Royal Surgical Associates blog

From the OR to the Boardroom: How Clinicians Are Trading Scrubs for a Career in Physician Recruiting - Royal Surgical Associates Royal Surgical Associates

Steve Mastrocola — Mon, 03 Aug 2026 16:00:00 GMT

For years, your calendar revolved around call schedules, back-to-back cases, and the unpredictable rhythm of hospital life. You know what it’s like to be on your feet for twelve hours straight, to miss dinner with your family because a case ran long, and to feel the slow burn of burnout creeping in even though you love medicine.

So what happens when you still want to use everything you know about healthcare, but you’re ready for a different kind of impact?

At RSA, we’ve been cultivating an answer: a pathway that takes clinicians from the OR to the boardroom and into careers in clinician recruiting. It’s not a common career move, and it’s not for everyone, but for the right person, it’s one of the most natural transitions in healthcare.

The Skills You Already Have

Here’s the part most people don’t expect: the qualities that made you excellent in the OR, on the floor, or in the clinic are the exact same qualities that make a great recruiter.

You already speak the language. You know the difference between a hospitalist and an intensivist, what a “1099 vs. W2” locums assignment actually means in practice, and why a facility’s call burden matters more than the base rate. That fluency is something recruiters spend years trying to learn from the outside.

You know how to build trust fast. Every patient interaction trained you to listen, read a room, and earn confidence quickly. Those same skills help you match providers with the right assignment.

You understand what “a good fit” really means. You’ve worked in enough different environments to know that a facility’s culture, pace, and support staff matter just as much as the pay package.

You’re not starting from zero. You’re translating a skill set, not replacing one. It’s exactly why RSA has made developing clinicians into recruiters a deliberate part of how we build our team.

What the Day-to-Day Actually Looks Like

Instead of rounding, you’re on the phone with providers, understanding what they’re looking for in their next assignment: flexibility, location, specialty focus, and income goals. Then you match those needs with real opportunities.

Instead of charting, you’re managing candidate pipelines, negotiating contracts, and helping facilities solve staffing gaps that keep patients cared for.

For many former clinicians, the biggest shift isn’t the work itself. It’s where you do it. Clinical recruiting is one of the rare healthcare-adjacent careers that’s fully remote. No commute. No scrubs. No hospital badge. Just a laptop, a phone, and a headset, wherever home happens to be.

The Income Potential Is Real

We won’t promise you a number. Anyone who does is getting ahead of themselves.

What we can tell you is that leaving clinical work doesn’t have to mean starting over financially. Recruiter compensation is typically structured as base plus commission, so your earning potential is tied to your performance, not your tenure.

For clinicians who bring real credibility and work ethic to the role, that structure has real upside. It takes time to build a pipeline and a reputation, just as it took time to build your clinical career. For those who put in the work, it’s genuinely possible to do well.

Understanding the Recruiter Compensation Structure

Income in this field usually relies on a mix of base salary and performance incentives.

♕

RSA Locums

Recruiter Compensation

Compensation Type	Typical Range	Details
Base Salary	$60,000 – $80,000	Provides a stable foundation for early and mid-career specialists.
Commissions	$1,000 – $40,000+	Performance-based bonuses tied directly to successful placements and contract negotiations.
Total Compensation	$150,000 – $300,000+	Experienced recruiters in high-demand markets frequently clear the six-figure mark when combining base, commission, and other incentives.

Your Partner in Locum Tenens Staffing | rsalocums.com

Why Now?

Healthcare staffing shortages aren’t going away. Facilities need locum and permanent providers more than ever, and they need recruiters who can have a credible, informed conversation with a clinician about what a role actually demands, not just what’s on a job posting.

That’s a gap clinicians are uniquely positioned to fill. It’s why RSA has chosen to invest in this pathway rather than treat it as an afterthought. Most staffing firms don’t build this bridge on purpose. We do.
uniquely positioned to fill.

Making the Leap, With RSA

Trading the OR for the office doesn’t mean walking away from medicine. It means stepping into a role where your clinical background becomes your competitive advantage. You can still change outcomes for patients and providers, just from a different seat at the table.

This isn’t a well-worn career path, and we’re not aware of many firms in this industry actively building one. That’s the point.

RSA is investing in clinicians who want to make this move because we believe it makes us better at what we do. We also want to help you figure out if it’s the right move for you.

If you’ve ever found yourself explaining to a colleague what a good assignment looks like, or fielding calls from recruiters and thinking “I could do this better”, that instinct might be worth listening to.

Curious what a career in recruiting at RSA could look like for you? Reach out to our team to learn more about this pathway and how your clinical expertise could translate into a rewarding career in healthcare staffing.

Speak with a Recruiter Today

Call or Text: (217) 673-0728

How to Structure Your CV To Get Placed at Locums Roles Faster - Royal Surgical Associates Royal Surgical Associates

Steve Mastrocola — Tue, 07 Jul 2026 16:00:00 GMT

A locum tenens CV has one job: make it easy for a hospital to say yes.

That doesn’t mean it needs fancy formatting, a long personal statement, or a design-heavy layout. It needs to show, quickly and clearly that you’re licensed, qualified, current, and ready to work.

For physicians, CRNAs, nurse practitioners, and physician assistants, a clear and concise CV can make a real difference. Locum assignments often move fast. A hospital may need coverage because a provider resigned, patient volume increased, leave coverage came up, or a schedule gap has to be filled.

When two qualified providers are available, the one with the cleaner CV and better credentialing file is often easier to move forward.

Your CV Is More Than a Career Summary

A traditional resume is built to get an interview.

A locum tenens CV is built to support credentialing.

Hospitals and medical staff offices need to verify your license, certifications, training, education, work history, and clinical qualifications before you can start. The Joint Commission requires primary source verification for licensure, certification, or registration when required by law or regulation, which means facilities must confirm key credentials through the original source or an approved source.

That’s why missing dates, vague job titles, and outdated license information create delays.

Use month and year for every role. Write January 2022 to June 2024, not just 2022 to 2024. Include every clinical position, hospital affiliation, locum assignment, training program, and employment gap.

A clean timeline builds trust.

What Hospitals Want to See First

Temporary privileges may be used for new applicants awaiting review, and The Joint Commission notes that these privileges are limited to no more than 120 consecutive days for new applicants. That puts pressure on the process. The cleaner your file is, the easier it is for a recruiter and facility to keep things moving.

Make sure your CV clearly shows:

Full legal name, credentials, phone number, email, and home state
Specialty and subspecialty
Education, residency, fellowship, and clinical training
Board certification or eligibility
Active licenses with state, license number, and expiration date
DEA registration and state controlled substance registration, when needed
Current certifications such as BLS, ACLS, PALS, ATLS, or NRP
Complete work history with month and year dates
Hospital affiliations and privileges
Recent locum tenens assignments
EMR systems used
Procedure logs or case logs when relevant
Malpractice history
Professional references

Don’t make the hospital hunt for the basics.

