How to Maximize Your Earning Power

When it comes to locums, you have more control over your pay than you think. Your rate isn’t just a reflection of market demand, it’s a reflection of how well you’ve positioned yourself in that market. That said, don’t let pay be the only thing driving your decisions. The best-paying assignments still need to be the right fit: the right culture, support, and workload. But if you want to earn top-of-market rates while building lasting relationships with great facilities, here’s how to do it. We’ll start with how to increase your value overall (the things that make hospitals pay more for you anywhere), then cover how to leverage that value when negotiating specific assignments.

Part 1: Building Your Market Value By Playing the Long Game

Keep Your License Clean and Get a Compact License

It sounds basic, but it’s foundational. A spotless license, free of malpractice issues, disciplinary actions, or expired credentials, is a big driver for top pay. Hospitals will pay more for providers who make credentialing easy, so the less flags the better.

And if you’re not already part of the Interstate Medical Licensure Compact (IMLC), make that your next move. It instantly expands your eligibility across dozens of states, giving you access to higher-paying regions and urgent needs. Compact licensure isn’t an expense, it’s a multiplier.

Pro tip: Providers with multi-state licenses see up to 20% higher average hourly rates because they can respond faster to demand spikes.

Stay Current and Versatile

Board certification matters, and so does range. Physicians who can work in multiple care settings (community, academic, rural, etc.) have far more options. Every setting you can navigate confidently adds another layer of value.

Experience is leverage. The more diverse your background, the more adaptable (and valuable) you become.

Maintain a Great Reputation

In a small industry, reputation compounds faster than any investment. Clean evaluations, positive peer references, and reliability travel fast — and can be the deciding factor in premium pay or repeat invites.

Locums work is trust work. Be the clinician everyone wants back.

And Whenever Possible, Skip the Agency

Here’s the math most people never see: traditional locums agencies can keep 30–60% of what hospitals actually pay. That overhead doesn’t disappear, it just doesn’t make it to your paycheck. As a result, some physicians try to go direct, knowing both sides save when they do, it's a solid strategy.

However, beware that going direct comes with trade-offs including less protection if something goes wrong and less structure around payment or coverage. Some hospitals also prefer a degree of separation for legal or internal reasons.

That’s where Sendit bridges the gap: direct transparency and higher pay, with the protection and professionalism both sides need. Hospitals spend less, you earn more and everyone wins through shared efficiency and transparency. Learn more →

Part 2: Leveraging Your Value When the Right Offer Comes

Let’s say you’ve been contacted about an opportunity that looks interesting. You’ve got the experience, the credentials, and the availability. Here’s how to make sure you’re negotiating from a position of strength.

Start by Owning Your Story

Lead with the facts that make you valuable:

• Board-certified, no malpractice or disciplinary hits
• X years of experience across [insert settings]
• Clean record, reliable references, ready to credential quickly

That’s your resume in one confident paragraph. State it early and clearly, it signals professionalism and reduces friction.

Use Data to Benchmark Your Worth

Before you even return a recruiter’s call, check what others are earning in that specialty and zip code using the Sendit Compensation Tracker.

Rates vary widely based on region, coverage need, and setting. Having some anecdotal idea on rates gives you an anchor for negotiation. Knowledge isn’t arrogance, it’s leverage, and it’s hard to negotiate your value if you don’t know it.

Force the Agency to be Transparent

“What’s the total bill rate for this position?”

If an agency is involved, the bill rate shows you what the hospital is actually paying. The difference between that and your quoted rate is their margin. Knowing the markup reframes the conversation from emotion to economics.

Treat it like buying a car, there are plenty of options for you, but the right deal should make you feel valued. You’re not asking for charity; you’re asking for transparency.

Deliver Quality That Keeps You Invited Back

Once you’ve landed a good assignment, think long-term.
Every shift is an audition for the next one. The fastest way to maximize income isn’t hopping constantly, it’s becoming the provider every site wants to rebook.

That means:

• Excellent KPIs (low LOS, minimal LWBS, efficient turnaround times, etc.)
• Sharing insights from other hospitals, framed positively (“what I’ve seen work well elsewhere…”)
• Being approachable and collaborative with nursing and admin staff

And yes, small gestures matter. Buy lunch for the team in your first week. Thank the schedulers. Those little things spread fast and have a bigger impact than you know.

You want leadership hearing, “We need that doctor back.” Because when a hospital wants you, you stop competing on rate.

Turn Your Gig Work Into A Strategy That Works For You

Maximizing your worth as a locum isn’t just about chasing the highest hourly number, it’s about building credibility, flexibility, and leverage. Keep your credentials clean. Expand your licensure. Stay data-driven. Go direct when you can. And once you’re on site, deliver excellence that makes you indispensable. That’s how you turn locums from a stopgap into a strategy and how you keep more of what you earn along the way.