybrid (some in-person clinic + remote sessions)
Telemedicine fits many specialties (primary care, psych, derm, endocrinology, sleep, urology follow-ups, pediatrics, urgent care), but feasibility varies based on exam needs, procedure dependency, and patient population.
What is Locum Tenens Work?
Locum tenens (“to hold the place”) is temporary physician work—covering staffing gaps, leaves, vacations, recruiting shortages, seasonal volume spikes, or service line launches. Locums can be:
Short-term: a weekend, a week, 2–6 weeks
Medium-term: 2–6 months
Long-term: 6–18 months (sometimes more)
Part-time recurring: e.g., one week per month, or 4 shifts monthly
Locums physicians can work in:
Community hospitals, large systems, rural facilities, outpatient clinics, urgent care centers
OR call coverage, inpatient consults, ED coverage, hospitalist shifts
Specialty services that need coverage (e.g., anesthesia, OB, urology, GI, EM, radiology)
Most locums work is structured as:
1099 independent contractor via an agency
Sometimes W-2 through a staffing firm
Occasionally direct contract with a hospital/group (rare but possible)
The most distinctive feature of locums: you’re stepping into an existing environment, quickly, and expected to deliver competent care with minimal ramp-up.
Part 2 — The Big Picture: Telemedicine vs. Locums
Who Telemedicine Tends to Fit Best
Telemedicine often fits physicians who want:
Predictable hours, reduced commute, home-based work
Control over schedule (especially if shift-based)
A lower physical overhead/strain
Ability to “stack” work blocks around family responsibilities
A lower-friction entry point into additional income (in some specialties)
Telemedicine is especially attractive when:
Your specialty supports remote evaluation and follow-up
You like rapid decision-making and patient communication
You prefer not to manage inpatient rounding/call in a facility
Who Locum Tenens Tends to Fit Best
Locums often fits physicians who want:
Higher earning potential per hour (common in many specialties)
Geographic flexibility and travel variety
Short bursts of work with longer time off
The ability to “try before you buy” a job or location
A bridge after leaving a permanent role or relocating
Locums is especially attractive when:
Your clinical skills are procedure-based or facility-driven
You’re comfortable adapting quickly
You don’t mind credentialing delays and paperwork
You can manage variability in workflow, staffing, and EMRs
Part 3 — Pros and Cons (Honest Version)
Telemedicine Pros
Lifestyle efficiency: no commute, easier to add blocks of work
Schedule control: many platforms allow shift selection
Lower overhead: minimal physical office needs
Broad patient reach: especially for underserved areas
Scalability: can combine with other income streams
Potentially lower stress environment (depends on platform)
Telemedicine Cons
Pay can be lower than certain facility-based locums work
High-volume environments can feel like a “call center” model
Clinical limitations: no hands-on exam; must refer appropriately
Licensing complexity: multi-state licensing is often required
Platform rules: metrics, documentation requirements, time pressure
Patient expectations: “I want antibiotics now” or “I want controlled meds” conflicts
Locum Tenens Pros
Strong pay potential in many specialties, especially with call/procedures
Time-off blocks: work intensely, then take extended breaks
Geographic variety: explore locations without committing
Less long-term politics: often fewer committee/admin burdens
Skill growth: exposure to different systems and clinical patterns
Negotiation leverage: rates can rise with scarcity and flexibility
Locum Tenens Cons
Credentialing delays: onboarding can take weeks to months
Variable working conditions: staffing, EMR, support can vary widely
Travel fatigue: flights, hotels, rental cars add wear
Inconsistent schedules: assignments can end or change suddenly
Taxes/benefits complexity: especially for 1099
Call burden: can be heavy; details matter (callback rate, coverage expectations)
Part 4 — Getting Started: Step-by-Step for Both Paths
Step 1: Clarify Your Goal (Because It Determines Everything)
Before you chase rates or platforms, decide your primary goal:
Maximize income quickly?
Reduce burnout and control schedule?
Explore new geography?
Build a semi-retired lifestyle with predictable work?
Replace your full-time job?
Add a side-gig without disrupting your main practice?
