Are ophthalmology locums rates worth giving up employed benefits?

Why this page states no locums rate

Other specialties on this site price locums from current agency postings. For ophthalmology, this page holds no verifiable locums rate data, and it prints none rather than invent a figure a negotiation might lean on. What it can give is the method, which travels to whatever rate a real engagement offers. Take the offered rate and annualize it honestly: the actual weeks available, not the theoretical year, minus the gaps between engagements, minus travel days that are worked but not paid as clinical time. Then subtract the structure: the self employment tax, the self funded health coverage, the individual disability policy sized to contractor income, the malpractice terms where the agency does not carry them, and the retirement contributions an employer would have made. Compare what survives against the employed total, salary plus every layer, and apply the premium rule: the contractor column must finish 25 to 30 percent ahead to be the same pay for the same work, because the contractor also carries the income volatility the reserve ladder prices at up to twelve months of expenses instead of six.

Ophthalmology adds two specialty specific items to the method. The first is procedural continuity: a cataract surgeon's income inside employment rides on a built schedule and a referral base, and locums work, which is weighted toward coverage, call, and clinic gaps in many markets, may not replace that surgical volume at the same rate, so the offered work mix is read as carefully as the rate. The second is licensure: locums across state lines runs on the physician's license portfolio, and each state's timeline and cost belongs in the engagement math. Neither item appears on an agency rate sheet.

When locums is the right answer anyway

Locums is a structure, and structures serve seasons. It serves the physician between positions who wants income without a commitment while the right partnership is found. It serves the established physician winding toward part time on their own terms, the pattern the featured household runs: Diane pairs part time W2 work with 1099 locums income inside a household whose foundation is finished, zero debt, a $150,000 reserve, and over $100,000 a year still flowing to retirement accounts. Locums there is not a career bet. It is a throttle on a finished machine. It serves the explorer pricing a region or a practice model before signing years to it. In each case the structure's costs are known and accepted for what the season buys. The failure mode is the first attending who takes locums as a default because the rate looked large, and discovers across the first year that the benefits, the forgiveness count, the surgical volume, and the stability were the compensation, and the rate was the remainder.