Make Your Recent Experience Easy to Find

Locum assignments are usually tied to a specific need.

A hospitalist role may require recent inpatient experience. An anesthesia assignment may require current case volume, call experience, and comfort with specific procedures. An urgent care role may require high-volume patient care, suturing, splinting, occupational medicine, or pediatric experience.

Put the most relevant experience where it can be seen.

If you’re a CRNA applying for a regional anesthesia assignment, list your recent anesthesia settings, case types, call experience, supervision model, and EMR experience. If you’re an NP or PA applying for urgent care, list patient volume, procedures, ages treated, and whether you’ve worked independently or with physician support.

The point is not to write more.

The point is to remove doubt.

Explain gaps before they create questions.

Time away from practice does not automatically make you a weak candidate.

Unexplained time does.

If you took time off for family, caregiving, relocation, licensing, health, military service, education, or personal reasons, include a short professional note in your timeline.

Examples:

March 2023 to July 2023: Family caregiving leave

August 2024 to October 2024: Relocation and state licensing transition

January 2025 to March 2025: Medical leave, returned to full clinical practice

Hospitals don’t need private details. They need a clear record.

A clean explanation is better than a blank space.

Build a Credentialing Folder Before You Need It

The strongest locum candidates are ready before the assignment opens.

Create a digital folder with current copies of your CV, licenses, DEA registration, certifications, diplomas, residency or fellowship certificates, board documents, immunization records, TB test, malpractice history, references, NPI confirmation, government ID, and procedure logs.

Use simple file names.

Example: Taylor_Jordan_CRNA_ACLS_Expires_2027.pdf

This saves time when a recruiter asks for documents and the facility needs them quickly. It also signals that you’re organized, responsive, and serious.

Those things matter when hospitals are deciding who can fill a need without delay.

Multi-State Licensing Can Make You More Competitive

If you want more locum options, licensing matters.

Providers who can work in more than one state are easier to match, especially for local and regional assignments near state lines. A clinician in Pennsylvania, New Jersey, Ohio, Texas, Tennessee, or the Carolinas may have more opportunities by being licensed across nearby markets.

For physicians, the Interstate Medical Licensure Compact offers an expedited pathway for qualified physicians who want licenses in multiple participating states. The IMLC does not give one universal license. It helps eligible physicians apply for separate licenses in the states where they intend to practice.

For nurses, the Nurse Licensure Compact allows eligible RNs and LPNs/VNs to hold one multistate license and practice in other compact jurisdictions.

For nurse practitioners and CRNAs, be careful. The NLC applies to RN and LPN/VN licensure, not APRN practice authority. APRNs must meet the APRN licensing requirements in each state where they practice.

For physician assistants, the PA Compact is moving forward, and day by day we are getting closer to PAs streamlining licensure across state lines.

The strategic move is simple: ask your recruiter which nearby licenses would make you more marketable. One additional state license can open assignments that other providers can’t accept.

References Should Be Ready to Respond

A great CV can stall if references don’t answer.

Choose references who know your recent clinical work and are willing to respond quickly. Ask them in advance. Tell them you’re pursuing locum tenens assignments and that hospitals or agencies may contact them.

Strong references can speak to your reliability, clinical judgment, communication, documentation, and ability to step into a new setting.

Fast references help you look ready.

Slow references can cost you the assignment.

Show That You Can Start Strong

Hospitals want providers who can function with limited ramp-up time.

That doesn’t mean you need to know every facility’s process before you arrive. It means your CV should show that you adapt well.

Include EMR systems you’ve used, such as Epic, Cerner, Meditech, Athenahealth, eClinicalWorks, or other platforms. Note experience with different care settings, patient volumes, call schedules, team structures, and procedure types.

If you’ve worked locums before, say so clearly.

Prior locum experience tells a facility that you understand temporary assignments, fast onboarding, new teams, and variable workflows.

Common CV Mistakes That Slow Providers Down

Most CV problems are easy to fix.

Avoid these:

Listing years without months
Leaving out short-term assignments
Forgetting license expiration dates
Using old certification information
Leaving gaps unexplained
Hiding malpractice history
Listing references without permission
Sending a CV that does not match your application
Failing to include EMR experience
Using a resume when a full CV is needed

Accuracy beats polish.

A complete CV with clear dates is more useful than a beautiful one-page resume that leaves the hospital with questions.

Get Your CV Ready Before the Right Assignment Opens

Locum tenens opportunities can move quickly, especially when a facility needs coverage now.

The best time to update your CV is before you see the assignment you want.

Clean up your timeline. Add your licenses. Confirm your references. Organize your credentialing folder. Ask which state licenses could make you more competitive.

RSA Locums helps physicians, CRNAs, nurse practitioners, and physician assistants prepare for local, regional, and travel locum assignments with the right recruiter support and placement strategy.

Your experience may already qualify you.

A better CV can help you move faster when the right opportunity opens.

Why Work With RSA Locums?

Local and regional opportunities can be easy to miss if you’re only thinking about traditional travel assignments. RSA Locums helps physicians, CRNAs, nurse practitioners, and physician assistants identify assignments that match their location, schedule, income goals, and clinical background.

That includes opportunities close to home.

Talk with RSA Locums about local and regional assignments near you, and find out whether flexible, high-paying work is closer than you think:

Available Travel Assignments

Speak with a Recruiter Today

Call or Text: (217) 673-0728

Local Locum Tenens Assignments: The High-Paying Career Option You Might Be Overlooking - Royal Surgical Associates

Steve Mastrocola — Thu, 18 Jun 2026 16:00:00 GMT

Local Locum Tenens Assignments: The High-Paying Career Option You Might Be Overlooking

You don’t always have to fly across the country to take a locum tenens assignment.

For many physicians, CRNAs, nurse practitioners, and physician assistants, the best opportunity may be one or two towns over.

Local and regional locum tenens assignments give providers a way to earn strong contract income, keep their schedule flexible, and still come home to the people who need them. You might work three days a week in another city, stay one or two nights if needed, and be back home for school pickup, family dinner, weekend games, or your own medical appointments.

That option matters.

Not every clinician can travel full time. Some have kids in school. Some care for aging parents. Some have a spouse or partner with a fixed schedule. Some are managing their own health needs and can’t be gone for weeks at a time.

Local locums gives those providers another path.

What Is a Local Locum Tenens Assignment?

A local locum tenens assignment is a short-term clinical contract close enough to your home that long-distance travel isn’t required.

That may mean commuting 30 to 90 minutes to a nearby hospital, clinic, surgery center, or specialty practice. It may also mean working a regional assignment a few hours away, staying overnight during your scheduled shifts, then returning home for your days off.

The assignment is still locum tenens. You’re filling a temporary coverage need.

The difference is location.

Instead of relocating for weeks or months, you stay within reach of your normal life. You can take a contract in a nearby town, work the agreed schedule, earn contract pay, and return home when your block of shifts is complete.