Your goal determines:
Which assignments you accept
Whether you prioritize licensing across multiple states
Whether you should go telemedicine-heavy, locums-heavy, or hybrid
How you negotiate pay structure and schedule guarantees
Step 2: Organize Your Credentials and Your “Credentialing Packet”
Both telemedicine and locums require strong organization. Create a digital folder with:
CV (updated)
Medical license(s)
Board certification
DEA (and state controlled substance registrations if applicable)
NPI
BLS/ACLS/PALS (as needed)
Immunizations, TB, mask fit, flu shot
Diploma, residency/fellowship certificates
References (names, emails, phone numbers)
Case logs (if required)
Procedure logs (if required)
Hospital privileges history
Malpractice claims history (if any)
Government-issued ID
A professional headshot (sometimes requested)
This packet saves hours. Locums agencies and telehealth companies both move faster when you can upload everything quickly.
Step 3: Decide Your Employment Structure Early
Telemedicine:
W-2: simpler taxes, sometimes benefits, often lower flexibility
1099: more flexibility, more responsibility; you manage taxes and deductions
Locums:
Commonly 1099 through an agency
Some W-2 staffing arrangements exist (less common)
Some physicians form an LLC / S-corp (depends on state, income, and tax planning—requires professional advice)
The correct structure depends on:
Your projected annual locums/telehealth income
Whether you want to set up retirement plans (Solo 401(k), SEP IRA)
Liability and administrative comfort
How many states you’ll work in
Part 5 — Licensing and Credentialing: The Bottleneck You Must Respect
Telemedicine Licensing Reality
Telemedicine often requires state licensure where the patient is located. That means:
If you want access to more shifts, you may need multiple state licenses
Some companies help, some don’t
Credentialing can still take time
Many physicians accelerate telemedicine options by:
Obtaining licenses in a handful of high-demand, high-volume states
Using Interstate Medical Licensure Compact (IMLC) if eligible (varies by state and eligibility criteria)
Locums Credentialing Reality
Locums credentialing typically includes:
Hospital privileges
Payer enrollment (sometimes)
Facility onboarding + training modules
Background checks
NPDB queries
References and work history verification
Expect:
4–12 weeks as a common range, sometimes longer
It can be faster with urgent need + clean, organized paperwork
It can be slower with missing documents or complex work history
Part 6 — Day-to-Day Workflow Differences
Telemedicine Day-to-Day
Common patterns:
Scheduled visits (15–30 min slots)
On-demand queues (see next patient immediately)
Asynchronous message review (bundles of cases, often quick)
Common friction points:
You must be comfortable triaging and referring
You’ll rely on patient-reported vitals, images, home testing
You need strong documentation to justify decisions
You need comfort with “not everything is solvable remotely”
Locums Day-to-Day
Common patterns:
You inherit local workflows
You adapt to the facility’s clinical culture
You may have less influence over staffing and operations
You often operate as a “highly competent guest”
Common friction points:
EMR variation (Epic/Cerner/Meditech/etc.)
Call coverage ambiguity
Local practice patterns and resources
Variable support from nursing, techs, anesthesia, consult services
Part 7 — Pay Structures (Deep Dive)
Pay is where most physicians focus—and where many mistakes happen.
Telemedicine Pay Structures
Telemedicine compensation tends to fall into a few buckets:
1) Hourly Shift Pay
You get paid a flat hourly rate for being available
May include minimum productivity expectations (e.g., patients per hour)
Best for predictability
Watch for:
“Hourly” that converts to per-visit if volume drops
Requirements to stay active even if queue is empty
2) Per-Visit / Per-Encounter Pay
You’re paid for each visit completed
Upside if you’re fast and queue is constant
Downside if volume is inconsistent
Watch for:
Unpaid admin time (messages, callbacks, documentation)
Forced follow-ups that reduce effective hourly rate
3) RVU-Based
Less common in pure telemedicine, but exists in some integrated systems
Works best with efficient workflows, stable patient population
4) Salary / W-2
Predictable but less flexible
Often includes meetings, quality metrics, coverage expectations
Telemedicine Earning Reality
Your real pay is not just the rate—it’s:
The effective hourly after documentation, admin, and downtime
Whether you control your shift schedule
Whether the platform sends you high-complexity cases requiring referrals
Whether follow-ups and inbox work are paid
Locum Tenens Pay Structures
Locums has more variations and more negotiation points.
