Most healthcare professionals enter locum tenens for flexibility.
But providers who successfully manage multiple locum contracts learn quickly that flexibility requires structure.
While stacking assignments can create more income stability, multiple contracts can also lead to burnout without organization and clear boundaries.
Ebony Thyme, a family medicine nurse practitioner based in New York, knows this well. After years of managing multiple locum contracts, she’s learned what it takes to thrive in the 1099 world. Today, she’s coaching physicians and advanced clinicians starting their locum careers.
“I always say this: you can be a burned-out contractor too,” Ebony explains. “People think that just because you become a contractor, life automatically gets better. You can get burnt out from contracting.”
Follow these four tips to manage multiple locum contracts successfully and to avoid burning out as a locum tenens provider.
1. Know If Your Specialty Allows Multiple Locum Contracts
Before you even consider adding a second assignment, understand whether your specialty realistically supports overlapping contracts.
“It’s going to be specialty dependent,” Ebony says. “For example, it doesn’t really help if you’re working in primary care. The chances of being able to add on contracts is slimmer, because they typically work Monday to Friday.”
Specialties that handle multiple contracts well:
- Urgent care – Flexible shift structures make it easier to stack contracts
- Emergency medicine – 12-hour shifts create natural gaps in your schedule
- Hospitalist – 7-on/7-off models allow room for additional work
- Anesthesiology – flexible shift schedules and call hours that support locum CRNAs
If your specialty doesn’t naturally support multiple contracts, you can still create flexibility through strategic contract selection, but you’ll need to be more intentional about it.
2. Know Your Numbers to Build Stability
Traditional work models tell us that 40 hours a week is the standard. But if your financial needs are covered in fewer hours, you gain more control over how you spend your time.
Working multiple locum contracts creates income stability while protecting your energy. However, locums burn out by trying to fill every available hour with constant work.
Why Financial Pressure Drives Physician Burnout
Working multiple contracts can create income stability, but many locum providers fall into the habit of filling every available shift. Over time, that pressure can lead to the same burnout they hoped locums would help them avoid.
As a locum provider, your income isn’t just about pay rates. You’re also managing:
- Licensing costs
- Credentialing fees
- Taxes
- CPA and accounting fees
- Malpractice tail coverage
- Travel and housing
“How much do you need to make per month and per year to feel comfortable?” Ebony asks. “That’s always going to be the priority. Anything else is extra.
“If you decide to take on an extra contract, that’s just for you to have extra money, but you don’t need that contract, right?”
How To Build Sustainable Income in Locum Tenens
- Calculate your baseline monthly income need (personal expenses + business expenses)
- Identify your primary contract (the locum contract that covers your baseline)
- Treat additional contracts as optional (for savings, travel, or specific goals)
3. Structure Locum Contracts Around the Life You Want
Now that you understand your financial baseline, your schedule, and how submissions work, you can evaluate contracts strategically instead of reactively.
“When people hear that sometimes, they think it’s about the highest offer, but I’m not driven by money. I like time freedom, so I’m the type of person where if it is not something that’s going to make me more marketable and it’s going to take up too much time, I don’t do it.”
She encourages locum nurse practitioners to ask:
- Does this align with my schedule without creating stress?
- Will this make me more marketable long-term?
- Is this a recurring opportunity that could lead to future contracts?
Successful locum providers design their careers intentionally.
One of the smartest moves Ebony made early in her locum career was creating her own version of paid time off.
She says, “With a W-2 job, PTO works because it’s your money—it’s just they’re saving a portion of your money for a PTO bank. I encourage locums to do the same.”
To protect against burnout, budget your income in such a way that, even when you’re not working, your expenses are covered.
Travel-Focused Locums
Some providers use locum work to explore new cities while getting housing and travel covered.
Ebony shares, “When I was in my 20s, I literally put my stuff in storage, sold my BMW, and traveled for work because housing and transportation were always covered for me, and I didn’t want to increase my expenses. And it worked for me.”
Locum Entrepreneurs
Some providers go into locum tenens because they want to build their own business. Locum work provides income while they establish their foundation.
Ebony says, “Some people go into contracting because they want to build out their own practice, and so that’s going to require you to probably work a little bit more.”
Investing time into your business may also mean investing time into locum contracts, which give you the flexibility to build and fund your business before it begins profiting.
Ultimately, the structure is up to you. Healthcare professionals who thrive in locum tenens build careers that support the lifestyle they actually want.
“I feel like 1099 contracting is a mindset,” Ebony says. “It’s going to come with its ebbs and flows, it’s going to come with cancellations, and it’s going to come with excess income and excess opportunity.”
Ebony teaches locum providers about honing their mindset in order to achieve success in locum tenens. You can sign up for her workshop or meet Ebony at her in-person event, Paychecks2Profit, this August
4. Work with Recruiters Who Understand Your Goals
The right locum strategy looks different for every provider. Some prioritize flexibility. Others prioritize stability, travel, or supplemental income.
Working with recruiters who understand those goals can help you build a schedule that actually supports the life you want to live.
Explore current locum opportunities or connect with a Consilium recruiter to learn more.
Part 2 with Ebony is coming July 2026!