Who Is Eligible for Local Locum Tenens Work?

Local assignments are usually open to the same providers who qualify for other locum tenens roles.

That includes physicians, CRNAs, nurse practitioners, and physician assistants with an active license, appropriate board certification or eligibility, current clinical experience, and the ability to meet a facility’s credentialing requirements.

Most facilities will look for:

An active state license
Current certifications for your specialty
Recent experience in the setting they need covered
DEA registration when required
Clean and complete credentialing documents
Availability that matches the facility’s coverage need
Willingness to commute or stay overnight if the assignment is regional

Some assignments move quickly. A facility may need coverage because a provider resigned, volume increased, leave coverage came up, or a schedule gap has to be filled.

That’s why being organized helps.

If your license, CV, references, malpractice history, immunization records, and certifications are current, you’ll be in a better position to move when a good local opportunity opens.

Why Local Assignments Are a Good Fit for Providers Who Can’t Travel

A lot of clinicians like the idea of locum tenens work but assume it means being away from home.

That assumption keeps people from exploring opportunities that may actually fit their life.

Local assignments can work well when you:

Have children in school
Share caregiving responsibilities
Need to stay close to your own doctors or specialists
Have a spouse or partner with a fixed work schedule
Want extra income without leaving your community for weeks
Are testing locums before committing to more travel
Want schedule control without giving up clinical income

Maybe you can’t (or don’t want to)leave the state for a 13-week assignment because you have kids at home? A local contract 90 minutes away could still work. You could potentially arrange it so that you drive in Monday morning, work three 10-hour shifts, stay two nights, and be home Thursday.

That can change the entire equation.

The provider earns strong money. The family routine stays intact. The facility gets needed coverage.

What Can You Earn on a Local Assignment?

Rates vary by specialty, location, urgency, schedule, and facility need. Still, current public locum listings show why local assignments can be worth a serious look.

Recent CRNA locum postings list rates around $220 to $250 per hour, with some assignments at $250+ per hour.

At $240 per hour, working (3) 10-hour shifts grosses $7,200 per week

Over a 13-week assignment, that’s $93,600 before taxes

Physician rates are even higher. Current Anesthesiologist locum postings show rates around $300 to $350 per hour, with some specialities commanding rates of $400 per hour.

At $325 per hour, working (3) 10-hour shifts pays $9,750 per week
Over 13 weeks, that’s a whopping $126,750 before taxes

For advanced practice providers (APP), expect rates in the $125 – $150 per hour range.

At $135 per hour, (30 10-hour shifts grosses $4,050 per week before taxes

Over 13 weeks, that’s $52,650 before taxes

^That’s the appeal.

A local assignment doesn’t have to replace your entire career plan. It can be a way to add meaningful income, create breathing room, or move toward a more flexible work model.

Local Doesn’t Always Mean Daily Commuting

Some local assignments are true commute assignments. You drive there, work your shift, and sleep in your own bed.

Others are regional. That may mean the assignment is close enough to make sense, but far enough that staying overnight is safer and more practical.

For example, a provider might live in one city and work three days a week in another town two hours away. Instead of driving back and forth every day, they stay near the facility during their work block and return home after the last shift.

That setup can be especially useful for night shifts, long days, call coverage, or winter driving.

It also expands your options. If you only look within 30 minutes of home, the list may be short. If you’re open to a 90-minute or two-hour radius, more assignments may become available.

Local travel arrangements are also really attractive to the facility. Instead of paying for airfare, lodging, and M&IE, they are just covering your mileage and maybe a daily per diem. You also know the area, and that context can help you onboard faster without the “new city” anxiety.

The Tax Piece Matters

Local assignments may be paid differently than travel assignments.

If you commute from your home every day, your income is generally treated as taxable wages or contractor income, depending on how the assignment is structured. Regional assignments may involve mileage, lodging, or meal support, but tax treatment depends on your situation, distance, and whether you’re duplicating living expenses.

Don’t guess.

Before accepting an assignment, ask how compensation is structured and speak with a qualified tax professional. The goal is simple: understand your real take-home pay before you commit.

How to Know if a Local Assignment Is Worth It

A local locums assignment should make sense financially, clinically, and personally.

Before saying yes, ask:

How many shifts are guaranteed?
What is the hourly rate?
How long is the assignment?
What is the commute in real traffic?
Will mileage be reimbursed?
Is lodging included for regional work?
What days and hours are required?
Is call required?
What EMR does the facility use?
How long does credentialing take?
Who covers malpractice insurance?

The best assignment is not always the highest hourly rate.

A three-day-a-week role with a clean schedule, reasonable commute, and strong rate may be better than a higher-paying assignment that creates stress at home or forces unsafe travel after long shifts.

Why Work With RSA Locums?

That includes opportunities close to home.

Talk with RSA Locums about local and regional assignments near you, and find out whether flexible, high-paying work is closer than you think: Available Travel Assignments

Speak with a Recruiter Today

Call or Text: (217) 673-0728

How to Travel Locum Tenens With a Family: Housing, School, Travel Tips - Royal Surgical Associates

Steve Mastrocola — Thu, 28 May 2026 16:00:00 GMT

How to Travel Locum Tenens With a Family: Housing, School, Travel Tips

Traveling as a locum tenens family works when you plan around housing, schooling/childcare, and transportation before you sign the contract. The best setup depends on assignment length, your children’s school needs, and whether your spouse can work remotely. This guide breaks down housing options, move logistics, and decision rules that reduce stress.

For many healthcare professionals, the locum life is synonymous with solo adventure. However, a growing number of clinicians are discovering that traveling with families is a great way to build memories, experience new environments, and avoid the burnout of traditional practice.

Whether you’re bringing a spouse, kids, or four-legged family members, successful locum travel requires some planning. This guide covers the housing options that actually work for families, the logistics that prevent last-minute chaos, and the decision rules that tell you when it’s smarter for the clinician to travel solo.

Housing Options: Finding Your Home Away from Home

Housing is the biggest variable when traveling with a family. Families need more space and basics like kitchens and laundry, so a standard hotel room usually won’t work for weeks at a time. The smart move is to pick a housing plan that matches your contract length, your shift schedule, and your kids’ routines, then lock it in early so the rest of the assignment feels manageable.

Housing drives your day-to-day quality of life on assignment. Space matters. Kitchens, laundry, and separate sleeping areas matter more.

Short-Term Rentals (Airbnb & VRBO)

Most locum families start here because it’s the easiest way to get bedrooms, a kitchen, and laundry in one place. Ask about monthly discounts if your contract is 30+ days. Confirm what’s included before booking: Wi-Fi speed, parking, pet rules, and what “fully furnished” actually means.

