Whether working as a locum tenens has been a long-term career goal, or you are excited by the flexible lifestyle, knowing what to expect can be helpful before exploring a career as a locum tenens. Since we staff rural and remote locations throughout the Northwest United States and Alaska, we’ll focus this article on the pros and cons of rural locum jobs based on the experiences we’ve had with our providers and clients.
While there are tradeoffs to working as a locum in an urban setting, our expertise is in remote and rural healthcare, which provides specific challenges and opportunities in itself. We understand that healthcare providers respect transparency, and the reality is that working as a locum tenens in rural locations isn’t for everyone. Rural healthcare, especially as a locum, takes a provider who is eager to undertake whatever challenges are thrown their way. Some providers prefer this kind of work because of the elements of adventure. For others, it might not be the best career fit. Keeping that in mind, let’s get the cons out of the way.
Cons of Rural Locum Jobs
We’ll get into specifics, but it’s helpful to remember that working as a locum tenens in remote locations is an experience all on its own. It’s not as simple as driving to a desk job, clocking in, finishing your shift with little to no difficulty, and driving back home. The entire job, from booking an assignment to starting on your first day, is a journey.
While we aren’t trying to discourage you from this type of career, it’s imperative that you understand what you’re signing up for. Doing so will help to ensure that you’re educated upfront and prepared to handle whatever comes your way. Here are some of the cons to be aware of when working as locum tenens in a rural or remote location.
While there are some things we can control, one thing we certainly cannot is the weather. Staffing in the states that we do (Alaska, Montana, Wyoming, Idaho, and Washington) includes all four seasons, sometimes to extremes that you may not be accustomed to or prepared to handle.
Alaska is a state that’s in a league of its own when it comes to the weather. We have the most experience with staffing remote Alaska compared with any other healthcare staffing agency in the country. Many of our internal team members have grown up or lived in Alaska at some point in their life. If there’s one thing we know, it’s that the weather in Alaska can be unpredictable, at best.
As any Alaskan will tell you, Alaska is bigger than Texas, California, and Montana combined. The weather in Alaska can change drastically by location, regardless of the season. It is not uncommon for healthcare providers who travel to Alaska to end up temporarily stuck in a village, many miles away from any other village while waiting for the weather to clear out, so they can continue with their travel plans.
Weather in the contiguous United States can prove to be unexpected for other reasons. In 2022, one of the locations we staffed was affected by the historic flooding near Yellowstone National Park. Wildfires during the summer have been known to put providers to the test in getting burn victims transferred out of facilities and off to specialized burn centers.
The healthcare providers who consider weather interruptions all part of the adventure, and are comfortable with adapting to changes quickly, are the ones who can make the best of an otherwise problematic situation.
The weather can significantly affect travel plans for providers. Regardless of if you’re traveling by vehicle or airplane, being prepared for interruptions in travel plans is key when planning to head to or from remote locum tenens assignment locations.
Traveling in summer isn’t typically as problematic as in winter. The weather in the states located in the Northwestern United States can be cold and snowy during the winter season. Montana, Idaho, Washington, and Wyoming all have multiple mountain passes. In the winter, it can be mandatory to use winter weather tires at the very least, with chains often required on vehicles to drive across the passes. Passes can become closed entirely due to weather, vehicle accidents, avalanches, or other unforeseen circumstances. Flights have also been known to be delayed or canceled due to severe weather, such as snowstorms or freezing temperatures in these states.
Alaska’s terrain includes everything from mountains to hundreds of islands, making travel plans more difficult to coordinate, with providers often needing to take a major airline, like Alaska Airlines, into the state. From there, they can be transferred to a much smaller bush plane, or helicopter, get a ride on a dog sled or snow machine, or simply acquire a rental car. Since many locations in Alaska are not able to be accessed solely by a vehicle, providers sometimes take ferries or boats to get to their final destination.
Sometimes, healthcare providers may have problems with luggage being lost or items arriving at their final destination in less-than-perfect condition. For providers who work with us, we always try to help to resolve issues with travel arrangements, but even with assistance, lost luggage can put a hiccup in the best-laid plans.
Housing isn’t a negative point overall, but we’d be remiss to not bring up the variety of housing options (or lack thereof) that you may come across as a rural locum tenens. In urban areas, locum tenens often know what to expect from the hotels or temporary apartments they are asked to stay in. In remote locations, these accommodations likely don’t exist.
We always work with our clients to find satisfactory housing that is clean and safe for our providers. Sometimes, clients will have apartments or small houses available for healthcare providers. Other times, the housing is part of the clinic and could be a bedroom with a shared living space. We have written an entire article about what to expect with housing for our providers that you’ll want to be sure to read before taking an assignment.
