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Choose Your Shift: The Freedom of a Locum Tenens Career in EM

By Leona Scott | on September 2, 2025 | 1 Comment
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James Neuenschwander II, MD, FACEP, FASAM, is a mission‑driven night‑shifter who turned a 30‑year career into a purpose‑built locums life.

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ACEP Now: September 2025

When Dr. Neuenschwander finished residency in 1998 he did what many new emergency physicians did then: He joined a private two‑hospital group, became an owner, board member, and vice chair. He participated in the meetings, joined the committees, the whole thing.

In 2006, he pivoted to teaching residents and medical students at Ohio State University. At the same time, he was discovering how much he enjoyed the locum tenens cadence while covering a 25-bed critical access hospital in Washington State where he worked as an emergency physician, hospitalist, intensive care unit physician, and even the nursing home physician.

Dr. Neuenschwander returned to community practice, adding skills in wound care and observation medicine to his toolbox. He earned board certification in addiction medicine, and today practices as a traveling physician with U.S. Acute Care Solutions. In 2024, he worked at 14 hospitals and for seven health systems.

It’s a Lifestyle

Dr. Neuenschwander

“I like the locums lifestyle,” Dr. Neuenschwander said. “The money is good. There are no hospital meetings or committees, and I’m far more focused on patient care and teamwork.” At age 60, nights are “a little tough,” he admitted, “but I’ve always gravitated to nights—and to the smartasses who work them.” (“Print that at your own risk,” he joked.)

The tradeoffs are real, he said, mostly dealing with office politics and consistency.

“You can get thrown under the bus—few people know you or what you stand for, and sometimes any accusation, no matter how ridiculous, is treated as valid,” Dr. Neuenschwander said. “The travel can be tough. Some days I feel like an animal—work, eat, sleep, repeat, repeat, repeat.”

What keeps him steady is a personal North Star he repeats often: “My mission is to provide the greatest opportunities for health and healing. I’ve learned I can do that anywhere, at any time.”

That clarity—plus the infrastructure of a contract management group that handles licensure, onboarding, and logistics (and a wife who’s all‑in on the lifestyle, sometimes joining him for multi‑week stints)—lets him keep practicing on terms that match this season of life. The perks don’t hurt either: three grown kids in Denver, Dallas, and Orlando, a Southwest Airlines companion pass, and the freedom to turn off‑weeks into “mini-honeymoons” after 34 years of marriage.

Pages: 1 2 3 | Single Page

Topics: BurnoutcareerEarly CareerIndependent ContractorLifestyleLocum TenensPhysician AutonomyPhysician WellnessPractice ManagementSchedulingTravelWork-Life Balance

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One Response to “Choose Your Shift: The Freedom of a Locum Tenens Career in EM”

  1. September 14, 2025

    Jamila Goldsmith Reply

    Locums work truly does offer freedom and flexibility, but a word of caution: not every company operates with integrity. Some will happily confirm your shifts, only to delay or withhold payment — and then try to strong-arm you into their travel team as leverage for money you’ve already earned. Physicians should know their worth, stand firm, and choose partners carefully so the locums lifestyle remains empowering rather than exploitative.

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