Rex says
Money math without the spreadsheet headache. Plug in your numbers and I'll show you exactly where the dollars land.
Try a scenario
Click to load — tweak from there.Inputs
Result
Cost difference (permanent minus locum)
-$8,301
Total locum coverage cost
$202,968
Total permanent-hire cost for period
$194,667
Productivity ramp cost (permanent hire)
$34,667
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How to use this
- 1Enter coverage period (working days).
- 2Enter locum day rate ($).
- 3Enter locum travel & housing cost per month ($).
- 4Enter permanent hire annual salary + benefits ($).
- 5Enter recruiting fee / signing bonus (one-time) ($).
- 6Enter months at reduced productivity for new hire.
- 7Read your cost difference (permanent minus locum) on the right — it updates as you type.
- 8Hit Share to keep the scenario or send it to someone.
About this calculator
Locum tenens day rates look expensive next to a permanent physician's annualized salary, but that comparison misses agency fees baked into the day rate, travel and housing costs, and — on the permanent-hire side — recruiting fees, signing bonuses, benefits load, and the productivity ramp period most new hires need before reaching full billing capacity. This calculator totals the true cost of covering a defined period (say, 6 months) with a locum against hiring a permanent provider for that same period, including the parts of permanent-hire cost that a locum comparison usually ignores, like the 3-6 month ramp-up during which a new permanent hire bills below capacity while still drawing full salary. It's most useful for maternity leave coverage, sabbaticals, unexpected departures, or bridging a credentialing delay, where the real question isn't 'which is cheaper forever' but 'which is cheaper for this specific window.' For genuinely temporary gaps under about a year, locum coverage is very often cheaper once you include hiring and ramp costs on the permanent side; for permanent vacancies, the math flips once the coverage period stretches past 12-18 months since locum day rates carry a persistent premium that permanent salary doesn't.
Worked example
Using the values the calculator loads with:
Inputs
- Coverage period (working days): 130
- Locum day rate: 1400 $
- Locum travel & housing cost per month: 3500 $
- Permanent hire annual salary + benefits: 260000 $
- Recruiting fee / signing bonus (one-time): 30000 $
- Months at reduced productivity for new hire: 4
Results
- Cost difference (permanent minus locum): -$8,301
- Total locum coverage cost: $202,968
- Total permanent-hire cost for period: $194,667
- Productivity ramp cost (permanent hire): $34,667
What each field means
Inputs
- Coverage period (working days)
- The coverage period (working days) used in the calculation. Starts at 130 so you have a working example on load.
- Locum day rate ($)
- The locum day rate used in the calculation, measured in $. Starts at 1400 $ so you have a working example on load.
- Locum travel & housing cost per month ($)
- The locum travel & housing cost per month used in the calculation, measured in $. Starts at 3500 $ so you have a working example on load.
- Permanent hire annual salary + benefits ($)
- The permanent hire annual salary + benefits used in the calculation, measured in $. Starts at 260000 $ so you have a working example on load.
- Recruiting fee / signing bonus (one-time) ($)
- The recruiting fee / signing bonus (one-time) used in the calculation, measured in $. Starts at 30000 $ so you have a working example on load.
- Months at reduced productivity for new hire
- The months at reduced productivity for new hire used in the calculation. Starts at 4 so you have a working example on load.
Results
- Cost difference (permanent minus locum)
- Returned as a money amount in US dollars and shown as the headline result. It recalculates instantly whenever you change an input, so you can compare scenarios without reloading.
- Total locum coverage cost
- Returned as a money amount in US dollars. It recalculates instantly whenever you change an input, so you can compare scenarios without reloading.
- Total permanent-hire cost for period
- Returned as a money amount in US dollars. It recalculates instantly whenever you change an input, so you can compare scenarios without reloading.
- Productivity ramp cost (permanent hire)
- Returned as a money amount in US dollars. It recalculates instantly whenever you change an input, so you can compare scenarios without reloading.
FAQ
What's a typical locum tenens day rate for physicians?
Physician locum day rates commonly run $1,200-2,500 depending on specialty, with surgical and anesthesia specialties running higher. Agencies typically also cover travel, housing, and malpractice, which is why the all-in day rate is higher than the physician's direct take-home per day.
Does the productivity ramp penalty apply to every new hire?
Yes, to some degree — new physicians take time to build a patient panel, learn the EHR and workflows, and reach the referral volume a departing physician had. Specialties with high procedural volume or established patient panels being transferred ramp faster than those building a panel from scratch.
When does locum coverage stop being the cheaper option?
Once a coverage period stretches past roughly 12-18 months, the persistent locum day-rate premium (which includes the agency's margin) usually exceeds the one-time costs of a permanent hire, even accounting for ramp-up. Long-term or permanent vacancies should default toward hiring unless recruitment is genuinely not possible.
Should malpractice tail coverage be included in this comparison?
For permanent hires with claims-made malpractice policies, factor in tail coverage cost if the position doesn't work out and the provider leaves — this can run 150-300% of one year's premium and is a real cost risk that pure locum coverage (where the agency handles malpractice) doesn't carry.
Accuracy and limitations
- Results are estimates before tax, fees, and inflation unless an input explicitly covers them.
- Rates are treated as fixed for the whole period — variable-rate products will drift from this projection.
- This is educational maths, not financial advice. Check anything contractual with the lender or your accountant.
Related tools
Cite this calculator
Writing about this topic? Grab a citation — every link helps keep these tools free.
RevenueLab. (2026). Locum Tenens vs Permanent Hire Cost Calculator. Retrieved from https://www.revenuelab.fyi/toolbox/locum-tenens-vs-hire-cost
<p>Source: <a href="https://www.revenuelab.fyi/toolbox/locum-tenens-vs-hire-cost" target="_blank" rel="noopener">Locum Tenens vs Permanent Hire Cost Calculator — RevenueLab</a> (2026).</p>
Source: [Locum Tenens vs Permanent Hire Cost Calculator — RevenueLab](https://www.revenuelab.fyi/toolbox/locum-tenens-vs-hire-cost) (2026).