Diversify Like a Pro - Why You Shouldn’t Rely on One Locums Agency

Why You Shouldn’t Rely on One Locums Agency

Let’s be honest: the locums world is fragmented. Some physicians make the mistake of working with just one agency. It feels simpler, right?

One contract. One point of contact. One number to call.

But here’s the truth — no agency has it all. And relying on just one can limit your options, reduce your pay, and expose you to unnecessary risk. Even here at Send-it, we encourage physicians to have multiple lines in the water. Until a marketplace solution like Send-it has mass adoption from healthcare organizations, it’s smart to diversify — at least a little.

This isn’t about bashing agencies. It’s about playing the game with your eyes open and setting yourself up for long-term flexibility. We’ve worked with plenty of physicians who tried the one-agency route and ended up either underpaid, overworked, or stuck.

Agencies Are Not Created Equal

Not all agencies are built the same. Some are bloated. Some are sneaky. Some are actually pretty great. But most are looking out for themselves first — not you.
There are three common routes for finding locums work:

1. Large agencies – High volume of jobs, but often lower rates, high overhead, and minimal transparency
   
2. Smaller agencies – Better rates and service, but fewer opportunities and geographic limitations
   
3. Internal locums programs – Slightly more predictable shifts and lower overhead, but fewer rights and less flexibility
   

Each of these can be part of your locums strategy, but relying solely on one path can leave you exposed — and likely underpaid.

Diversification = Protection and Leverage

Think about how you invest your money. Would you put 100% into one stock?

Of course not. You diversify. You spread out your risk and give yourself a better chance to win. Locums should be no different:

• Diversification protects your income if one site suddenly drops shifts
• It gives you leverage to negotiate better rates and terms
• It prevents burnout from over-reliance on a single facility or schedule

Some physicians build a smart mix of local part-time work plus 1–2 locums sites they rotate through. If one dries up, the others keep the schedule full.

Control Where, When, and For How Much You Are Presented

We’ve seen it too often: a physician takes one phone call with a recruiter, and suddenly that agency “owns” their ability to work at that healthcare organization with any other agency. They submitted you — sometimes without permission.

That’s clearance. It’s like a digital leash or a sneaky non-compete.

Even if another agency has a better offer for the same job, you’re blocked. That’s not just frustrating — it’s damaging to your earning potential and flexibility.

Tip: Always ask, "Are you clearing (or presenting) me, or just checking my interest?" Never let an agency present you without written consent.

What About Internal Locums Programs?

Internal programs are marketed as more stable and direct. And sometimes, they are. Healthcare organizations build internal locums teams to avoid the high agency overhead and keep their costs low.

Although you may have more stability and pay that’s competitive (or better) than what an agency would offer, make no mistake — you’re still premium labor. If patient volume dips or positions get filled, internal departments are under pressure to cut costs quickly. Guess who’s the first to go?

Good news: they’ll likely drop external agencies first, then internal locums next. However, being “in-house” doesn't mean you're safe — just that you're slightly closer to the budget cuts.

Also, internal programs may ask you to cover undesirable locations or shifts as a condition for staying active.

Treat them like any other agency: useful, but not your only lifeline.

Tips and Tricks for Diversifying

You don’t need 10 agencies — in fact, that’s a recipe for chaos. Here’s what we recommend:

• Start with 2–3 trusted agencies that communicate well and offer transparency
  
  
• Track your submissions in a spreadsheet or simple note app so you always know where you’ve been cleared
  
  
• Ask the right questions before moving forward (facility, rate, coverage, overhead, travel, housing)
  
  
• Create your own system for evaluating opportunities based on your goals: pay, location, clinical fit, schedule
  
  

At Send-it, we use technology to simplify this juggling act. All the details — the rate, facility, schedule, and required steps — are displayed clearly in our platform. You can see exactly where you are in the process, what’s needed from you, and which shifts are confirmed — all in one place, no phone tag required.

The goal isn’t more volume — it’s smarter options.

Final Takeaways

• No single agency has everything — and those that claim to often have the worst pay
• Clearance is a trap that can quietly limit your future opportunities
• Internal programs aren't a guarantee of consistency — they’re still vulnerable to volume swings
• A thoughtful mix of 2–3 channels keeps your income protected and your options open