1) Hourly Rate
Common in many specialties
Paid for clinical hours worked, sometimes with separate call pay
Watch for:
Shift definitions (8 hours vs 10 vs 12)
“Clock time” vs “patients seen” expectations
2) Day Rate / Shift Rate
Flat fee per day or per shift
Easy to understand
Can be amazing if volume is light, brutal if volume is heavy
3) Call Pay + Callback Pay
Some contracts pay for:
A base call stipend for being on call
Separate callback hourly for time spent handling calls or coming in
Watch for:
Definition of callback (phone vs in-house)
Minimum increments (e.g., 2-hour minimum if called in)
Documentation of call times
4) Per-Procedure or Collections-Based (Less Common in Locums)
Sometimes for surgical specialties:
Payment per case, per procedure, or a percentage structure
Often complex; require excellent billing clarity
5) Blended Models
Example:
Base daily rate + RVU bonus over threshold
Base hourly + productivity bonus
Base call stipend + procedure pay for add-on cases
What Determines Locums Rates?
Specialty scarcity
Location (rural, underserved areas often pay more)
Call intensity and case complexity
Coverage urgency (short notice often pays more)
Your experience, subspecialty, procedure comfort
Malpractice environment and facility risk
Assignment length and schedule (weekends, holidays, nights often pay more)
Negotiation Levers Most Doctors Miss
Guaranteed hours (paid even if they send you home early)
Travel days (paid travel, travel stipend, or counted as work)
Housing quality (direct-booked vs reimbursement)
Rental car class and mileage reimbursement
Call conditions (1:2 vs 1:4, backup call, consult-only)
Cancellation clauses (if they cancel your shifts last minute)
Chart completion time and admin expectations
Part 8 — Malpractice, Tail Coverage, and Risk
Telemedicine Malpractice
Telemedicine companies may:
Provide malpractice coverage (common)
Require you to carry your own (less common)
Specify limits and whether it’s occurrence vs claims-made
Telemedicine risk points:
Standard-of-care must match in-person standards
Document why remote care is appropriate
Use clear safety-net instructions and follow-up plans
Locums Malpractice
Locums agencies almost always arrange malpractice coverage for the assignment.
Key terms:
Occurrence policy: covers incidents that occur during the policy period regardless of when claim is filed
Claims-made: covers only if policy is active when claim is filed; requires tail if policy ends
Ask explicitly:
Is malpractice occurrence or claims-made?
If claims-made, who pays tail?
What are the policy limits?
Are you covered for moonlighting or only that facility?
Part 9 — Taxes, Retirement, and “Real Income”
This is where 1099 work becomes either a wealth accelerator or a mess.
1099 Basics (Telemedicine or Locums)
If you’re 1099:
No taxes withheld
You must pay estimated quarterly taxes (federal + state)
You should track deductions (travel, licensing, CME, home office where appropriate, etc.)
You can potentially contribute to a Solo 401(k) or SEP IRA if eligible and structured properly
Your effective income depends on:
Tax planning
Deduction tracking
Whether you are paying for your own benefits
Whether downtime is unpaid
W-2 Basics
If you’re W-2:
Taxes are withheld
Benefits may be included
Retirement plan may be provided
Less deduction flexibility
Neither is “better” universally—it depends on your priorities, income level, stability, and how much administration you want.
Part 10 — How to Choose: A Practical Decision Framework
Ask yourself these questions:
1) Do I want a consistent weekly routine or blocks of time off?
Consistent routine → telemedicine often wins
Blocks of time off → locums often wins
2) Do I tolerate variability and rapid adaptation?
Low tolerance → telemedicine or stable virtual clinic model
High tolerance → locums can be rewarding
3) What kind of clinical work energizes me?
Communication + triage + longitudinal follow-up → telemedicine
Procedures + inpatient + facility-based medicine → locums
4) What’s my risk tolerance?