Corporate Housing

Some facilities and recruiters can place you in corporate housing through preferred vendors. These units are usually furnished, utilities are typically included, and you may get community extras like pools, gyms, or playgrounds. The tradeoff is less flexibility on location and layout. Pro Tip: When traveling with a family, always ask your recruiter about taking a tax-free housing stipend to help offset the cost of securing a larger multi-bedroom space.“

Extended Stay Hotels

Extended-stay brands can work for short contracts or a “landing zone” while you hunt for a rental. Free breakfast and housekeeping reduce stress fast. The limitation is space, especially if you’ve got more than one child or you’re traveling with pets. Brands like Residence Inn or Homewood Suites offer suites with kitchenettes.

The RV Life

RV setups are common for clinicians who want consistency even when the zip code changes. RV parks can be the most pet-friendly option and simplify packing. The real constraint is weather, school logistics, and where you can park safely near the facility.

Who covers housing and utilities?

This depends on the contract. Some assignments include agency-arranged housing, others offer a stipend or reimbursement structure. Don’t guess. Get it in writing before you commit, including what happens if the assignment ends early or shifts dates.

Should you drive or fly for a locums assignment?

Transportation is a money decision and a stress decision. The best option depends on length of assignment and how much of your home life you’re bringing with you.

How you get to your assignment depends greatly on the length of the assignment and the distance from your home base.

Drive when the assignment is regional

Driving your own SUV or minivan lets you bring bikes, car seats, pantry basics, and the stuff kids can’t live without. It also means you arrive with a familiar vehicle, which matters in unfamiliar cities.

Fly when the assignment is long-distance

For cross-country contracts, flying can reduce exhaustion and protect the first week of the assignment. For longer stays, shipping a few items can be cheaper than repeated baggage fees. If you ship, label everything and plan for delays so you’re not waiting on essentials.

Use movers only for true long-term relocations

Most families don’t need professional movers for short contracts. If you’re doing a permanent-to-locums transition or committing to 6+ months in one location, movers or a pod service can make sense.

Quick Decision Guide

Assignment length	Best setup for most families	Why it works
1–4 weeks	Drive if possible, pack light	Less complexity, fewer shipped items
1–3 months	Rental or corporate housing, drive if regional	Kitchen/laundry stability matters
3–6 months	Rental with monthly discount, ship select items	Comfort rises, travel fatigue drops
6+ months	Consider pod shipping or movers	At that point, you’re temporarily relocating

How do you handle school, childcare, and pets while traveling?

Living in a new city every few months requires a digital village. But, you don’t need a huge support system in every city. You need a repeatable process.

School options for locum tenens families

If your kids are school-aged, decide on education before you accept the assignment dates. Consider online homeschooling curriculums (like Khan Academy or Time4Learning), or local “Worldschooling” Facebook Groups.

Short stays: Some families keep routines stable and treat the contract like an extended trip.
Longer stays: Look at temporary enrollment, online programs, or homeschool plans that follow you.
Community support: Local parent groups and worldschooling communities can help you find activities and social connection fast.

Childcare without guessing on quality

Start with the facility. Ask if they have recommendations, employee networks, or childcare perks. Explore sites like Care.com or UrbanSitter. Always ask the facility where you are working if they have recommendations or facility sponsored childcare perks. Then use this checklist:

Confirm availability that matches your shift schedule
Ask about background checks and references
Do a video call first, then a short paid trial
Have a backup option ready for call shifts or unexpected schedule changes

Pet care that doesn’t break your schedule

If you’re traveling with pets, plan care like you plan childcare. Rover and Wag are essential for finding reliable walkers and sitters in unfamiliar territory.

Identify a local vet and emergency clinic in the first week
Confirm rental pet policies in writing
Set up a walker or sitter before your first long shift
Keep vaccines, meds, and microchip details accessible

Should you travel solo or bring the whole family?

Sometimes the best family decision is not relocating everyone. This is common if children are in school or a spouse has a non-remote career.

When solo travel makes sense

Solo is common when kids are in school, your partner can’t work remotely, or the assignment is short. In those cases, the clinician often goes alone, maximizes earnings, and returns home on planned breaks.

Block scheduling can keep everyone stable

For longer contracts, block schedules (example: 7 on, 7 off) can reduce disruption. It lets you spend off weeks at home, protect school routines, and still keep locums income in play.

A few questions to help you decide:

Is the assignment longer than 8 weeks?
Is block scheduling available? (i.e. 7 days “on”, 7 days “off”)
Will your housing cost rise materially if the family joins?
Are school or childcare changes realistic for the contract dates?
Can your partner work remotely, or would they take a career hit?
Do you have at least one backup plan if the contract changes?

If you can’t answer these questions, then the right move is to negotiate your start date, ask your recruiter for housing support, or consider a local or close-to-home assignment.

What are local locums assignments?

Yes, these exist! Local locums are drive-in assignments within commuting distance from home (usually 50-100 miles) They reduce travel costs and keep your family anchored at home.

Why facilities use local locums

Facilities use local coverage to fill gaps, manage seasonal volume, and test long-term fit. Some hospitals use locums as part of a locums-to-perm pathway when they want to “try the relationship” before a permanent offer.

When local locums is the best option for families

You want locums flexibility without moving kids or changing schools
Your partner’s job requires staying in one location
You’re near a metro with multiple hospital systems or outpatient networks

This approach keeps the upside of locum work while lowering the disruption.

Locum tenens as a family is a lifestyle decision, not only a career decision. The families who enjoy it most don’t wing it. They pick the right contract length, lock housing early, and build repeatable routines for school, childcare, and pets. Your first time traveling with family may seem daunting, but thousands of travelers have crafted a safe, lucrative, family lifestyle as “digital nomad” healthcare providers.

Thinking about taking the show on the road? If you’re exploring family-friendly assignments, start with openings that match your timeline and location needs: Available Travel Assignments

Speak with a Recruiter Today

Call or Text: (217) 673-0728

Securing Clinical Continuity: The Operational Case for Flexible Staffing - Royal Surgical Associates

Steve Mastrocola — Mon, 27 Apr 2026 16:00:00 GMT

Securing Clinical Continuity: The Operational Case for Flexible Staffing

The modern healthcare landscape presents a unique set of challenges for hospital leadership. As patient volumes grow and the competition for top tier clinical talent intensifies, the cost of an empty seat has never been higher. Recent data indicates that a single physician vacancy can result in losses of $8,000-$10,000 per day, more for surgical specialties.

This figure does not just represent lost billing opportunities. It reflects a disruption in patient care, a strain on existing resources, and a potential decline in community trust. Strategic staffing is no longer a temporary fix for a crisis. It is a vital component of operational resilience.

RSA Locums understands you are looking for a partner that can maintain the integrity of your clinical programs while safeguarding your financial health. This guide explores why a proactive approach to locum staffing is essential for the modern hospital.

The Hidden Financial Impact: Beyond the Base Salary

When evaluating locum tenens coverage, finance committees often compare the hourly locum rate directly against the base salary of a permanent FTE. In a healthcare landscape defined by tight operating margins, this incomplete equation creates a false sense of cost savings.

