Editor’s Note
This week’s issue keeps circling back to the idea of staying in control of your career. AI’s growing role in healthcare is raising new questions about how physicians’ work may change as the technology is increasingly integrated into care. A fresh hospital survey shows advanced practice providers are becoming a more established part of patient care. That shift is reshaping what a physician’s actual workday looks like, especially in rural facilities facing significant staffing shortages.
Control extends to your finances too. A tax planning webinar walks through backdoor Roth conversions and entity decisions worth making before the year closes. Another piece runs the full math on locum tenens pay, showing how travel packages and tax deductions add real value beyond the posted rate. One physician’s year running her own direct primary care practice shows what full ownership of a schedule actually costs and delivers.
None of this works without attention to the parts of life outside the clinic. A new report finds most physicians say their friendships have stayed the same or worsened over the past year. That’s a reminder that professional control means little without personal connection to match it. Taken together, these stories offer tools and the perspective for building a locum tenens career and life on your own terms.
– The Locumpedia Editorial Team
Lead Story
97% of Hospitals Are Locking In APP Staffing for Good. Where Does That Leave Physicians?
August 25, 2026 | Medical Economics
A new national survey of 327 hospital and health system leaders found that 97% plan to keep or grow their APP ranks in 2026, demonstrating that APPs are becoming a more permanent part of the healthcare workforce.
The shift has benefits for both APPs and physicians, especially in rural areas where staffing shortages are most pronounced. Around 80% of facilities reported that APP deployment had a positive effect on physician burnout, with the strongest gains occurring in team-based models where APPs handle routine cases, and physicians focus on more complex care.
Urban and rural facilities are now pulling in different directions on how much they invest in APP staffing. That could change the makeup of the clinical teams providers encounter depending on where you practice. For physicians, roles may emphasize oversight and complex cases as APPs absorb routine visits, and this survey suggests that shift may continue. When taking on an assignment, ask directly how the facility deploys APPs on your service line. That answer can tell you more about the day-to-day than the job posting does.
Your Locums Prescription
Backdoor Roth IRA and Mid-Year Tax Moves for 1099 Clinicians
August 11, 2026 | Barton Associates
For 1099 clinicians earning above the Roth IRA income limits, a backdoor Roth conversion is an important option to consider before the year closes. It can involve moving existing pre-tax IRA balances into a Solo 401k, which avoids a tax trap called the pro rata rule. High earners with no employees may also qualify for a mega backdoor Roth, moving far more money into Roth accounts than a standard IRA allows.
You may also want to consider an S-corp election, although you should be wary of common audit triggers, such as not giving yourself a reasonable salary. Other year-end moves include HSA strategy, real estate professional status rules, and a new 2026 floor on charitable deductions. Many of these strategies work best before filing season, making a mid-year check-in with your CPA something to consider.
The Rest of the Math: Locum Tenens Total Compensation Beyond the Base Rate
August 26, 2026 | Era Locums
A recent breakdown of locum tenens total compensation looks at what actually shows up beyond the posted rate. Using a realistic OB-GYN week as an example, it walks through holiday premiums that often run one and a half times your base rate. It also spells out the real dollar value of a covered travel package. That package can add $2,000 to $3,000 per assignment week in lodging, transportation, airfare, and per diem that you never pay out of pocket.
It also runs the numbers on the other side of the ledger. A locum physician may avoid costs associated with employed practice, like malpractice insurance and tail coverage. That’s why it’s important to look at the full picture when comparing locums and employed offers. Remember that legitimate 1099 deductions and other costs you’re not paying belong in that comparison too.
AI on Call
- Oracle Health rolled out new AI capabilities for its Clinical AI Agent, adding automated coding suggestions during patient visits and letting clinicians dictate notes directly into the EHR in real time.
- The AMA examined how health systems are moving from AI pilots to daily workflows, with leaders at several major systems stressing that governance, clear data, cybersecurity, and trust will determine whether AI actually helps rather than hurts.
- Advisory Board weighed in on the debate over whether AI could eventually replace physicians for some cognitive tasks, siding with the view that clinical intuition and accountability are not things a model can replicate, even as AI keeps improving.
Wellness Retreat
Medscape Physician Friendships Report 2026
August 25, 2026 | Medscape
A new report on physician friendships found that eight in 10 doctors say theirs have stayed the same or gotten worse over the past year, while only 16% said they had improved. Medical training and demanding schedules shape more than clinical skill. They also influence who ends up in your closest circle, often narrowing it to other physicians.
The report adds to a growing body of research linking strong social connections to better health outcomes. Isolation, by contrast, is tied to poorer outcomes across the board, including higher rates of depression. Maintaining friendships can present an additional challenge for locums, as assignments may bring a new location and a new routine. Making room for relationships outside medicine may be one of the more overlooked parts of a sustainable career.
Doctors’ Notes
Financial Freedom for Physicians Starts with Purpose
August 15, 2026 | KevinMD
Wealth and purpose are not competing goals but two parts of the same conversation. Physicians are often taught to treat financial strategy and life purpose as separate topics, when they should inform each other. Building wealth, in this view, is really about buying back the option to say no to work that does not fit your priorities.
Financial freedom is not having a specific net worth from this perspective. It’s defined by having real options, like the ability to turn down a well-paying role that conflicts with your values, or protect time with people you love. Clarify your own mission first, then develop the financial plan that lets you live it on your own terms.
Umbrella Insurance and Medical Malpractice: Do They Overlap?
August 15, 2026 | White Coat Investor
A common point of confusion for physicians is whether umbrella insurance offers any backup protection for a malpractice claim. Umbrella insurance extends your personal liability coverage beyond your home and auto policies, protecting against liabilities from things like a car accident or an injury on your property. Malpractice insurance only covers claims tied to your professional duties as a physician.
The two do not overlap in either direction. A malpractice policy will not help if you are sued after a fender bender, and an umbrella policy will not touch a claim of professional negligence. Most physicians need both types of coverage to avoid a real gap in protection, and it’s worth double-checking your umbrella limits periodically to make sure they still provide adequate protection.
Lessons from a Year of Running a Direct Primary Care (DPC) Practice, with Christine Li Wan Po, D.O.
August 25, 2026 | Physician Side Gigs Podcast
Host Dr. Nisha Mehta talks with family medicine physician Dr. Christine Li Wan Po about what her first year owning a direct primary care practice actually looked like. She left a high-volume, insurance-based practice to build her own patient panel. She’s candid that DPC did not automatically mean more income or a lighter schedule. The financial realities, from funding startup costs to setting membership fees and reaching the point where she could pay herself, are part of the discussion as well.
She also talks through the unexpected parts of becoming a practice owner rather than just a clinician, including staffing, day-to-day business operations, and setting real boundaries around her own availability. Despite the steep learning curve, she says she’s glad she made the switch. It’s a useful, honest look at what DPC ownership actually demands before you sign a lease.
