How to Choose a Locum Tenens Agency

The agency you sign with shapes your locum experience more than most providers expect. It decides which assignments you ever hear about, how fast you get credentialed, what your malpractice coverage actually protects, and how much administrative weight lands on you instead of on someone else.

 With the U.S. facing a projected shortfall of up to 86,000 physicians by 2036, new firms continue to enter an already crowded market, making the choice harder, not easier. Two providers with identical specialties and identical availability can have completely different years depending on which agency picked up the phone first.

So the short answer to how to choose a locum tenens agency is this: choose the one that consistently brings you assignments worth taking, protects you with the right malpractice coverage, pays transparently, and treats the relationship as a partnership rather than a transaction. 

The rest of this guide explains how to tell which agencies actually do that, which questions surface the truth quickly, and which red flags should end a conversation.

Quick Answer: How to Choose a Locum Tenens Agency

• Weigh eight factors: assignment quality, the consultant relationship, credentialing speed, malpractice coverage, pay and contract transparency, travel and logistics, reputation and ethics, and communication.
  
• Confirm malpractice coverage in writing before you sign. Occurrence and claims-made-with-tail both protect you fully; what matters is knowing which one you have and who pays for tail.
  
• Start with NALTO membership as your fastest filter for basic industry accountability.
• Favor depth of relationship over breadth of registration. One or two agencies that consistently deliver beat a long list that treats you as interchangeable.
  
• Walk away from pressure to commit before you have seen the contract, vague malpractice answers, and assignments that clearly do not fit your stated preferences.

What a locum tenens agency actually does for you

A locum tenens agency is more than a job board with recruiters attached. A good one serves as the operational layer between you and the facility, handling the work that would otherwise consume your time and pose risk. Understanding that role is what makes the evaluation criteria below meaningful.

A full-service locum tenens agency typically handles:

• Sourcing and matching assignments to your specialty, license, schedule, and pay expectations
• Negotiating your rate and contract terms with the facility
• Managing credentialing and hospital privileging paperwork
• Coordinating state licensing, including Interstate Medical Licensure Compact (IMLC) applications where eligible
• Providing and administering malpractice insurance for the assignment
• Arranging and paying for travel and housing
• Handling billing with the facility so you are paid correctly and on time
• Offering support while you are on assignment when something goes wrong

The difference between agencies is rarely whether they do these things. It is how well they do them, how transparent they are about the details, and whether the people doing the work treat you like a colleague or a line item.

The eight factors that matter most when choosing an agency

When you compare locum tenens agencies, weigh these eight factors. The table gives you the standard to hold each agency to and the single question that exposes how they actually perform.

Factor	What “good” looks like	Question to ask	How All Star delivers it
Assignment quality and inventory	Real depth in your specialty and the states you want, not a thin list padded with stale postings	“How many active assignments do you have right now in my specialty and my target states?”	Deep, longstanding client relationships across more than 150 hospital systems and 1,600+ facilities; consultants negotiate rates and terms on your behalf
Consultant relationship	A consistent point of contact who learns your preferences and does not churn	“Will I work with one dedicated consultant, and how long have they been with the company?”	A specialty-team model pairs you with a dedicated expert in your field, reflected in a 99.5% rematch rate
Credentialing and licensing	A dedicated team that drives the paperwork, with realistic timelines	“Who manages credentialing, and what is your average time to get a provider working?”	A full-service team manages credentialing, hospital privileging, and state licensing, including IMLC applications where eligible
Malpractice insurance	Occurrence coverage, or claims-made with tail included, confirmed in writing	“What type of malpractice policy do you provide, and is tail coverage included?”	Malpractice and tail coverage are included with the assignment, along with state licensing costs (confirm your policy type in writing)
Pay and contract transparency	Clear rates, no vague “we’ll figure it out,” and contracts you can actually read	“How is my rate structured, and can I see the assignment contract before I commit?”	Consultants explain how your rate is structured and walk you through the contract before you commit
Travel and logistics	Travel and housing arranged and paid by the agency, not reimbursed weeks later	“Do you book and pay for travel and housing directly, or do I front the cost?”	Travel and housing are arranged and covered as part of the assignment, so you are not fronting costs
Reputation and ethics	NALTO membership, verifiable reviews, and references from providers in your specialty	“Are you a NALTO member, and can you connect me with a provider in my specialty?”	NALTO member and 2026 ClearlyRated Best of Staffing winner (Client and Talent), based on independently verified surveys
Communication and support	Responsive during business hours and reachable when an assignment goes sideways	“If my flight is canceled the night before a shift, who do I call?”	Your dedicated consultant stays reachable throughout the assignment, not just at signing

Three of these deserve extra attention because they are where providers most often get burned.

