Physicians Are Bypassing Staffing Agencies to Reclaim Control of Their Work
A growing number of physicians are rethinking the assumption that flexible practice must flow through a locums agency. Three clinicians behind FlexMedStaff are building a case for direct contracting with hospitals and clinics, arguing that physicians can negotiate their own arrangements, keep more control over their schedules, and stay in medicine without surrendering decision-making to a middleman.
A 2025 Doximity poll of nearly 1,200 U.S. physicians found that more than 63% of respondents were already working in locum tenens or considering it within the next five years. That appetite for flexibility has created a market in which many physicians feel pushed toward staffing agencies by default. FlexMedStaff is trying to reverse that reflex. The platform, cofounder Aaron Morgenstein, M.D., describes as an educational resource for physicians who want to explore independent work and negotiate directly with facilities rather than hand over the process to a recruiter.
Direct contracting changes the power dynamic immediately. Instead of accepting a facility’s packaged offer through an agency, physicians can approach administrators themselves, discuss local needs, and shape a relationship around coverage gaps, scheduling realities, and compensation terms that reflect actual work performed.
How a Physician Network Became a Practical Playbook
The network around FlexMedStaff grew from conversations between physicians who had already felt the limits of employed practice. Morgenstein connected online with internist Corinne Rao, M.D., and both recognized how little practical guidance existed for physicians interested in independent work. Rao had already concluded that an employed pathway no longer fit her career goals. Once she applied the direct-contracting strategies Morgenstein shared, she wanted to pass those lessons along to others.
OB-GYN Holly Shen, M.D., reached the group after searching for resources that would help her work independently. She had already created a Facebook community for female OB-GYNs interested in locums, but the deeper question for her was how to negotiate directly with facilities. A comment on one of Morgenstein’s YouTube videos led to a conversation, and that exchange became the bridge to her first direct contract.
The educational ecosystem they have built is intentionally physician-centered. FlexMedStaff now connects clinicians through educational videos, free webinars, an annual summit, and a physician-only Facebook group called Physicians Helping Physicians. The stated purpose is simple: share the tactical knowledge that many doctors never receive in training, from compensation discussions to state licensure questions and health insurance logistics.
Autonomy, Not Interim Work
Shen wants physicians to stop viewing locums as a temporary bridge between “real” jobs. Independent work can be the plan from the start, with recurring assignments and coverage models tailored to a physician’s interests, home life, and tolerance for travel.
Now, plan A can be that you work independently.
That mindset matters because physician dissatisfaction often begins with the false belief that only permanent employment offers stability. Morgenstein pushes back on that assumption by describing many physician contracts as short-term arrangements that feel more secure than they really are. A 90-day contract offers little of the long-run certainty many physicians think they are buying. The practical difference is significant for clinicians who want bargaining power, multiple income streams, and room to leave an unhealthy arrangement without uprooting their entire career.
For Morgenstein, the shift away from employment came after he found that full-time practice did not suit him. He had already worked with several locums agencies when he decided to begin approaching hospitals directly. The result was a model that let him continue orthopedic surgery while making time for family and other professional interests. He framed the change as a way to remain in medicine without letting employment structure dictate every part of his life.
Why Physicians Hesitate to Leave the Employed Track
Rao identifies three barriers that keep physicians from making the leap: isolation, fear, and lack of information. Those barriers often reinforce one another. A physician who does not know anyone practicing independently may assume the path is fringe or financially reckless. Without examples, concerns about insurance, work volume, or licensing across states can grow into a complete standstill.
The knowledge gap is especially visible in the day-to-day questions physicians ask once they begin to imagine working on their own. How is health coverage arranged? How are multiple state licenses handled? How does a physician start a conversation with a hospital administrator without sounding underprepared? Those questions are not abstract. They determine whether a clinician can convert professional dissatisfaction into a workable business model.
Working with more than one facility can also reduce dependence on any single employer. Rao points out that multiple relationships can spread risk and make it less likely that one administrator, one scheduling change, or one contract dispute will determine a physician’s livelihood. In an environment where many doctors feel tethered to a single institution, that kind of diversification has obvious appeal.
Direct Contracting Can Reach Communities That Need Coverage
Flexible contracting is not only a career strategy; it can also fill real access gaps. Shen, who is based in Colorado, travels to critical access communities to provide obstetric and gynecologic care. Instead of relocating her family, she negotiates coverage based on what each facility actually needs. Her own phrase for the work is “OB boots on the ground.”
Her discussions with administrators focus on what is missing locally: clinic visits, surgical access, hospital coverage, or some combination of those services. She then structures her work around those needs. In underserved communities, that kind of customization can be the difference between intermittent access and dependable specialty coverage.
Patients may respond more positively than physicians sometimes expect. Shen said she initially worried that a visiting physician would be viewed as temporary or unfamiliar, but the reaction has often been the opposite. Patients and staff frequently express gratitude when a physician comes in to help. In rural settings, where specialty access can be thin and delays can be long, a clinician who shows up consistently and clearly communicates expectations can quickly become essential.
Morgenstein argues that physicians who feel boxed in by a large-city job should not assume they have exhausted their options. Hospitals in rural America still need coverage, and direct contracting can be a path to meeting that need without surrendering autonomy. The unresolved issue is how widely physicians will embrace the extra effort required to negotiate, credential, and manage independent work on their own terms.