When considering the choice between working directly at a hospital (on a PRN basis) versus through a locum tenens company, there are several key factors to consider, especially from a high-earning doctor’s perspective.
Firstly, tax implications play a significant role. With 1099 income, typically associated with locum tenens work, you can deduct work-related expenses, lowering your taxable income. This option is only sometimes available with W2 employment, which is common when working directly for hospitals or on a PRN basis.
Secondly, working with a reputable locum company or recruiter often leads to better hourly rates than direct hospital employment. I have never once, as a locum, met a doctor who works PRN and makes more than me.
Hospitals know they need to pay a premium for high-quality, flexible medical professionals. This premium often covers the hourly rate and travel and accommodation expenses. In my experience, it’s rare for a doctor to negotiate a higher rate working PRN directly with a hospital than a locum agency can secure.
Lastly, many hospitals prefer to avoid engaging in the time-consuming process of vetting doctors for short-term placements. They often have exclusive contracts with locum agencies and vendor management systems to handle this vetting process. This arrangement simplifies the hospital’s staffing logistics and provides a steady stream of pre-screened, qualified candidates through the locum agency.
There is no need to ever work as a PRN unless the hospital/group is willing to pay you as a 1099 independent contractor, and if that rate matches what you can get working locums at another site.
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