We try to be as transparent as possible with the healthcare providers who we work with about what the housing will be like at the different locations we staff, so they know what to expect upon arrival. However, if you’re the type of person who prefers not to compromise on your living situation, remote or rural locum jobs may not be for you. If don’t mind cozy, moderate living situations, the housing may be of little or no concern to you and instead may be part of the fun of the assignment.
Limited Medical Resources & Supplies
Working as a locum tenens in a rural or remote area comes with its challenges. One of them that our healthcare providers are often quickly aware of is the limited medical resources and supplies at the different facilities.
We commonly staff small, critical access hospitals, rural health clinics, school-based clinics, and industrial plants with healthcare providers. The resources and supplies you have at your disposal will not be comparable to what you’d have in a larger, more urban healthcare facility.
At rural and remote facilities, you will likely have less of an ability to get lab results quickly, various types of scans or testing, or medications that you’d typically have on hand. Healthcare providers who work in these areas need to quickly adapt and think on their feet to problem-solve and achieve the best outcomes for patients.
Keep in mind that the people who typically live and work in these locations are accustomed to the resources they have and not the ones they don’t. It’s your job to go in as a helper and to make the best of what’s available to you.
Limited Support Staff
Many of the healthcare facilities that we staff are solo-provider sites, meaning that you’ll be the ONLY healthcare provider within a village or community who is providing healthcare. You may have a health aide or nurse at some facilities, but sometimes, you’re it. Being able to jump into urgent and emergent situations is a necessity and doing so confidently is key to taking care of patients in remote and rural locations.
You will find that some locations include additional healthcare providers, but it’s site-specific. If you’re interested in working with Wilderness Medical Staffing, our account executives and recruiters can provide you with additional information about the details of the support staff at the facility.
Packing for a locum tenens assignment in rural locations can require a lot of planning and forethought. We’ve written entire articles about packing, including an Alaska-specific packing list, unusual items to pack for an assignment, and an article about how to prepare food for rural locum tenens assignments.
How and what you pack can be instrumental for your success at an assignment. Many locations do not have a store so providers need to bring groceries or order them ahead of time from a larger city in Alaska and have them flown to their assignment (this is common to do in Alaska and stores like Costco and Fred Meyer are set up to have groceries flown via a bush plan to various parts of the state). In rare situations, providers need to bring their own drinking water, especially if you’re driving to your assignment or if potable water is unavailable.
Packing the right clothing for the time that you’ll be on assignment can take a fair amount of planning and consideration for the weather. For providers who become accustomed to the locum life of rural and remote healthcare, they often keep suitcases packed with essentials that they use time after time on assignments. Many times, besides washing clothing, these suitcases stay packed so providers don’t have to worry about repacking over and over again. While it’s important to adjust your packing list for the location and the season, plenty of items can be planned for ahead of time and taken with you to every assignment.
As we mentioned before, luggage can get lost or delayed, so we always recommend for providers to pack an overnight bag with essentials like medications, a phone, your laptop, chargers, glasses, a change of clothing, and snacks or food to hold you over for a day or so.
Leaving Pets and Family Behind
Healthcare providers encapsulate all ages and life stages. The providers who we work with often have significant others, children, or pets. We often get asked about which assignments would accommodate a lifestyle that includes bringing family along.
Typically, for an assignment to allow family or pets, it usually comes down to housing. For clients who have housing within the clinic, bringing family or pets is not allowed. If you’ll be living in a house with one or two rooms, you may be able to have a significant other or bring your children along. Some of our providers go to assignments solo but take assignments in areas that are conducive to having their family join them for short stints of time while they are there.
Just like housing rentals you’d find where you live, certain ones accept pets and others don’t. The same is true when on assignment. If it’s mandatory that you bring pets and family, and you’re working with WMS, be sure to discuss this with your recruiter or account executive, so we can work to find assignments that match your needs.
Many times, assignments do not have the flexibility to bring family or pets. For some providers, this can prove especially challenging. While the idea of traveling to a faraway place and providing healthcare is enticing, if you struggle with being away from pets or loved ones, you’ll want to consider this carefully before taking on rural locum tenens assignments.
On the flip side, sometimes taking shorter assignments can be a good compromise if family or pets cannot accompany you.
If having your employer pay for your health insurance is a prerequisite for you, the lifestyle of a locum tenens may not be for you. As a locum tenens, you are an independent contractor, meaning you own your own business. You are not an employee of the staffing agencies or the healthcare facilities that you work with. Because of this, you will need to find and pay for your health insurance.