Telemedicine: less physical risk, more medicolegal “remote decision” risk
Locums: system variability risk, call burden, higher clinical complexity in some settings
5) Do I want to build relationships with patients/teams?
Telemedicine (specialty follow-up) can provide relationships
Locums often provides less continuity (unless long-term assignment)
Part 11 — Hybrid Strategy: The Best of Both Worlds
Many physicians do best with a hybrid:
Locums for high earning bursts (e.g., 1–2 weeks/month)
Telemedicine for consistent supplemental income and flexibility between assignments
Hybrid can:
Smooth income volatility
Reduce travel fatigue
Create stability while preserving autonomy
Part 12 — Red Flags and Contract Pitfalls
Telemedicine Red Flags
Unclear pay model or “rate changes” based on demand
Unpaid follow-ups or inbox work
Unrealistic patient-per-hour expectations without support
Pressure to prescribe inappropriately
Poor clinical escalation pathways (no clear referral instructions)
Locums Red Flags
Vague call responsibilities
Undefined backup coverage
High-risk setting without adequate resources
Bad cancellation clause (facility can cancel without paying you)
Housing/travel reimbursement that’s unclear or slow
“You’ll figure it out” onboarding with minimal orientation
Rule: If something matters, it must be in writing.
Part 13 — The “Insider” Practical Tips That Make These Paths Work
Efficiency Tips for Telemedicine
Use templated documentation (within legal/ethical rules)
Get excellent at safety-net instructions
Know your referral pathways
Be consistent about prescribing boundaries
Optimize your workspace: camera, lighting, audio, dual monitors
Efficiency Tips for Locums
Ask for the EMR name and training ahead of time
Ask for typical day volume and case mix
Clarify call expectations with real numbers
Confirm clinic staff support, MA/RN ratios, scribes
Build a “first day checklist” (logins, badge, dictation, OR processes, consult pathways)
Keep a personal credentialing tracker with dates and documents
Part 14 — Final Take: Which Should You Choose?
If you want maximum flexibility and home-based work, telemedicine can be a powerful tool—especially if you find a platform that values quality, supports escalation, and pays fairly for time.
If you want high earning potential, new environments, and the ability to compress work into intense periods, locum tenens can be incredibly rewarding—if you respect credentialing timelines and negotiate the details.
And if you want the highest resilience and optionality: build a hybrid portfolio.
FAQ: Telemedicine and Locum Tenens for Doctors
1) What’s the biggest difference between telemedicine and locum tenens work?
Telemedicine changes how you deliver care (remote platform, digital workflow). Locum tenens changes where and for whom you deliver care (temporary coverage in physical facilities). Telemedicine is defined by the modality; locums is defined by the employment arrangement and temporary nature.
2) Can I do telemedicine as a side gig while keeping my full-time job?
Often, yes—depending on your employment contract, noncompete language, moonlighting policies, malpractice restrictions, and time/energy. Many physicians pick up evenings or weekends. The key is to confirm you’re not violating your contract or employer policies and that you’re licensed where you’ll treat patients.
3) Can locum tenens be part-time?
Yes. Many physicians do:
One week per month
A couple weekends per month
A recurring set of shifts (e.g., 4–6 shifts monthly)
Recurring part-time locums can work well if a facility has a stable ongoing gap and you’re dependable.
4) Which model pays more: telemedicine or locums?
It depends heavily on specialty and setting. Locums often has higher upside because it frequently includes:
facility-based work with higher acuity
call stipends and callback pay
procedure opportunities
Telemedicine can still pay well, but many virtual roles are optimized for scale, which can compress compensation. The better question is: which gives you the highest effective hourly rate for your preferences and risk tolerance?
5) What pay structure is best for telemedicine: hourly or per-visit?
Hourly is best if volume fluctuates and you want predictability.
Per-visit can be best if volume is consistently high and you’re efficient.
If the platform expects inbox work, follow-ups, or extensive documentation, hourly often protects your effective rate better.
6) What pay structure is best for locum tenens?
