6 Signs to Read Locum Tenens Demand in Your Region

How do you know whether a region really has unfilled anesthesia and advanced practice provider (APP) coverage? Job boards only show the gap after it has been open for a while, so the earlier clues are easy to miss.

Locum tenens means temporary clinician coverage, filled by anesthesiologists, CRNAs, nurse practitioners and physician assistants who work short-term assignments. When a region needs a lot of it, you can see the pressure in how hospitals staff, what they pay and how long openings stay open. Six signs below show you what to check, whether you’re a clinician choosing where to work or a recruiter choosing where to look.

Key takeaways

Check two or three of these in your region, because one sign alone can mislead:

• Rural geography: small towns with big catchments lean on locums, which helps clinicians pick places and recruiters pick states.
• Anesthesia, CRNA and APP requests: counting open shifts and NP and PA requests shows direct coverage gaps for both clinicians and recruiters.
• Rates and time to fill: rising hourly rates and slower fills show tight supply, which gives clinicians leverage and tells recruiters what to budget.
• Long-term facility planning: hospitals that build locums into budgets signal steady demand, so clinicians can expect repeat work and recruiters can build pipelines.

Why national locum demand is growing

The national locum tenens market is growing steadily, not surging, so a regional sign only means something when you read it against that baseline. Staffing Industry Analysts (SIA) estimates the US market reached $9.6 billion in 2025, up 5% year over year. It projects $9.9 billion for 2026, up 4%, and expects the same pace in 2027.

Leaders quoted by Locumpedia describe 2026 as a continuation, not a reset. April Hansen of Barton Associates says she doesn’t expect sudden spikes, and Tom McLain of Medicus Healthcare Solutions notes that locums never had the rocket-ship takeoff travel nursing saw after COVID. Ethan McWilliams, who leads locum tenens at Elite365 and Wilderness Medical Staffing, calls the forecast a good benchmark and describes locums as one of the more stable segments in healthcare staffing.

Some firms plan to do better than the market. Hayes Locums, for example, is budgeting to outpace the projected industry growth, which fits Locumpedia’s point that higher projections show up more often at the firm level than across the industry. A single company’s growth tells you about that company, so don’t read it as a regional signal.

Two forces keep the baseline rising:

• Projected physician shortages: federal projections from the Health Resources and Services Administration run through 2037. The largest gaps are in vascular surgery (-36%), thoracic surgery (-34%), ophthalmology (-32%) and family medicine (-27%), and retirements and physician maldistribution drive them.
• Burnout: the Physicians Foundation’s 2025 survey found 55% of physicians report high stress or frequent burnout. Some leave bedside practice, and others move to part-time locum roles. It is especially pronounced in emergency medicine, family medicine and internal medicine.

The result is that hospitals and clinics find it hard to keep service lines covered, so locums become a way to hold coverage steady. If your region’s openings, rates or fill times move faster than the national pace, that’s a hot spot. If they just track it, you’re seeing general growth.

1. Rural and low-density geography

Locums demand is highest in low-density rural communities. If you’re a clinician, rural catchments are where assignments cluster. If you’re a recruiter, they’re where outreach pays off first.

The reason is how rural hospitals work. Tiny towns often have large hospitals that draw patients from huge geographic areas, and permanent staff are harder to recruit there, so locums fill the gap.

Several sources lists these high-utilization states:

• Wisconsin
• Pennsylvania
• Missouri
• Minnesota
• Illinois
• Maine

They share colder climates, wide open spaces and large rural populations. Sources also note its geographic patterns reflect where the healthcare organizations on its platform are concentrated, so treat the list as a starting point, not a complete map.

2. Anesthesia and CRNA openings stacking up

Anesthesia is a bottleneck specialty. When patients and surgeons are ready but nobody can put the patients under, hospitals reach for temporary staff, so open anesthesia and CRNA shifts are a direct demand signal for clinicians and recruiters alike.

Reports show that anesthesiology saw the greatest locums growth in 2025 at 271%, while CRNAs had the highest total spend at $180.9 million. Nearly 20% of all shifts added to its platform that year were for CRNAs.