Assignment quality matters more than assignment quantity. An agency with thousands of postings but little depth in your specialty will keep sending you mismatches. You want a consultant who can name real, current openings that fit you, not one who promises that something will come up.

The consultant relationship is the part you live with day to day. A responsive, honest consultant who remembers that you will not take call-heavy assignments is worth more than a slightly higher rate from an agency that treats you as interchangeable. Ask how long your consultant has been there. High turnover on the agency side becomes your problem.

Malpractice coverage is the factor most providers underweight and the one that can cost the most if it goes wrong. It gets its own section below.

Malpractice coverage: the one thing to get in writing

Most agencies provide malpractice insurance as part of the assignment, but the type of policy matters, and the language is easy to gloss over. Get this in writing before you sign anything.

Two policy structures are common, and both can fully protect you. What matters is knowing which one you have and confirming the details in writing.

Coverage type	What it covers	What to confirm
Occurrence	Any claim arising from work done during the policy period, even if the claim is filed years later	That the policy is genuinely occurrence-based; if so, you are covered with no further action
Claims-made	Claims filed while the policy is active	That tail coverage is included or arranged, so you are not exposed after the assignment ends
Tail coverage	Extends a claims-made policy to cover claims filed after it ends	Whether it is included and who pays for it: you or the agency

Why this matters: malpractice claims in many specialties surface months or years after the care was delivered. With occurrence coverage, you are covered no matter when the claim lands. With a claims-made policy, you are equally protected as long as tail coverage is in place; without it, you can be personally exposed for care you provided on an assignment that ended long ago. Ask every agency, in writing, which type they provide, and if it is claims-made, whether tail is included and who pays for it. An agency that answers clearly and puts it in the contract is showing you how they operate. One that gets vague is telling you something too.

Note: This guide is general information, not legal advice. For high-value, long-term, or complex contracts, independent legal review is worth the cost.

Questions to ask before you sign with an agency

Use this as a script on your first real conversation. The goal is not to interrogate anyone. It is to see how clearly and honestly the agency answers.

Assignments

• How many active openings do you have in my specialty and target states right now?
• How are assignments matched to my preferences and availability?
  

Pay and contracts

• How is my rate structured, and what is and is not included?
• Can I review the assignment contract before committing?
• How and how often will I be paid?
  

Credentialing and licensing

• Who handles credentialing, and what is your average time to a first assignment?
• Will you manage my state licensing and IMLC applications?
  

Malpractice

• Is the policy occurrence-based or claims-made?
• If claims-made, is tail coverage included, and who pays for it?
  

Support

• Will I have one consistent consultant?
• Who do I reach if something goes wrong during an assignment, including after hours?

Red flags to watch for

A few warning signs should make you slow down or walk away:

• Pressure to commit before you have seen the contract. A rate quoted only verbally tends to change.
• Vague or shifting answers about malpractice coverage. This is too important to be fuzzy.
• A recruiter who pushes assignments that clearly do not match your stated preferences. It signals they are filling their gap, not serving you.
• No NALTO membership and no verifiable reviews or references. Reputable agencies are easy to check.
• High turnover on the agency side, so you keep starting over with someone new.
• Asking you to front travel or housing costs and “get reimbursed later.”
• Reluctance to connect you with a current provider in your specialty.

None of these alone proves an agency is bad, but two or three together is a pattern worth respecting.

Should you work with one agency or several?

Many providers register with more than one agency, especially early on, to see a wider range of assignments. That is reasonable, but there is an etiquette and a risk to manage.

The main risk is double presentation: two agencies submitting you to the same facility, which looks unprofessional and can disqualify you from the assignment entirely. Avoid it by keeping a simple record of where each agency has submitted you, and by telling every agency to confirm with you before presenting you anywhere.

