The gig economy and/or temporary contract work have become increasingly prevalent among healthcare professionals, including physicians. of the U.S.-trained physician workforce practice medicine as locums or temporary assignments. This is only expected to grow as a new generation of young physicians become disenchanted by increasingly demanding jobs and the growing prevalence of burnout.
According to the American Medical Association, experienced burnout in 2021, up from 38% the previous year. Practicing physicians in the post-pandemic era are reducing their clinical hours or closing their private practices, worsening the expected . Similar trends are playing out in other healthcare fields. Overall, it is not surprising that physicians of my generation (and likely the following generations) have turned to locum tenens (Latin for placeholder), temporary assignments, and independent contract work to protect themselves from burnout.
Since switching to independent contract work ("gig work"), I enjoy greater flexibility, independence, and autonomy at work, better control over my schedule, personal goals, and overall health. I will describe why gig work for physicians can lead to higher compensation, improved work-life balance, enhanced autonomy, independence, and happiness.
I currently earn an hourly rate that is generally 30% to 40% more than I would as a staff physician at a hospital, but this can vary depending on your situation. Note this higher rate of compensation does not account for the lifetime tax benefits, which is a outside the scope of this article. A higher rate of pay is even more likely in rural medicine assignments with a of primary practitioners or specialists. What's driving this higher compensation? It is often influenced by factors such as remote work locations, previous difficulty in meeting demand, and travel time. Furthermore, temporary contract work allows physicians to negotiate their rates based on their qualifications and expertise. Higher pay has another added benefit: fewer shifts means more time to focus on personal goals.
This leads me to another reason why temporary work is so attractive: work-life balance. I now have more time to write, focus on scholarly and leadership activities, keep up with my medical knowledge (CME, reading), spend time with family, and prioritize my physical and mental health. For those with big or small families, this means maximizing time on the people and things that matter the most. On the other hand, traditional full-time positions often come with demanding schedules, long working hours, and limited time off.
Through this work, I've also found greater independence and autonomy, which allow me to practice medicine in a way that aligns with my values and career goals. For example, I prioritize picking a practice setting with a predominantly high patient population from underserved communities, including Latino/a/e/x communities that require a culturally and language-concordant physician. I have the flexibility to choose different practice settings. This could include urban, rural, and academic centers. Contract work also empowers physicians to painlessly resign from assignments that are not the right fit, regardless of the reasons. For the most part, there are no stringent contract stipulations. Alternatively, full-time positions may have restrictive non-compete policies, institutional bureaucracy, and hierarchical structures that limit decision-making authority. Colleagues have told me how their employer has limited their scope of practice based on monetary-driven decisions.
Temporary work also allows physicians to be intellectually challenged more consistently, expand their knowledge and skills, and avoid becoming bored with routine. For example, in one of my locum outpatient gigs, the permanent neurologist has graciously offered to teach me how to do Botox injections and nerve blocks for migraine headache patients. I had previously sought to learn these skills, however, due to time constraints, I was unable to do so in training. Additionally, a mentor in one of my telemedicine gigs has offered to proctor in intraoperative monitoring cases as needed. This additional support is pivotal in more complex cases, providing me the confidence to excel. The constant stimulation and professional growth have helped me feel satisfied long-term, staving off burnout.
Finally, temporary contract work allows physicians to build an extensive professional network, which can lead to various career opportunities. I have fostered a network of colleagues and friends while traveling to assignments, impacted the lives of trainees, and have had opportunities to connect with mentors and other potential clients/employers. These opportunities can be more limited when working for one employer. Additionally, I have time to focus on leadership endeavors such as becoming a board member for healthcare advocacy organizations, and joining an editorial board and high-impact committees in one of my specialty societies.
Of course, gig work may not be right for every physician. Drawbacks can include extensive licensing and credentialing requirements, lack of job security, fluctuating income, lack of fixed benefits (health insurance, CME), the administrative tasks of running a business (taxes, billing, insurance, expenses, etc.), and an ever-changing environment. For those that cherish structure or routine, this may be difficult. Additionally, extensive travel is involved, which can be a drawback for some. However, there are potential workarounds to these disadvantages. Administrative tasks can be delegated to other contractors you hire (like accountants) or, soon enough, artificial intelligence. In my personal experience, I have built a business folder with all the credentialing, immunization records, and necessary materials so I can send, in bulk, the requested information to my employer or clients. I do not accept any contract that does not include malpractice with lifetime tail coverage. I do not mind the fluctuation in routine and income, as reclaiming my time as a physician is of greater importance. Extensive travel is definitely a valid concern; it is essential to discuss time away from a spouse or other family members in the household. Telemedicine is an excellent way to mitigate travel time while retaining independent contractor status. Over time, I have also found local contract assignments that, although compensated less, further reduce travel time. Overall, the advantages outweigh the drawbacks for me.
In summary, my experience with gig work has offered greater compensation, work-life balance, professional autonomy, intellectual stimulation, and networking opportunities. I believe independent contract work can contribute to a more satisfied physician workforce. This positively influences patient care and the healthcare system as a whole, as a fulfilled physician workforce delivers higher-quality care, reduces medical errors, and improves health outcomes. These healthcare workers fill gaps in continuity of care, address workforce shortages in underserved areas, and foster innovation by exploring different practice settings and collaborating with diverse colleagues. Healthcare facilities also benefit from the flexibility of gig work, optimizing staffing and resources based on patient demand, and enhancing cost-effectiveness.
Gig work can shape a healthier and more resilient healthcare system.
is an adult board-certified general neurologist and clinical neurophysiologist, and owner and solo practicing physician of Imperium RevDoc Neuroanalysis, a professional service medical corporation that provides culturally concordant care to diverse patient populations.