Locums CME #100 | Celebrating 100 with a Look Back at Landmark News, Today’s Top Stories, Locums in 5 Years & More

By Jonathon Ayers

2026-09-28

Editor’s Note

One hundred issues is a milestone we don’t take for granted. What began as a roundup of news for locum tenens providers has grown alongside a profession that keeps rethinking how and where care gets delivered. Thank you for reading, sharing, and telling us what matters to you along the way.

Looking back across those issues, many of yesterday’s headlines are still shaping healthcare today. Workforce shortages, new technology, policy upheaval, and a steady search for more control over time and work have shaped nearly every edition. The stories that stand out most are those where clinicians chose the structure of their careers on purpose rather than accepting the default option.

This week carries those threads forward, from the pressures that shape how physicians feel about their work to the growing pains of new tools and the side ventures clinicians are building on their own terms. The details keep changing, but the goal behind them hasn’t. Here’s to the next 100 issues, and to the clinicians who make every one of them worth writing.

– The Locumpedia Editorial Team

Landmark Stories from 100 Issues of Locums CME

Locums CME #1: A Primary Care Warning Sets the Tone

June 30, 2022 | Locums CME #1

The first Locums CME opened with a warning about primary care. Projections at the time put the national shortfall at 17,800 to 48,000 physicians by 2034. In small towns, doctors were already fielding anxious questions from patients about retirement plans, and one rural Wisconsin internist noted that a local psychiatrist who retired two years earlier still hadn’t been replaced.

The outlook has only sharpened since that debut issue. Federal workforce analysts now project a shortage of 70,610 full-time primary care physicians by 2038, with the gap expected to hit nonmetro areas hardest. The physician shortage has remained the backdrop for nearly every issue since.

Locums CME #7: ChatGPT Enters the Exam Room

January 26, 2023 | Locums CME #7

Just two months after ChatGPT’s public launch, CME led with its first AI story. The tool had passed 1 million users in under a week. Physicians were weighing uses like patient-facing virtual assistants and personalized treatment plans, even as early adopters warned that the answers were built to feel correct rather than be correct.

That early curiosity has since become a daily routine for many clinicians. Daily AI use among physicians tripled from 10% to 38% between 2025 and 2026, even as 74% of clinicians named hallucinations and deskilling as top concerns. To keep up with new developments, the topic eventually earned its own recurring section in AI on Call.

Locums CME #28: Four in 10 Physicians Consider Cutting Back

January 10, 2024 | Locums CME #28

In 2024, a national survey of more than 1,300 physicians found that around 40% were considering reducing their clinical hours within the next year. That share was up from about 20% in 2014 and 16% in 2011. Emotional exhaustion was the strongest driver, and almost 26% of respondents said they might leave their practice within two years.

Later data showed burnout easing from its pandemic high without disappearing. About 45% of physicians reported at least one burnout symptom in late 2023, down from 63% in 2021. The desire for fewer, more flexible hours became a steady CME theme, from part-time locum work to portfolio careers.

Locums CME #41: The Pandemic’s Locum Converts Decide to Stay

October 2, 2024 | Locums CME #41

A survey of nearly 400 locum tenens providers found that a third had been nudged into locum work by the pandemic. Of those, 64% planned to keep working locums, with geographic flexibility cited most often. Nurse practitioners were the most pandemic-influenced group, with 39% of locum NPs saying they started due to the disruption. Of those, 70% planned to continue.

The shift from emergency stopgap to deliberate career choice has become one of CME’s defining themes. Roughly 17% of the physician workforce is currently working or has worked locum tenens at some point, based on one national staffing firm’s proprietary data. Coverage since has focused less on whether to try locums and more on how to build a sustainable career around them.

Locums CME #61: The One Big Beautiful Bill Reshapes the Landscape

August 29, 2025 | Locums CME #61

Signed into law on July 4, 2025, the One Big Beautiful Bill cut nearly $1 trillion from Medicaid and $500 billion from Medicare. This led to more complex patient populations and heavier strain on the safety-net and rural facilities where locums are often called to step in. The law also opened new doors, including direct primary care models paired with HSA plans and permanent pre-deductible coverage for telehealth.

The bill’s effect on the physician pipeline is now coming into view. New federal loan caps took effect July 1, 2026, limiting professional students to $50,000 per year and $200,000 total, with Grad PLUS eliminated for new enrollees. With the median four-year cost of attendance for the class of 2026 at $297,745 at public medical schools and $408,150 at private ones, some aspiring physicians are rethinking medicine altogether.

Feature Story: Locumpedia Introduces the Winners of Its 2022 Locum Tenens Providers of the Year Award

February 13, 2023 | Locumpedia

Locumpedia’s first Providers of the Year award honored five locum tenens clinicians, reviving a recognition tradition started by the now-defunct LocumLife magazine. One winner was a general surgeon who drove four hours round trip every day for a week to follow a new mother through her recovery after a complex surgery. A physician assistant in the inaugural class served as the sole provider for remote Alaska villages with fewer than 100 residents. A hospitalist new to locums quit his full-time job to help stabilize an understaffed facility in Roswell, New Mexico, leasing an apartment there until permanent staff could be found.

