---
title: "Is locums worth it compared with an employed job?"
canonical: "https://www.joinandwise.com/answers/contract-work-vs-employed"
checked: "2026-10-21"
claim: "andwise:answer/contract-work-vs-employed@2026-10-21"
license: "CC BY 4.0"
---

# Is locums worth it compared with an employed job?

Compare net income and hours, not gross. At $330,000 for 32 weeks, the model nets about $190,000 after tax and out-of-pocket benefits — roughly $63,000 less than a $320,000 employed year, for about 25 hours a week instead of 55. Whether that trade is worth it is yours to make; the arithmetic should be explicit.

## The rule

1099 pay carries costs an employed salary hides: the employer half of Social Security and Medicare, health coverage, malpractice tail, licensing, retirement match, and weeks without a contract. The gross rate is not comparable to a W-2 salary until those are subtracted.

Locums also has income gaps and administrative load: credentialing between assignments, state licenses, housing, and invoicing. A cash buffer of three to six months is the practical requirement, not a luxury.

The non-financial trade is real: schedule control and time off versus stability, benefits, and colleagues. The career model lets you put your own numbers on both sides and name the priority that decides it.

## Numbers

- Locums model: ≈$189,700 net ($330,000 gross, 32 weeks, $28,000 benefits cost, 1099 FICA)
- Employed comparison: $320,000 gross (55 hours/week, 48 weeks, employer benefits)
- Difference: ≈−$63,000 net (For about 25 hours/week instead of 55)

## Actions

- Price health coverage, tail and the lost retirement match before accepting a rate. — https://www.joinandwise.com/decide/career
- Confirm the contract is 1099 and that you control your schedule.
- Keep three to six months of expenses liquid before the first assignment.

## What could change this

- Your gross rate or weeks worked differ from the model's $330,000 over 32 weeks — at higher rates the gap can reverse.
- You can get equivalent coverage more cheaply, through a spouse's plan or a marketplace — the out-of-pocket benefits line shrinks.
- You weigh schedule control and time off more than the income gap — that trade is a preference, not arithmetic.

## When the numbers aren't enough

- You are choosing an entity or tax election for the first time.
- You will work in multiple states and need licensing and credentialing coordination.
- Your first contract has cancellation or tail terms you do not understand.

## Sources

- [IRS: Self-employment tax](https://www.irs.gov/businesses/small-businesses-self-employed/self-employment-tax-social-security-and-medicare-taxes)

Checked 2026-10-21. General information, not legal, tax or financial advice. The site describes what the law and rules say; it does not say whether a clause is enforceable or what you should do.