Working with several agencies widens your options, but it also dilutes the relationship. A consultant who knows you are one of many tends to invest less. Many experienced locums eventually consolidate to one or two agencies that consistently deliver, because depth of relationship produces better assignments than breadth of registration. The right number is the one that keeps your calendar full with assignments you actually want.

How recruiter pay works, and why it affects you

Agency-side staff are typically compensated when they place you, often with a commission tied to the assignment. That is not sinister, but it explains a lot of behavior. A recruiter under pressure to fill a specific opening may steer you toward it even when it is a weak fit. The way to protect yourself is simple: be clear about your non-negotiables, monitor whether the agency respects them, and favor firms whose people behave as if they are building a long-term relationship rather than closing a single deal. Transparency about pay and contracts is the best signal that an agency’s incentives are aligned with yours.

The All Star Advantage

The agencies worth staying with share a pattern. They are transparent about pay and contracts; they handle credentialing and logistics, so you do not have to; they protect you with the right malpractice coverage, and the people you work with treat you like a colleague rather than a transaction.

At All Star Healthcare Solutions we have built our model around exactly that. Founded in 2003 and headquartered in Boca Raton, Florida, All Star matches physicians, nurse practitioners, physician assistants, and CRNAs across more than 85 specialties, all 50 states, more than 150 hospital systems, and more than 1,600 healthcare facilities. All Star is a NALTO member and a 2026 ClearlyRated Best of Staffing award winner for both client and talent service.

Specialty-team expertise, not a generalist desk

All Star works on a specialty-team model. You work with a consultant who is a dedicated expert in your field, not a generalist managing a mixed caseload. For a cardiologist, that means a consultant who understands cardiology credentialing timelines, market rates, and the clinical environment you are walking into.

Full-service credentialing, licensing, and coverage

All Star manages credentialing and hospital privileging, coordinates state licensing, and arranges travel and housing. The team covers malpractice insurance, tail coverage, and state licensing costs as part of the assignment. As with any agency, confirm your specific policy type in writing before you sign.

A relationship built to last

All Star maintains a 99.5% rematch rate, a direct reflection of providers who come back. And because All Star offers both locum tenens and permanent placement, a provider who starts in locum work and later wants a permanent role can make that move without starting over with a new agency. This is a long-term career partnership, not a one-assignment transaction.

Recognized service

All Star has earned repeated “Best Places to Work” and “Top Workplace” recognition, along with the ClearlyRated 2026 Best of Staffing Client and Talent awards, which are based on independently verified surveys of the clients and providers it serves, not self-reported testimonials.

If you are new to this model, it is worth understanding what locum tenens is and how it works before you commit to an agency. And if you are weighing your options, see how All Star compares in our breakdown of the top locum tenens companies.

Ready to find the right locum tenens partner?

Whether you are exploring locum tenens for the first time or ready to find your next assignment, the most useful next step is to talk to a consultant who will be straight with you. All Star’s consultants specialize by field and will tell you what they actually have in your specialty and target states.

Submit your CV or browse current locum tenens jobs to see what kind of assignments and conversations to expect. 

Frequently asked questions

Are locum tenens agencies worth it?

For most providers, yes. A good agency handles credentialing, licensing, malpractice, travel, and billing, and negotiates your rate, which frees you to focus on clinical work. The value depends heavily on choosing an agency that is transparent and responsive.

Can I work with more than one locum agency?

Yes, and many providers do, especially when starting out. Just track where each agency submits you to avoid double presentation to the same facility, which can cost you the assignment.

Who pays for malpractice insurance on a locum assignment?

The agency typically provides and pays for malpractice coverage during the assignment. Confirm whether it is occurrence-based or claims-made, and if it is claims-made, confirm that tail coverage is included and who pays for it.

How do I check a locum agency’s reputation?

Amongst other reputation signals, look for NALTO membership, read verified reviews on sites such as ClearlyRated.

Sources

National Association of Locum Tenens Organizations (NALTO) — member directory and code of ethics

Association of American Medical Colleges (AAMC) — physician workforce projections

ClearlyRated — Best of Staffing verified provider and client reviews

Interstate Medical Licensure Compact (IMLC) — multistate medical licensing