A fully loaded permanent physician carries an administrative and benefits burden that typically adds 40% to their base compensation.

To understand the true financial impact of an internal hire, administrators must account for three core areas of fixed overhead. By shifting these rigid liabilities into a variable model, forward-thinking facilities are unlocking a massive competitive advantage:

The Burden of Total Compensation
Payroll is only a fraction of the cost. Facilities absorb the compounding weight of health insurance premiums, maximum retirement matches, paid time off accruals, and continuing medical education stipends. These are recurring liabilities that hit the operating margin regardless of patient census. Strategic locum coverage allows you to transition to a precision-driven financial model where you pay exclusively for productive, revenue-generating clinical hours.
Capital-Intensive Talent Acquisition
Sourcing permanent clinical staff requires heavy upfront capital. Between retained search firm fees, specialized job board marketing, site visit logistics, and the internal bandwidth drained from your credentialing committee, the hard cost to acquire a single physician can reach six figures. Partnering with a premium locum agency allows you to bypass the months of candidate sourcing and gain immediate access to top-tier, pre-vetted specialists who are ready to generate direct patient revenue on day one.
Static Malpractice Liabilities
Permanent staff demand comprehensive, fixed premium malpractice and tail coverage. These policies remain static expenses on your balance sheet, offering zero flexibility during low volume periods. A strategic locum partnership completely removes that cost from your ledger. The complex and expensive burden of malpractice and tail coverage is absorbed by the agency, allowing you to secure the clinical excellence your facility demands with less financial liability and risk exposure.

Partnering with RSA fundamentally restructures this financial model. Your facility transforms rigid, compounding FTE liabilities into a highly efficient, variable cost structure.

You deploy capital exactly when and where patient demand requires it. RSA absorbs the operational friction by managing the malpractice policies, travel logistics, and administrative credentialing. This model delivers true operational leverage, allowing your leadership team to protect the bottom line while forecasting budgets with complete precision.

Maintaining High-Margin Service Lines

Every hospital has service lines that are critical to its financial stability. Whether it is a specialized surgical department or an advanced diagnostic unit, these areas cannot afford downtime. When a key provider is absent, the ripple effect is felt throughout the entire facility.

The Risk of Inaction	The RSA Solution
Procedure Cancellations: A lack of specialized coverage leads to delayed surgeries and lost revenue.	Rapid Deployment: We provide specialized clinicians who are ready to maintain your surgical schedule without interruption.
Referral Leakage: Patients who cannot be seen at your facility will seek care from competitors, potentially severing a long term relationship.	Continuity of Care: Our providers integrate into your system to ensure that your referral network remains intact.
Unit Underutilization: Empty rooms and idle equipment still incur maintenance costs without generating revenue.	Operational Efficiency: RSA ensures that your assets are utilized to their full potential, maximizing the utility of your facility.

Protecting Your Most Valuable Asset: Your Staff

One of the most dangerous consequences of a staffing gap is the impact on your permanent team. When a vacancy exists, the workload is distributed among the remaining physicians and nurses. In 2026, the direct cost of replacing a physician who leaves due to burnout is estimated to be between $80,000-$100,000.

Locum professionals serve as a pressure release valve. By bringing in high quality support, you demonstrate a commitment to the well-being of your core team. RSA providers report high levels of job satisfaction precisely because they are focused on clinical delivery rather than administrative politics. This positive energy can be infectious, helping to stabilize your internal culture during periods of high demand.

Clinical Excellence and Speed to Productivity

A common concern with temporary staffing is the time it takes for a new provider to become productive. RSA addresses this through a rigorous pre-vetting process that goes beyond simple background checks. We look for providers who possess both the clinical expertise and the “soft skills” required to thrive in a collaborative hospital environment.

Our goal is Speed to Productivity.

This means that when an RSA professional arrives at your facility, they are already briefed on your culture and operational expectations. We handle the heavy lifting of licensing and travel, ensuring that they are ready to step into the clinical rotation on day one.

Strategic Planning for a Volatile Future

The healthcare environment is increasingly unpredictable. Seasonal surges, sudden departures, and planned expansions all require a flexible approach to staffing models. Leading hospitals are adopting a “hybrid ecosystem” model. This involves maintaining a lean, high performing permanent core that is supported by a flexible pool of pre-vetted specialists from RSA.

This model allows you to scale your capacity up or down based on actual patient census. It provides a level of agility that a traditional staffing model cannot match. By treating locum tenens as a strategic tool rather than a last resort, you position your hospital to lead in an uncertain market.

Common Strategic Questions for Hospital Boards

How does RSA ensure quality among temporary providers?

Every provider undergoes a multi stage vetting process including primary source verification of credentials, peer references, and a review of clinical competency.

What is the long term value of a locum partnership?

Beyond filling immediate gaps, RSA provides data and insights that help you understand your staffing patterns, allowing for better long term workforce planning.

How do we manage the integration of temporary staff?

We work closely with your medical staff office and department heads to ensure that RSA providers are properly oriented and supported from the moment they arrive.

The Bottom Line

Strategic staffing is about protecting the future of your hospital. It is about ensuring that every patient who walks through your doors receives the highest standard of care, regardless of the challenges you face behind the scenes. RSA Locums is here to manage the complexity of staffing so that you can focus on the mission of your facility: delivering world class healthcare to your community.

Protect Your Revenue and Your Staff: Stop managing shortages and start securing clinical continuity. Explore our roster of vetted providers ready to support your facility 👉 Available Specialties

Upcoming Gap in Coverage? Speak with Us Today

Call or Text: (217) 673-0728

The Future of Physician Autonomy: Why Locum Tenens is the Strategic Career Move for 2026 - Royal Surgical Associates

Steve Mastrocola — Tue, 24 Mar 2026 16:00:00 GMT

The Future of Physician Autonomy: Why Locum Tenens is the Strategic Career Move for 2026

The healthcare landscape in 2026 is being shaped by two major realities: a growing physician shortage and rising demand for quality patient care. As health systems continue searching for ways to maintain coverage, reduce delays, and support service lines, locum tenens has become much more than a temporary staffing solution. It is now a meaningful long-term strategy for facilities and a smart career move for physicians who want more control over their practice.

For many providers, that shift is creating something that has felt increasingly rare in medicine: choice. Physicians are looking more carefully at how they spend their time, where they practice, and what kind of professional life they want to build. Locum tenens offers a path that supports those priorities while still allowing physicians to stay focused on what matters most, delivering excellent patient care.

RSA Locums helps Physicians navigate the locum tenens market with a provider-led approach built on clinical understanding, responsive support, and access to high-quality opportunities.

Reclaiming Clinical Autonomy and Combatting Burnout

For many physicians, the traditional employment model has become synonymous with administrative overload and hospital politics. Travel healthcare offers a powerful alternative. By choosing locum tenens, physicians can sidestep the “bureaucratic burden” and return to the core of their calling: clinical excellence.