There isn’t one best structure—what matters is total compensation relative to workload. Many physicians like hourly with clearly defined shifts, but call-heavy specialties often require a mix of:
base rate
call stipend
callback pay
The “best” contract is the one where responsibilities are explicit and the pay matches the intensity.
7) What should I negotiate in a locums contract?
Common high-impact items:
Rate (hourly/day/shift)
Guaranteed hours
Call stipend and callback rules
Travel, housing, rental car (direct billed vs reimbursement)
Cancellation policy and pay protection
Malpractice type (occurrence vs claims-made) and tail responsibility
Assignment schedule, start/end dates, and any flexibility
Credentialing support and timeline expectations
8) What should I negotiate in a telemedicine contract?
Pay model (hourly vs per-visit) and how it changes with volume
Expectations for patient-per-hour or response times
Whether charting time is included
Whether asynchronous work is paid
Licensing support (fees, CME, compact support)
Malpractice coverage details
Prescribing policies and escalation protocols
Required availability, weekend/holiday requirements
9) How long does locums credentialing take?
Often 4–12 weeks, but it can be shorter or longer. It depends on:
facility efficiency
your responsiveness
how complete your paperwork is
whether your work history is complex
payer credentialing requirements
10) How long does telemedicine onboarding take?
Ranges from days to weeks depending on:
licensing needs
credentialing requirements
platform training
background checks
Telemedicine can sometimes move faster than hospital privileges, but multi-state licensing can slow it.
11) Do I need multiple state licenses for telemedicine?
Usually yes if you’re treating patients across state lines, because you generally need to be licensed where the patient is located. Some roles are state-limited (patients only in one state), which can simplify your life and still provide good income.
12) Is the Interstate Medical Licensure Compact (IMLC) worth it?
For many physicians, it can be a major accelerator if you qualify and if your target states participate. It can reduce administrative friction for multi-state licensing compared to applying separately. Whether it’s “worth it” depends on your specialty, target markets, and how much telemedicine or multi-state locums you plan to do.
13) What specialties are best suited for telemedicine?
Common good fits include:
Psychiatry
Primary care (especially follow-ups and chronic disease management)
Urgent care triage
Dermatology (especially asynchronous)
Endocrinology follow-up
Sleep medicine
Weight management/metabolic care
Some urology follow-ups and men’s health care (with appropriate constraints)
But suitability depends on whether your clinical decisions can be made safely without a physical exam.
14) What specialties are best suited for locum tenens?
Many—especially those with facility-based workflows:
Emergency medicine
Hospitalist
Anesthesia
OB/GYN
Radiology
GI, surgery, urology
Critical care
Primary care coverage in underserved areas
Rates are often highest when demand is high, call is heavy, or location is less desirable.
15) What’s the biggest mistake doctors make when starting locums?
Underestimating:
credentialing time
call burden
local resource limitations
the importance of contract clarity
Also: accepting a low rate early because they’re eager to start, rather than negotiating based on workload.
16) What’s the biggest mistake doctors make when starting telemedicine?
Assuming telemedicine is automatically easier. Some platforms are extremely high volume and metric-driven. The big mistake is not asking:
what counts as “work”
whether downtime is paid
how prescribing is handled
what the escalation and referral pathways are
17) Is telemedicine more legally risky?
Not inherently, but it has unique risks:
limits of remote exam
patient identity verification
prescribing restrictions
documentation requirements
If you practice within scope, document well, and use conservative escalation, it can be very manageable.
18) Is locums more clinically risky?
It can be because:
you’re in unfamiliar systems
you may have limited support
you may be covering high-volume/high-acuity environments
The risk decreases when you choose facilities carefully, ask the right questions, and avoid vague call responsibilities.
19) Who pays for malpractice in locum tenens?
Often the locums agency arranges malpractice for the assignment, but you must confirm:
occurrence vs claims-made
tail coverage responsibility
policy limits
whether coverage is restricted to that site only
20) Who pays for malpractice in telemedicine?
Often the telemedicine employer/platform provides coverage, especially for W-2 roles, but it varies. Always request proof of coverage terms, limits, and type.
21) How do taxes work for locums as a 1099?