Acquiring health insurance as a locum tenens can be done in several ways, but one of the best is to find a healthcare insurance broker near where you permanently reside. They can be a good resource in helping you to navigate your options for finding appropriate healthcare coverage.
Optionally, if you’re married, and your spouse is employed, you may be able to get added onto your spouse’s healthcare insurance, typically for an extra monthly fee.
We often recommend that healthcare providers also look into getting insurance for air medical coverage that is applicable in the state(s) where you will be working. It can be beneficial to have peace of mind in knowing that you can use this service if the opportunity is needed. This type of insurance is a nominal cost per year and can be worthwhile while on assignment.
Be Prepared to Work Call
While taking assignments that include being on call is not atypical for medical providers, for those in rural and remote locations, being on call can make for some interesting scenarios. The most grueling part of being on call is probably the disruption to your normal sleep schedule, especially if you’ll be working a normal shift the following day.
Calls can also come in when it doesn’t warrant an emergency, which for some providers can be a nuisance more than anything, but it often comes with the job.
For providers who are accustomed to working call in different medical settings, this shouldn’t be much of a challenge.
In solo provider clinics, you can be on call the entire time you are working day and night. For assignments with Wilderness Medical Staffing, our team tries to be as transparent as possible with you before accepting a position, so you know what call might entail for that specific location.
The Pros of Rural Locum Tenens Jobs
If you read through our list of cons and are thinking that those seem like less of a con and more of an adventure, then rural locum jobs might be for you! As a locum tenens who works in rural and remote locations, there are plenty of pros to this type of career. We work with many providers who genuinely love working in locations that are often off the beaten path. Here are the main benefits of being a locum tenens in rural and remote locations.
Many rural and remote locum tenens assignments are made for healthcare providers who don’t mind rolling with the punches, thinking on their feet, and being a master problem solvers, which is necessary for most assignments.
Providers also like the literal adventure of the work these types of assignments provide. We work with healthcare providers who often send us photos of fishing trips they were able to take in Alaska, the wildlife they saw while on assignment, and interesting stories of what happened while on the job.
Especially if it’s your first assignment or if it’s an assignment at a new location that you haven’t worked at before, you’ll be immersed in a new experience, with challenges and rewards that come with it.
It’s not every day that you can go to work and when you walk outside you get to see the stunning Northern Lights glistening in the night sky. You may not normally see grizzly bears while taking a drive and having an opportunity to travel to Yellowstone or Glacier National Parks on your weekends off might not be a typical excursion compared to where you reside full-time.
For the healthcare providers who work a rural locum tenens position, often, the locations themselves are worth the trip. You have rare opportunities to travel to locations that you maybe have only dreamed of visiting, with the bonus that the travel is paid for as part of your assignment!
Immerse Yourself in Culture and History
At Wilderness Medical Staffing, we have the distinct privilege of working with Native American and Alaska Native tribes throughout the states we staff. We frequently have assignments at school-based clinics in small towns or at healthcare facilities in villages that have been occupied by indigenous peoples for hundreds of years. As a locum tenens who has the opportunity to come and work in these areas, the immersion into the community often becomes the provider’s favorite part of the job.
Our healthcare providers frequently write in with stories. We had a provider who brought their spouse along for their assignment. The spouse became the high school’s sports coach, and the tribe gifted him with a star quilt for his role in the community. Providers tell us about being invited into the homes of community members to celebrate holidays or to learn about special occasions within the tribe, like the raising of a totem pole. One of our providers volunteered to be Santa during Christmas and handed out gifts to the children of the village.
These stories are not isolated incidents. Stories like this are one of the main reasons why healthcare providers enjoy taking jobs in these remote areas. Not only do they get to provide healthcare, but they also become connected to the families who live there. They become a part of the community, even as a visitor, which is an opportunity not often presented to others.
The experiences will differ from location to location and from community to community. Alaska has over 200 Alaska Native tribes and Montana has seven Native American tribes spread out over large reservations in the state. Not to mention, the members of non-Native communities in small towns have their traditions and histories, as well. For healthcare providers, working in different areas, even within the same state, can provide unique experiences which are often a common draw to rural jobs.
Connections with Other Healthcare Providers
Even though locum tenens in rural and remote areas may work alone, there are often opportunities for providers to connect with other locums. Some facilities have multiple locum tenens who will work at the same time. Many have permanent healthcare staff who get to know the locum tenens who come to work there. As a locum tenens, it’s not uncommon to be welcomed into the facility and to make lasting connections with the staff.
Often, before our healthcare providers head out to a new location for an assignment, we’ll connect them with a provider who has been there in the past. This allows them to learn more about the area, the community, the facility, and any other details that might be helpful before starting the assignment.