“In a market projected to reach $9.9 billion, physicians are no longer tethered to a single zip code or a rigid institutional hierarchy.”

Whether you are looking to explore diverse clinical environments across the U.S. or simply want to take back control of your calendar, the locum lifestyle provides the flexibility to design a career that serves your life, not the other way around.

The Financial Advantage: Competitive Pay and Tax Benefits

The financial incentives for physician locums in 2026 have never been more compelling. On average, locum MD/DOs can earn 30% to 50% more than their salaried counterparts.

Beyond the higher hourly rates, working as a 1099 contractor allows for significant tax advantages and wealth-building opportunities. RSA Locums ensures that our physicians are positioned to maximize their earning potential while maintaining a work-life balance that prevents the burnout currently plaguing the medical profession.

Why Partner with RSA Locums?

Transitioning into locum work involves logistical complexities that require a sophisticated partner. RSA Locums provides a concierge-level experience designed to remove every friction point:

Streamlined Credentialing: Our expert team manages the intricate process of multi-state licensing and facility privileging, ensuring you are ready to work when and where you choose.
Provider-Led Insight: Founded by healthcare professionals, we speak your language. We understand the nuances of your specialty and match you with facilities that align with your clinical standards.
Ongoing Placement Support: From scheduling to travel coordination, our team handles the logistics so you can focus on patient care and show up ready to practice.

High-Demand Specialties in 2026

The current healthcare staffing crisis has created an urgent need for specialists across the country. RSA Locums is currently placing physicians in high-demand fields, including:

Anesthesiology	Gastroenterology	Cardiology
Critical Care	Urology	Hema/Oncology

Whether you are a seasoned specialist or looking to transition your practice, these fields represent the front lines of modern medicine, offering the highest levels of compensation and geographic flexibility.

Your Path to a More Purposeful Career

The shift to locum tenens is more than a career change; it is a strategic move toward professional longevity. Experience the prestige of high-specialty locum work with a partner that understands the weight of your white coat.

Ready to redefine your practice? Explore current openings and start your journey toward clinical freedom: 👉 Browse Open Jobs

Connect with a Recruiter Today

Call or Text: (217) 673-0728

The Ultimate First-Timer’s Guide to Locum Tenens Success: Preparation, Packing, and Professionalism - Royal Surgical Associates

Steve Mastrocola — Sat, 21 Feb 2026 17:00:00 GMT

The Ultimate First-Timer’s Guide to Locum Tenens Success: Preparation, Packing, and Professionalism

Starting your first locum tenens assignment is a milestone. Whether you are a CRNA, Nurse Practitioner (NP), or Physician Assistant (PA), moving from a permanent staff position to a travel-based role is more than just a job change- it’s a lifestyle shift.

At RSA Locums, we know that the difference between a stressful first week and a seamless transition lies in the details. We’ve polled our veteran travelers to compile this comprehensive guide on how to prepare, what to pack, and how to master the “boots-on-the-ground” logistics of your first assignment.

Phase 1: The “Digital Suitcase” (Documents & Credentialing)

Before you even think about packing a real bag, ensure your “digital suitcase” is in order.

The RSA Document Vault: Keep a folder on your phone (and a physical backup in your bag) containing your State License, DEA, Board Certifications, and ACLS/PALS/BLS cards.
The “Yellow Folder” Hack: Many of our travelers recommend a physical folder. If a facility’s IT system is lagging on your first morning, having your primary source verifications ready can prevent onboarding delays.
Emergency Contacts: Keep a digital list of your RSA recruiter, your facility’s credentialing coordinator, and your housing contact.

Phase 2: Logistics & The “Dry Run”

The biggest source of Day 1 anxiety isn’t the clinical work-it’s the “Where do I go?” factor. Veteran locums know that scouting is the secret to success.

The “Recon Rule”

Always arrive in your assignment city 24-48 hours before your first shift. Use this time for Reconnaissance (Recon):

Test the Commute: Drive from your housing to the facility at the exact time you’ll be leaving for your shift. A 10-minute drive on a Sunday afternoon can turn into a 30-minute crawl at 6:30 AM on a Monday.
Locate Provider Parking: Hospital parking is a maze. Don’t assume you can park in the main deck. Ask your recruiter specifically: “Where do the locum APPs/CRNAs park, and do I need a physical hangtag or a transponder?”
The Hospital “Vibe Check”: If security allows, walk into the main lobby. Locate the cafeteria (and check their hours), the locker rooms, and the path to your specific unit.

Transportation & Backup Plans

Flight Issues: If you are flying, make sure your flight arrives early enough (ideally 24-48 hours before your first shift) so that if there are any delays or cancellations, you can catch the next flight out. Be prepared to fly standby, if you have to!
Getting Around: The decision to rent a car or use rideshare to get around the new city is one you should think about in advance. Plan to stay local? Rideshare is likely fine. If you plan to explore the area or take weekend trips, renting a car (or driving your own) may be the better option for you on the assignment.
Rideshare Apps: Have Uber or Lyft downloaded and set up. If your rental has a flat tire or the parking garage is full, you need a way to get to your shift on time.

Phase 3: Packing Like a Pro

Packing for a locum assignment is a balance of clinical necessity and personal comfort.

The Clinical Essentials

Unbranded Scrub Layers: Hospitals are notoriously cold. Bring a high-quality, solid-colored vest or jacket that fits over your scrubs. Avoid wearing gear with another hospital’s logo.
The “Comfort” Shoes: You’ll be on your feet in a new environment. Bring two pairs of clinical shoes and rotate them to prevent fatigue. If you have a brand you love- rock ’em. If you don’t, our travelers love the Hoka Bondi for maximum cushioning, Brooks Ghost Max for a stable, lightweight feel, and Dansko Professional Clogs if you prefer that style.
Personal Gear: Your own stethoscope, trauma shears, and a high-quality pen light.

The Lifestyle Essentials

The “Home” Kit: If you’re staying in a hotel or corporate housing, bring your own pillow or a specific coffee press. These small comforts significantly improve your sleep quality. If you work the night shift, a good sleep mask can be a lifesaver.
The Tech Stack: An extra-long (10ft) phone charger and a portable power bank. Outlets in call rooms or break areas are rarely convenient.

Find Your “Local”: On Day 1, identify one non-work spot: a coffee shop, a nearby park, or a local library. Having a familiar place to go grounds you in the new community.
The Gym Guest Pass: Don’t rely on a tiny hotel treadmill. Use national gym chains or local guest passes to maintain your fitness routine and clear your head after a long shift.

The “Kitchen in a Suitcase”

Takeout burnout is real. To keep your energy high and your gut healthy, treat your hotel room like a mini-apartment.

