they don’t want you to know your worth.
One of the most empowering parts of working as a locums physician is this: you get to decide what your time is worth. But that freedom also comes with a challenge. Without a clear roadmap or transparency in the industry, many physicians are left wondering:
“Am I charging too much… or way too little?”
Here’s how I approach rate-setting as a full-time locums neurologist—along with the tools I use to stay informed, advocate for myself, and make sure I’m not leaving money (or sanity) on the table.
1. Start with Transparent, Real-World Data
The locums world is notoriously opaque when it comes to compensation. That’s why I always start with two sources that prioritize transparency:
Marit Health: A female physician-founded locums agency that publishes real pay ranges across specialties, settings, and shift types. Their philosophy is grounded in fairness and physician empowerment. They’re one of the few agencies that actively discourage exploitative contracts—and they’ll even coach you through negotiating your rate.
OffCall: A crowd-sourced physician salary transparency site where you can filter by specialty, region, years in practice, and even gender. It’s especially helpful for comparing what W2 employed physicians make in similar roles.
Before you throw out a number, look at what comparable roles are offering. Then layer in your unique skill set, availability, and tolerance for volume or call.
2. Factor in Your True Costs
As a 1099 contractor, you’re not just setting a “salary.” You’re building a business. That means your rate has to account for:
Self-employment taxes (about 15.3% unless you are incorporated into a S-CORP or LLC)
Malpractice insurance (especially if tail isn’t covered)
Health insurance and retirement contributions
Licensing, credentialing, travel, lodging
Unpaid time off between gigs
If you're charging $1,400/day and covering your own travel and malpractice, that may actually net out to closer to $900/day. Don’t fall for the headline rate—do the math.
3. Don’t Work Nights, Call, or Holidays “For Free”
Too many locums physicians—especially women—are expected to “just help out” by taking call or covering nights and weekends, often with no extra compensation.
That’s a clear boundary issue. The argument is we are not “billing” overnight- but are you saying our nights and sleep are not valuable?
Be clear up front:
Base day rate (e.g. 8a–5p): $1,600-$2,000
Call coverage (overnight phone or in-house): +$400–$800/night depending on volume
Weekend or holiday shifts: 1.5x base rate, minimum
If they want 24-hour coverage, your rate should reflect 24 hours of your life being constrained.
4. Use Contracts to Protect Your Peace
You should never accept a vague agreement that leaves key terms like “call,” “expected patient volume,” or “malpractice coverage” undefined.
What to watch for:
Are travel/lodging pre-paid or reimbursed?
Is malpractice included with tail?
What’s the cancellation policy (for both sides)?
How many patients are you expected to see per shift?
Are you supervising any APPs?
Is there a travel fee to reimburse for your travel time?
A good contract reflects both value and boundaries.
5. Set Your Rate with Intention—Then Add Buffer
Once you know your ideal minimum rate, start 10–20% higher.
If your true bottom line is $1,600/day, ask for $1,800. Negotiation is expected.
You can always come down if it feels right—but you’ll rarely be offered more than you ask for.
Locums can be deeply fulfilling, flexible, and financially empowering—but only when you treat it like the business it is. Use tools like Marit Health and OffCall to anchor your expectations in reality and data. Then layer in your own non-negotiables.
You didn’t survive medical training just to be underpaid, overworked, and kept in the dark.
You are the supply. Know your worth—and charge accordingly.