The award has since become an annual tradition, honoring six providers for 2023, seven for 2024, and five for 2025. Across every class, the common thread has been clinicians willing to go where the need is greatest. Often, that means rural and underserved communities that would otherwise go without care.

Locums Brief: 20 Burning Questions Physicians and APPs Have About Getting into Locum Tenens in 2023

August 18, 2023 | Locumpedia

Written for physicians and advanced practice providers weighing a first assignment, this guide took on the 20 questions clinicians asked most about starting a locum tenens career. It covered credentialing, privileging, and enrollment, which some facilities finish in weeks while others take months, along with the CV, references, and interviews that come before a first day. Its answer to when to start was at any career stage, whether testing practice settings after residency or easing into retirement.

One thing that’s changed is which specialties are in greatest demand. Anesthesiology, hospitalist medicine, and psychiatry topped the 2023 list. A 2026 ranking points instead to urology, cardiology, gastroenterology, radiology, and APPs, noting that more than 60% of US counties have no practicing urologist.

Lead Story

New Survey of America’s Physicians Finds Practice Conditions Are Driving Physician Distress

September 17, 2026 | The Physicians Foundation

Nearly six in 10 physicians experienced debilitating stress in the past year, according to a national survey of 1,000 physicians conducted in August 2026. The findings were released on National Physician Suicide Awareness Day and break down distress by employment setting, gender, age, and geography. Employed physicians fared noticeably worse, with 67% reporting inappropriate feelings of anger, tearfulness, or anxiety compared with 54% of independent physicians.

Autonomy sits at the center of that gap. Some 34% of employed physicians cite organizational policies, productivity expectations, or internal pressures that limit clinical autonomy as a contributor to distress, more than twice the 13% share among independent physicians. Only 23% of female physicians report a great deal of or complete control over expected patient volume, compared with 36% of male physicians. More than a third of physicians say their workplace culture doesn’t prioritize physician well-being, and 71% say stigma around seeking mental health care persists within the profession.

This distress reflects the conditions of practice. Physician leaders are calling for system-level fixes, including less administrative burden and access to mental healthcare without fear of professional repercussions. Questions about patient volume, productivity expectations, and clinical autonomy are worth asking before signing on to any assignment.

How to Get Licensed in a New State as a Locum Tenens Physician

September 20, 2026 | Weatherby Healthcare

For many physicians considering locum tenens, getting licensed in another state feels like the biggest hurdle to accepting a first assignment. The two main options are to apply directly to an individual state medical board or use the Interstate Medical Licensure Compact, which covers most states for physicians who meet its eligibility rules. New licenses can take anywhere from a month to more than a year to process, so starting the application as soon as an assignment looks likely is the safest move.

State-specific requirements can add time when they catch a physician off guard. Texas requires a jurisprudence exam, and Florida requires electronic fingerprinting through an approved vendor. Every license typically has to be reported on future licensing and credentialing applications, so it pays to be selective about which states to pursue. Early in a locum career, though, an active license in a high-demand state can make the difference in landing a sought-after assignment.

Pros and Cons of Locum Tenens

September 4, 2026 | VISTA Staffing

Locum work puts you in charge of where, when, and how much you practice, and assignment lengths can leave room for extended time off between contracts. When a facility needs coverage urgently, you can often command premium hourly or daily rates. You also spend less time on administrative tasks, with the chance to practice in a rural critical access hospital one month and a major urban medical center the next.

The trade-offs deserve the same honest look. As a 1099 contractor, you’ll likely pay self-employment tax and fund your own health coverage and retirement. Practicing across state lines means keeping multiple licenses and facility credentials current, and gaps between assignments can make income less predictable. The right fit often comes down to whether you value flexibility and variety more than a predictable income and long-term patient relationships.

The American Hospital Association’s chief physician executive argues that healthcare AI works only when clinicians are at the table from the start.
University of Toronto researchers found that AI scribes cut documentation time by 69% in simulated primary care visits, shrinking charting from 36% of each encounter to 11%.
Health systems are mostly using AI to retire administrative busywork rather than clinical staff, and employer training appears to separate successful rollouts from expensive ones.

Wellness Retreat

How Physician Leadership Shapes Culture, Care, and Well-Being

September 22, 2026 | AMA

At Northwell Health, clinician leadership is built into the structure, from its first physician CEO to a clinician executive in every market and a chief medical officer at each hospital. When surveys named the old electronic health record as doctors’ most common complaint, the system invested in a move to Epic, then paired physicians with administrators to steer the rollout after pausing a go-live that wasn’t ready.