You’re responsible for:
quarterly estimated taxes
self-employment taxes (depending on structure)
state taxes in states where you work (sometimes)
You’ll want strong bookkeeping and ideally professional tax guidance, especially if income is significant or multi-state.
22) Can I deduct travel expenses for locums?
Often, travel and lodging for assignments away from your tax home may be deductible, but it depends on your tax home definition and specific IRS rules. Because mistakes here can be expensive, most physicians doing meaningful locums income benefit from professional tax advice.
23) Can I do telemedicine while traveling?
Sometimes yes, but you must consider:
where the patient is located (licensure)
where you are located (some platforms have rules)
data privacy and secure setup
stable internet and HIPAA-compliant environment
Also, some employers restrict working outside certain regions or outside the U.S.
24) What equipment do I need for telemedicine?
At minimum:
Reliable high-speed internet
Quality webcam
Good microphone or headset
Private space with good lighting
Dual monitor (optional but very helpful)
Secure device practices (encrypted computer, strong passwords, updated software)
25) How do I evaluate whether a locums assignment is “good”?
Ask:
What’s the typical daily volume?
What’s the case mix and acuity?
What’s the call schedule and how often are you called in?
Is there backup coverage?
What’s the EMR and is training provided?
What staffing support exists (RN/MA/scribe/anesthesia/consults)?
Why is the vacancy happening?
How often do locums return to this site?
26) How do I evaluate whether a telemedicine platform is “good”?
Ask:
Is pay hourly or per visit—and what’s the real expected throughput?
Are follow-up messages paid?
Are charts audited and what are the quality expectations?
What are prescribing restrictions?
What’s the escalation pathway?
What happens if you refer patients out frequently?
How are patient complaints handled?
27) Can locums lead to a permanent job?
Yes. Many physicians use locums as an extended interview. It’s one of the best ways to assess:
culture
staffing reality
leadership
local referral patterns
volume stability
If you like the facility, you can often transition—sometimes with better negotiating power.
28) Can telemedicine lead to a permanent role?
Yes, especially in systems building hybrid models. Physicians who perform well can move into:
leadership roles
quality/clinical guideline roles
training/onboarding roles
stable full-time virtual clinic positions
29) What about benefits—health insurance, disability, retirement?
W-2 roles may include benefits
1099 roles generally require you to arrange benefits independently
Many 1099 doctors build strong plans (health insurance, disability, umbrella policy, retirement contributions) but it requires proactive planning.
30) How do I avoid burnout in telemedicine?
Set boundaries:
don’t overstack shifts
avoid platforms that measure you solely by speed
take breaks between calls
choose roles with a sustainable mix of complexity
don’t accept prescribing pressure
Also: diversify your work (e.g., some scheduled follow-ups rather than all on-demand urgent care).
31) How do I avoid burnout in locums?
Choose assignments with realistic workloads
Clarify call intensity upfront
Build recovery time after travel blocks
Don’t accept chronically understaffed, chaotic facilities unless the pay matches and you truly want that environment
Track your energy the same way you track your finances: patterns become obvious
32) What is the best way to start if I’ve never done either?
Two common low-friction paths:
Start telemedicine with limited hours to learn the workflow and boundaries
Start with a shorter locums assignment (1–2 weeks) at a facility known for good onboarding
In both cases, keep your credentialing packet ready and learn contract basics early.
33) Is it safe to do both telemedicine and locums?
Yes—many do. The keys are:
clear scheduling
ensuring malpractice coverage is appropriate for each role
managing multi-state licensing if relevant
staying organized with documentation and taxes
34) How do I protect myself in contracts?
Get everything in writing
Avoid vague “as needed” call language without compensation clarity
Ensure malpractice type and tail responsibilities are explicit
Ensure cancellation protection exists for locums
Ensure pay model is explicit for telemedicine
35) What’s the bottom line?
Telemedicine optimizes for flexibility and remote convenience; locums optimizes for earning potential and geographic autonomy, but demands more logistics and variability tolerance. Many physicians find the best long-term path is a hybrid portfolio that matches their personal energy, financial goals, and preferred clinical style.