To use this signal in your own region:

• Count open anesthesia and CRNA shifts at the hospitals and surgery centers near you.
• Note how long they stay posted.

Sources also say anesthesia and radiology continue to stand out because they support entire service lines inside a hospital.

3. Locum hourly rates climbing

Hourly rates for locums rise when supply is scarce against steady demand. Clinicians can use that as context when negotiating, and recruiters can use it when setting budgets.

Provider rates are holding steady or increasing because supply is tight. For your region, compare current rates on postings with what the same role paid a year ago, and look at whether they’re moving the same way for anesthesia, CRNA, NP and PA roles.

4. Slower time to fill

Days-to-fill measures the gap between open needs and available candidates: the longer a need stays open, the fewer clinicians there are for it. Recruiters can track it for their own openings, and clinicians can read a posting that’s been open a long time as leverage.

Demand grew across a candidate pool that hadn’t grown at the same rate. We expect the trend to reverse in 2026 as healthcare organization demand tapers, with fill times returning below 2024 levels.

That means one number is not enough. Compare your region’s fill times over several months, because a rising trend suggests tight supply and a falling one suggests cooling.

Interim Physicians’ Hand put the constraint plainly: you can only grow as fast as you can staff.

5. Facilities building locums into long-term plans

When hospitals delay permanent hires and build locums into their budgets, demand is structural and not a stopgap. SIA says many hospitals are doing exactly that, relying more on locum providers while holding off on permanent hires.

A survey backs it up:

• 66% of facilities include locums in long-term staffing plans.
• The share using locums for growth and expansion rose from 11% in 2023 to 33%.
• Nearly 70% of organizations work with more than one locum agency.

To see it locally, ask nearby facilities whether locum coverage is budgeted or arranged shift by shift. Planned coverage means repeat work for clinicians and a standing need for recruiters to fill.

6. Advanced practice providers among top requests

Nurse practitioners and physician assistants are becoming a core part of the locum tenens workforce, so requests for them show APP coverage gaps. Recruiters can build pipelines where requests outpace supply, and clinicians can see where APPs are most needed.

The US Bureau of Labor Statistics projects nurse practitioner job growth of 40.9% through 2034. SIA says NPs consistently rank among the most requested roles in both locum and permanent searches, often above many physician specialties. Expanded practice authority in many states and lower-cost care help explain why.

The gaps are sharpest in these settings:

• Primary care
• Behavioral health
• Hospital medicine
• Rural facilities where physician shortages are most severe

SIA also reports that 47% of advanced practice staffing revenue ran through a managed service provider or vendor management system in its 2024 survey. For staffing firms, the practical takeaway is efficient credentialing, so APPs can be deployed quickly where they’re needed.

Locum demand FAQ

Is locum tenens demand expected to cool in 2026?

Somewhat. Sources expect healthcare organization demand to taper in 2026, with an average specialty opening about seven new needs instead of ten. We also expects median days-to-fill to fall below 2024 levels as candidates see fewer opportunities.

Why do clinicians choose locum tenens?

Mostly for flexibility. In one survey, 74% of healthcare professionals cited schedule flexibility, compared with 54% who cited better pay. And 75% of active locum providers reported satisfaction with their work-life balance.

How will telehealth changes affect locum demand?

SIA expects limits on home-based telehealth taking effect in 2026 to move more care back into hospitals. That raises the need for onsite coverage in primary care, geriatrics, therapy and outpatient areas.

Which specialties do facilities expect to use more locums for?

Surveyed organizations expect increasing locum use over the next year in these areas:

• Primary care
• Psychiatry
• Emergency medicine
• Hospitalist medicine
• Anesthesiology

Turning the signs into a next step

Pick two or three of these signs and check them together in your region, since a single sign can mislead. Clinicians can compare open anesthesia and APP roles against how long they’ve been posted and what they pay, and recruiters can aim at the tightest geographies first.

If you want help checking what’s open, Medical Associates Consulting recruits anesthesiologists, CRNAs, nurse practitioners and physician assistants for permanent and locum roles, so start by asking its specialist recruiters about your region.