Northwell’s leaders describe a real risk that physicians inside large organizations lose their sense of agency over their careers and professional identities. Modest investments like doctors’ lounges, dinners, and cultural events have taken on outsized meaning, and a Stress First Aid program helps physicians and care teams recognize and manage stress. It’s an example of how the way physicians are heard can offer a useful read on an organization’s culture.

What Expert Witness Work Actually Pays and Why Most Clinicians Never Collect It

September 22, 2026 | White Coat Investor

Expert witness work often gets pitched as easy side income, and it’s a great opportunity for those who can make it work. A single retainer typically brings in $1,500 to $5,000. Hourly review rates commonly run $300 to $600 or more, so four or five cases a month at the lower end can push a clinician past $100,000 a year working part-time.

What separates repeat experts from one-time hires is usually writing. Clinical notes build toward a conclusion, but legal reports need to lay out the full reasoning, and attorneys rarely give feedback when a report misses the mark. Because the income arrives as 1099 earnings, it can also open the door to business deductions and SEP-IRA or solo 401(k) contributions on top of an employer plan.

Working Smarter, Not Harder, in Private Practice and the Personal Injury Space, with Dr. Amit Mehta

September 22, 2026 | Physician Side Gigs Podcast

An interventional pain physician who left traditional private practice for an independent 1099 model now provides specialized services inside other practices. He uses their existing infrastructure and referral networks instead of carrying his own overhead. Spreading his work across several locations has given him more control over it, and building a personal injury and workers’ compensation practice has raised his revenue per procedure.

Reimbursement in personal injury and workers’ compensation can run significantly better than Medicare and traditional insurance, but the model comes with its own mechanics. Clinicians entering the space need to understand liens, MedPay, workers’ compensation payments, facility fees, and paid depositions. Keeping a long-term exit strategy in view matters too, since creating transferable value in a physician-owned practice can be difficult.

Locum Tenens in 2031

What will Locums CME be covering five years from now? These predictions start from where the news stands in September 2026 and imagine where it could lead by the time we reach issue #300.

Congress Settles It, and Qualified Locums Are Independent Contractors Under Federal Law

By 2031, the long debate over whether locum tenens clinicians are contractors or employees has a federal answer. Legislation classifying qualified locum providers as independent contractors under the Fair Labor Standards Act and the National Labor Relations Act has become law, ending years of state-by-state uncertainty. Independent contractor status now comes with clearer footing and fewer surprises when assignments cross state lines.

The groundwork was laid in 2026, when the RURAL Healthcare Act cleared the House Committee on Education and the Workforce after its April 2026 introduction. No federal locum classification bill had advanced that far until that point, making it a major milestone. At the time, more than 55,000 physicians worked locum assignments, representing over 5% of US doctors.

Experienced PAs and NPs Practice Without Supervision in Most States

Five years on, supervision requirements for experienced APPs have become the exception rather than the rule. States have steadily replaced collaboration mandates with hour-based pathways to independent or team-based practice. For locum PAs and NPs, the range of available assignments has widened, though credentialing now depends on documenting exactly which thresholds a clinician has met in each state.

The shift was already underway in 2026. North Carolina began allowing PAs with 4,000 clinical hours, including 1,000 in a specialty, to work in team-based settings without physician supervision on August 1 that year. The same year, Georgia was weighing a proposal to double the number of APRNs who could work under a single physician’s protocol from four to eight.

Most Physicians Try Locum Tenens Before Midcareer

In 2031, a stretch of locum work is a normal chapter in a physician’s career rather than a detour. Many clinicians blend a permanent role with locum assignments, telehealth shifts, or independent contract work. As locum tenens becomes more integrated into physicians’ careers, discussions around when to try independent work become more common.

The trend line was clear by 2026. A national physician survey found that 41% of respondents had worked locums at some point, up from 20% in 2016, with 14% actively taking assignments. Some clinicians were also building independent 1099 models that spread their work across several practices.

Telehealth Locum Work Becomes Its Own Career Track

Remote locum assignments are no longer a pandemic-era novelty in 2031. Telehealth-only roles, especially in behavioral health and rural follow-up care, now form a distinct career path. Clinicians can build full schedules from home while covering patients across the states where they hold licenses.

The policy foundation was still being poured in 2026. The One Big Beautiful Bill made pre-deductible telehealth coverage permanent. The same year, CMS proposed keeping Medicare’s mental health in-person visit waiver and telehealth payments to rural health clinics and federally qualified health centers in place only through December 31, 2027.

AI Agents Join the Care Team on Locum Assignments

By 2031, locum clinicians arriving at a new facility expect AI to be part of the workflow from day one. Ambient documentation is standard, and AI agents handle routine patient outreach and monitoring between visits. Orientation now covers a facility’s AI tools as thoroughly as its EHR.

Physicians’ daily AI use tripled from 10% to 38% between 2025 and 2026. In September 2026, ARPA-H tapped seven organizations to develop, oversee, evaluate, and implement an AI cardiovascular care platform designed to extend around-the-clock digital care to cardiac patients. That same month, ambient AI became available across all VA medical centers.