Locums CME #103 | Multi-State Licensing for Locums, What Rural Physicians Need, Finding Freedom Through Locum Tenens & More

Editor’s Note

Physician shortages are adding pressure to patient care, leaving many doctors working in difficult conditions. That’s especially true in rural communities, where new research shows many providers lack adequate specialist and colleague backup. Heavy call schedules and administrative work add to the stress.

Flexibility is a significant theme in this edition of Locums CME. The demand for clinicians can also create opportunities to build schedules that work for them. The Interstate Medical Licensure Compact makes it easier for eligible physicians, whether they work locums or not, to obtain licenses in other states and choose from more job options.

The stories in this issue also show how states are responding. Some have put measures in place to limit physician noncompete agreements, while protections for clinicians seeking mental health care vary by state. With more providers looking at side gigs and alternative career paths, locum tenens offers a way to gain more freedom in how they practice.

– The Locumpedia Editorial Team

Lead Story

“You’re Willing to Help the Team, But Only for So Long”: What Rural Physicians Need to Stay

October 16, 2026 | Medical Economics

New rural workforce research shows that gaps in coverage are a bigger problem than pay. Nearly two in three rural clinicians say they lack adequate specialist and colleague backup. Another 42% say pay doesn’t reflect their scope, call, and workload. Overall, 59% are at least somewhat likely to leave their positions within two years, a figure that rises to 67% among those without backup.

MGMA released the research at its 2026 annual conference. It draws on 227 respondents with rural experience, including 168 clinicians and 59 administrators, and was fielded in August. OB-GYN services are particularly strained, with only 7% of respondents rating local coverage as adequate. Since the end of 2020, 146 rural hospitals have stopped delivering babies or announced plans to stop in 2026.

A workable OB-GYN schedule is to be on call every one in three or four nights, yet most rural units require physicians to be on call every other night. A Montana hospital addressed a three-year OB-GYN vacancy by arranging to split one full-time job among three physicians, two of whom have been hired. Locum tenens providers weighing a rural assignment should ask how call is split and who covers specialty questions before signing.

Your Locums Prescription

How Multi-State Licensing Expands Locum Tenens Opportunities

October 13, 2026 | Jackson and Coker

The states where you hold a license determine which assignments you can take. A hospitalist licensed only in Georgia might miss openings in Alabama and Tennessee because new applications take too long. Health systems increasingly staff sites across state lines in hospital medicine, emergency medicine, anesthesiology, and psychiatry.

The IMLC is an expedited pathway for eligible physicians to pursue a wider range of locum opportunities across state lines. You apply through your principal license state and then request licenses in other member states. Adding new ones with steady demand in your specialty can open more options than seeking licensure nationwide. More licenses also bring renewal requirements and paperwork, so locums can start small by listing the states where they’re licensed and picking two neighboring states worth adding.

How One Patient’s Question Turned a Florida NP Into a Locum Tenens Traveler

October 20, 2026 | Barton Associates

A patient once asked a Florida nurse practitioner why she became an NP, and the question changed how she viewed her career. She said she wanted to help people. The patient suggested she could do that through locum tenens practice, but she hesitated at first. After talking through her concerns with a recruiter, she took her first assignment and has done locum work ever since.

“Pajama time,” or work that follows clinicians home, was one of the main reasons she gave locum tenens a chance. She also wanted more flexibility, the opportunity to travel, and greater earning potential. Her story shows how NPs can take back control of their careers while staying true to their mission of patient care.

AI on Call

• The American Medical Association urged the FDA to base oversight of generative AI medical devices on how the tools are used and the harm they could cause.
• Harvard Medical School researchers found that 52% of queries from about 950,000 US clinicians using OpenEvidence involved clinical decision-making, particularly treatment and management.

Wellness Retreat

Why Physician Depression Goes Untreated, and What Helps

October 18, 2026 | KevinMD

Fear of stigma is a leading barrier to depression treatment for 30% of early-year medical students, 53% of final-year students, and 58% of residents. About two-thirds of practicing physicians point to confidentiality as a primary barrier. A JAMA Network Open analysis of 11 studies and 21,517 doctors also linked depressive symptoms to nearly double the risk of medical errors.

Addressing these barriers is difficult because physicians have legitimate concerns about mental health diagnoses historically being seen as a sign of incompetence. Strong programs share traits that combat these issues, such as genuine confidentiality, accessibility, and flexible scheduling. Protections vary by state, so locum tenens providers who work in several states can confirm a program’s privacy and board-reporting rules before enrolling.

PA Burnout Persists as Workload, Pay, and Administrative Burdens Take a Toll

October 16, 2026 | Dermatology Times

A new report surveyed physician assistants on burnout and workplace well-being in the US between January 26 and May 5, 2026. Among burned-out PAs, 44% say symptoms have lasted more than two years, up from 37% in 2024 and 20% in 2022. Administrative work is the top cause at 57%, followed by low pay, long hours, and lack of respect.

PAs with depression are less willing to confide in an administrator or a supervisor. Among those experiencing burnout, 15% of men and 10% of women say their symptoms are severe enough to consider leaving medicine. The changes they want most are higher pay and lighter patient loads. Locum tenens PAs can consider those same factors to choose assignments that prioritize their mental health.

Doctors’ Notes

Why You (and I) Aren’t Retiring

October 20, 2026 | White Coat Investor

More than half of respondents to a 2026 survey of physician investors spend under $200,000 a year, and more than a third have $4 million or more. Only about a quarter consider themselves financially independent. Meanwhile, 32% say they need $5 million to $7.4 million to retire, while most retiring clinicians have $2 million to $3 million.

The author says he reached financial independence at 45 and kept working for about three more years. At that point, his household spent about $60,000 a year and had a $1.5 million net worth. Reasons for not feeling ready include thin margins, high market valuations, limits in historical data, saving habits, and the discomfort of moving from expert to novice. Locums can use shorter assignments to ease into a lighter schedule before retiring fully.

5 Legal Fights Over Where Physicians Can Practice

October 20, 2026 | Becker’s Physician Leadership

Virginia, Utah, Montana, and Maine added new limits on doctor noncompetes in 2026, and Washington will void them all on June 30, 2027. Five legal disputes show how contested the clauses still are. They include a New York judge lifting a restraining order tied to 27 cardiologists and a Minnesota ruling that blocked enforcement against a family physician.

Noncompete rules differ from state to state, and courts are weighing these clauses case by case. Several of the disputes began when physicians moved to a new employer or when practices merged, sold, or formed new ventures. That means a restriction signed years ago can shape where someone can work next. Locums who work in several states can check how each state treats noncompetes and review any restrictive clause in an assignment contract before signing.

Turning Academic Medical Expertise Into a Profitable Side Gig in Industry, With Dr. Joshua Guttman

October 20, 2026 | Physician Side Gigs Podcast

Host Dr. Nisha Mehta talks with Dr. Joshua Guttman, an associate professor of emergency medicine at Emory University and founder of Peachtree POCUS. He built a side business around point-of-care ultrasound while staying in academic medicine after noticing that running these programs brings challenges few people help with. His revenue streams include consulting for hospitals and physician groups, industry partnerships, education courses, and sponsored medtech content.

The conversation covers building a personal brand as an expert in a narrow area and handling institutional policies and conflicts of interest. They discuss the safety net of staying clinical while the business grows. Guttman also shares practical advice for doctors without business training, including books, AI client-communication tools, and ways to test market demand. Locum tenens providers with a niche skill can consider a similar path alongside their assignments.