Even at small facilities, providers can end up crossing paths as one is leaving an assignment and the other is beginning. This can allow them to meet a fellow locum tenens provider and sometimes is the beginning of a friendship based on shared experiences.
Provide Healthcare to Underserved Populations
It’s well-known that people who live in rural and remote areas have less access to high-quality healthcare than those who live in more urban locations. According to the CDC, rural Americans account for 15% of the United States population. It’s less common for healthcare providers to want to live in rural communities. The National Rural Health Association points out that, “The patient-to-primary care physician ratio in rural areas is only 39.8 physicians per 100,000 people, compared to 53.3 physicians per 100,000 in urban areas.” The lack of population density doesn’t often support facilities that would typically include various types of specialty medical care.
These communities still need and deserve excellent healthcare. As a locum tenens, you have an opportunity to provide healthcare to populations that would otherwise not receive it. When healthcare is unavailable in these areas of the country, the communities suffer.
Stepping in as a locum tenens in rural areas allows you to practice meaningful medicine with people who appreciate the care. It literally can be the difference between life or death in remote and rural areas. Whether you’re providing primary care, urgent care, emergency medicine, or another specialty, your presence will be appreciated.
Challenge Your Skills
We often say that providers who work locum tenens jobs in rural and remote areas get to practice “meaningful medicine.” This means that your patients aren’t just a number and providers often get opportunities to help patients in a more meaningful way. Your work is less about paperwork and more about medicine.
In rural and remote locations, you will be tested. As we mentioned earlier, you may not have access to some of the typical resources and supplies that you may be accustomed to at larger healthcare facilities. For many providers, this is part of the excitement and naturally lends itself to a challenge, in a positive way. For healthcare providers who enjoy thinking on their feet, coming up with creative solutions, and putting their skills to the test, rural and remote locum tenens jobs can be a welcome change.
Variety of Patients
In many rural areas, specialists are not commonplace. Since you may be working at a solo-provider site, you will be the healthcare provider who sees it all and does it all. From the common cold to a life-threatening emergency, it’s your job to diagnose the patient and provide care for them as best as possible. You may be the only medical professional for hundreds of miles who can treat a patient.
Sometimes this means working with outside resources, like Avel eCare for provider-to-provider consultations, or connecting with a medivac to arrange a pickup of your patient and transfer to a larger medical facility.
For many rural and remote healthcare providers, the variety of cases brings excitement to the job and allows for more time spent putting your skills and training to good use.
One of the reasons that working as a locum tenens is so appealing is because of the flexibility. You can pick and choose the assignments that you can work based on your qualifications, where to work, and when to work them.
Providers will sometimes make their rotations of assignments for months to a year, making an entire career out of locum tenens work. Other providers use locum tenens jobs as supplemental income to their full-time career, using shorter assignments during some of their days off. Some choose locum tenens as a way to continue working in semi-retirement. Whatever your career goals, you can often find locum tenens opportunities that will fit your career goals.
The flexibility of locum tenens work can also give you unique opportunities to travel to different locations for each assignment. It’s not uncommon for a provider to travel and work at multiple facilities as a locum. While this can take some planning for document collection and credentialing at each facility, it’s an appeal of the job.
On the flip side, we also get providers who will find a longer-term rotation, learn that the community is an excellent fit, and only work at one location for months. Whatever your preference, working as a locum tenens in a rural and remote location allows for flexibility, whatever that means to you.
Providers also appreciate the flexibility of picking and choosing what types of shifts they’d like to take. While many shifts in rural and remote locations are in clinics, working a typical 8-5 is common, some assignments include varying call needs, less traditional hours, or taking a variety of shifts, sometimes at multiple locations.
Many healthcare providers are drawn to locum tenens work because they can often make good pay for their time and expertise. While it can be a misconception that you won’t make as much money in rural and remote places, this simply isn’t true. Because there is such a need for healthcare in these locations, there is also value to the whole community in staffing high-quality providers.
Many times, full-time locum tenens in rural areas can earn more money than they would when working a permanent position, for the same duration of work.
Flights, rental cars, housing, malpractice insurance, and baggage are all things that can be quite expensive but luckily most or all, of these expenses, are covered for the provider.
If you’re considering rural locum tenens work, but you aren’t sure if it’s right for you, we’re always happy to talk to you more about it. In addition to resources like this that you can find on our website, you’re welcome to reach out to our recruiters to ask questions to get more information.
The best locum tenens providers for rural and remote areas are the ones that are up for a challenge and are excited for the adventure that these types of jobs can come with. (Of course, you’ll need to be qualified, as well.) If you’re ready to get started, we’d like to talk to you about it.