The Grocery Strategy: Use a delivery app the night you arrive to stock your mini-fridge with some healthy snack options like Greek yogurt, fresh fruit, and easy proteins.
The “Portable Pantry”: Pack a small kit with real silverware (in your checked bag), a collapsible bowl, and your favorite spices. It makes a hotel meal feel less like “travel” and more like a real dinner. Amazon sells “mini” hot sauces that are clutch in a pinch.
Time your Deliveries: Working day shift? Schedule your Starbucks delivery to arrive in the lobby at 6:30am so you can conveniently grab it on the way out the door. Working nights? Schedule your breakfast to be delivered before you give morning report so it’s waiting on you when you get home.

Phase 4: Navigating the First 48 Hours

Every unit has its own “unwritten rules.” Your goal is to integrate quickly and safely.

Identify the “Gatekeepers”

On your first shift, introduce yourself immediately to the Unit Secretary and the Lead Tech. They know where everything is-from the extra blankets to the secret code for the breakroom. Bonus points if you can meet the scheduler in-person. Block scheduling for the win.

Master the EMR

If you aren’t familiar with the facility’s Electronic Medical Record (Epic, Cerner, Meditech), ask for a “Sandbox” login or a “cheat sheet” for common order sets. Don’t wait until you’re in the middle of a busy caseload to realize you can’t find the discharge tab.

The “Visitor” Mindset with “Expert” Skill

You are there to help. Be the provider who says, “How can I best support the flow today?” Stay humble regarding the facility’s culture, but stay confident in your clinical decision-making.

FAQ: Frequently Asked Questions for New Locum Travelers

Q: Does RSA handle my travel and housing?

A: Yes. Our team team can assist you with your flights, rental cars, and housing options. We prioritize safety and proximity to the facility.

Q: Should I bring my own scrubs?

A: Always check with your RSA recruiter first. Some facilities (especially in the OR) require hospital-laundered scrubs, while others allow you to wear your own in specific colors.

Q: How do I handle meals on assignment?

A: Assume the cafeteria will be closed during your break. Pack high-protein, easy-to-eat snacks. Many travelers use their first “Recon” day to find the local grocery store and meal-prep for the week.

Conclusion: You Aren’t Temp Staff – You are a Solution

Transitioning to locum tenens is an incredible way to expand your clinical skills and see the country. By taking the time to scout your location, organize your documents, and pack strategically, you ensure that your focus remains where it belongs: on the patient.

Ready to book your first assignment for 2026? RSA is currently staffing for CRNA & APPs for premium assignments across the U.S.

👉 Browse Open Jobs

👉 Connect with a Recruiter Today

Reflecting on a Year of Purpose, Partnership, and Service - Royal Surgical Associates

Steve Mastrocola — Thu, 15 Jan 2026 17:00:00 GMT

Reflecting on a Year of Purpose, Partnership, and Service

As we start the new year, Royal Surgical Associates is taking time to reflect on the progress we have made, the partnerships we have strengthened, and the responsibility we carry as a healthcare staffing organization. This past year brought meaningful growth, deeper relationships with clinicians and facilities, and renewed clarity around our role in supporting high-quality patient care.

One of the moments we are most proud of last year was the opportunity to support CRNA Ali Carver through the Royal Surgical Associates scholarship program as she participated in a medical mission trip to Honduras. This experience represents the values that guide our work every day: clinical excellence, service to others, and removing barriers that prevent skilled clinicians from answering the call to care.

Creating Access to Service Through the RSA Scholarship Program

Royal Surgical Associates established its scholarship program to support clinicians who wish to use their skills in underserved communities but face logistical or financial obstacles. For many clinicians, mission work remains a long-held goal that can feel out of reach once training, career demands, and personal responsibilities take hold.

Ali Carver’s story reflects this reality. From her first semester in nursing school, she hoped to one day participate in a medical mission trip. Despite years of dedication to her profession, self-funding an international mission remained difficult. When Ali learned about the RSA scholarship program, she applied with sincerity, humility, and a clear commitment to service.

The scholarship covered the logistics that often prevent clinicians from participating in global health initiatives. By removing those barriers, Royal Surgical Associates enabled Ali to focus on what mattered most: delivering safe, reliable, and compassionate care alongside a multidisciplinary clinical team.

Delivering Care in Resource-Limited Settings

Through the RSA scholarship, Ali joined a mission team in Honduras composed of surgeons, CRNAs, nurses, pharmacists, and volunteers. The group worked at the Nuestros Pequeños Hermanos campus, which provided a stable and welcoming environment that supported daily clinical operations. Together, the team shared a single objective: to deliver high-quality care to patients who had often waited months for surgical intervention.

Ali supported adult spine surgeries, assisted with patient preparation, and collaborated closely with local nursing staff who managed complex cases with limited resources. The environment required heightened communication, adaptability, and clinical precision. Each day demanded careful coordination across language and cultural differences, along with thoughtful clinical decision-making.

Ali approached this work with professionalism and composure. She relied on her training, adhered to best practices, and maintained patient safety under challenging conditions. Her contributions reflected the standards Royal Surgical Associates expects of every clinician we support.

The Impact of Service on Clinicians and Communities

Experiences like this extend beyond a single mission or location. For the patients served, the impact is immediate and meaningful. For clinicians, the experience deepens clinical confidence, reinforces teamwork, and strengthens perspective on the global healthcare landscape.

Ali’s time in Honduras reinforced the value of collaboration across disciplines and cultures. It also highlighted how preparation and purpose can translate into effective care, even in environments with limited resources. These experiences follow clinicians home, influencing how they approach patient care, teamwork, and leadership in their everyday practice.

Looking Ahead for 2026: Making an Impact in Healthcare Staffing

We are excited to announce that the mission scholarship program will be offered again. Applications will open in early Q1 and more information will be provided in coming weeks. We look forward to supporting additional clinicians who wish to pursue service opportunities through acts of care and kindness.

As a leading provider of locum tenens, we believe our impact goes far beyond staffing. We’re committed to empowering providers to do work that matters: professionally, personally, and for the patients they serve.

We start this year with immense gratitude for the clinicians we work with, the partners who trust us with their staffing needs, and the opportunities we have to contribute to care that reaches beyond traditional settings. Here’s to another year of meaningful work, shared purpose, and improving lives, one shift at a time.

Best Regards,

RSA Leadership Team

Ready to make your next move?
Explore locum tenens opportunities with a healthcare staffing organization committed to service, flexibility, and meaningful impact:

👉 View Open Jobs

Getting Your First Job - An Open Letter to the Cardiac Surgery Team - Royal Surgical Associates

Steve Mastrocola — Fri, 30 May 2025 16:00:00 GMT

A Willingness to Learn

Although I have no formal PA employment experience, I believe that I have a significant amount of surgical exposure and would be a great candidate to train. I am a very adaptive applicant and can learn to succeed in any situation that I am placed in.

My Passion for Surgery

My number one goal as a PA is to provide competent and effective care to my patients. I chose surgery because it excites and amazes me. Each of my rotations has been exciting, but my cardiothoracic surgery experiences have by far been the most memorable.

Trauma Case That Changed Everything

An experience that directed me toward a career in cardiothoracic surgery began when I assisted the trauma team and the cardiothoracic surgery team in the operating room with a cardiopulmonary penetrating trauma case. That experience allowed me to gain exposure to CT surgery and ECMO.

The experience began in the ED with a trauma alert and quickly escalated to the OR, where the work began. The patient had been shot at least five times. One wound, the area of most concern, was just inferior to the left mid-clavicle. The injury warranted exploratory surgery to investigate.

This was the first time that I had seen a sternotomy performed. The heart was exposed, with one healthy lung and one very damaged left lung. The bullet had damaged the left upper lobe. Being in a trauma scenario, we ligated the damaged lobe and stopped the bleed. We then had to assess the bullet wounds affecting the extremities, which fortunately did not damage any large vessels.

It was then decided to close the chest. As first assist, the surgeon and I began to wire the chest shut. As we placed the last wire, our patient began to decompensate. It was then decided that the patient required ECMO. The patient was cannulated, and the chest was able to be closed. Thankfully, our patient survived. He then became “my patient” during my rotation, and from then on, I was responsible for his wound care and for following their management.

That was my first experience with cardiothoracic surgery.

The Organ Procurement That Left a Mark

Another experience that has shaped me began by leading the “Walk of Life” down the halls of the ICU into the OR for organ procurement. All available staff was asked to meet in the halls to honor the donor. At the head of the bed, I proceeded with our patient into the operating room.

I then scrubbed in with three fantastic transplant surgeons from Miami University Hospital in preparation to harvest the lungs, kidneys, and liver. It was an experience I will never forget. I was first assist within the cardiothoracic cavity for the procurement of the lungs.

I was blessed to have been the only student in the OR—a situation where a PA student would likely get bumped by a more senior resident or fellow. Throughout the process of dissecting, I watched the heart and lungs perform and was in awe of the anatomy and beauty of the structures.

After the procurement of the lungs was complete, the surgeon placed the fully inflated lungs in my hands. I braced—but when I received them, I smiled. I had just assisted with something so amazing—a moment I will never forget.

My efforts on that 20-hour day at the hospital felt impactful and filled me with satisfaction. I left the hospital that night knowing that I had helped three people receive healthy organs that could change the trajectory of their lives. I had difficulty sleeping that night because of the excitement.

Looking Ahead

Had I known that I would have so much passion for cardiothoracic surgery, I would have pursued an official CT surgery rotation. However, I am confident that I am fascinated by and passionate about cardiothoracic surgery.

I understand that I do not yet have experience as a practicing Physician Assistant but would appreciate an opportunity, because I believe that I would be an impactful contributor to your service.

Sincerely,

Eric Kingsley, PA-S2

CRNA Trends for 2025: Higher Pay, More Flexibility, and Growing Demand - Royal Surgical Associates

Steve Mastrocola — Thu, 22 May 2025 16:00:00 GMT

I’ve been working in and around the surgical and anesthesia space for more than a decade, first in hospital strategy and operations, now as the founder of a firm that connects CRNAs with top-tier locum tenens opportunities. And I can say this without hesitation:

CRNAs are no longer just supporting the anesthesia model, the market is being redefined.

CRNA Trends. The Clinical Shift is Real, and Measurable.

Let’s start with the numbers. In 2013, CRNAs delivered around 35 million anesthetics. Today? That number is closer to 50 million, and it’s projected to surpass 55 million by 2028.¹,² At the same time, anesthesiologist-delivered anesthetics have dropped from ~30 million in 2013 to around 21–25 million today—a trend expected to continue as more physicians retire or shift to supervisory roles.²

Overlay that with national surgical demand, which rebounded post-pandemic to ~50 million cases in 2023, and is expected to reach ~60 million by 2028.³ It’s easy to see why CRNAs are more essential than ever.

Wages Reflect That Value

Over the last five years, CRNA compensation has risen more than 20%, outpacing other APPs. The average salary jumped from $174,790 in 2018 to over $221,000 in 2023,⁴ and current projections place it at $245,000+ by 2027.⁵ Those numbers are even stronger for CRNAs working contract or 1099 roles, many of whom are earning at or above market rate due to the flexibility and speed locum coverage provides hospitals.

Why So Many CRNAs Are Choosing the 1099 Path

At Royal Surgical Associates, we speak to providers every week who are weighing a move away from the W-2 model. For a growing number of CRNAs, 1099 work just makes more sense. Here’s why:

Higher Earning Potential
As an independent contractor, you can negotiate your rates, avoid employer overhead, and often earn more, especially in rural or high-demand settings. In a tight labor market, scarce skills are leverage.
Real Tax Advantages
1099 CRNAs can deduct business expenses: travel, housing, CME, scrubs, licensure fees, and more. With the right planning, your taxable income becomes far more manageable—and you keep more of what you earn.
Lifestyle Flexibility
You decide when and where to work. Want winters off? Prefer 13-week assignments? Don’t want to take call? That’s all on the table. The schedule works around your life, not the other way around. I’m not saying you’ll get everything you want, but this is definitely a shift back to the provider as opposed to the long-time position of strength from the employer.
Solo 401(k) & Retirement Power
Here’s a hidden gem: As a 1099 CRNA, you can contribute to a solo 401(k) as both the employee and the employer. In 2024, that means up to $69,000 annually, or $76,500 if you’re over 50.⁶ That’s a game-changer for long-term wealth building.

Why the Market is Leaning on CRNAs

Two big trends are accelerating this shift:

Physician Shortages: The anesthesiology field is on track for a shortfall of over 12,500 physicians by 2033.⁷ The supply just isn’t keeping up with retirements or demand.
Expanded Scope of Practice: More than 20 states now allow CRNAs to practice independently.⁸ In many hospital and ASC settings, CRNAs are leading cases without direct physician supervision, and excelling at it.

Add the growth of ambulatory surgery centers (expected to handle 60% of all surgeries by 2025), and CRNAs aren’t just in demand, they’re indispensable.

If you’re a CRNA who’s been thinking about stepping into the 1099 space, whether for more freedom, more income, or more control over your career, you’re not alone. This shift is already happening, and it’s not a trend. It’s a transformation.

And at RSA, we’re here to help you navigate it, on your terms.

James Hensley, Co-Founder, Royal Surgical Associates

References

American Association of Nurse Anesthesiology. CRNAs Provide Nearly 50 Million Anesthetics Annually. Published 2023.
Sun EC, et al. Anesth Analg. 2020;130(5):1302–1309. doi:10.1213/ANE.0000000000004274
American Hospital Association. TrendWatch Chartbook 2023. https://www.aha.org
NursingProcess.org. CRNA Salary Trends. https://www.nursingprocess.org
VMG Health. CRNA Compensation Trends. https://vmghealth.com
IRS. Solo 401(k) Contribution Limits. https://www.irs.gov/retirement-plans