“I never work Wednesdays,” she said. “My son’s swim lesson is non‑negotiable. When I’m on, I’m on. When I’m home, I’m 100 percent home.”

The Locum Tenens Section is also pushing policy. One current ACEP resolution asks certifying bodies like the American Board of Emergency Medicine to recognize that short contracts can make traditional hospital‑based quality improvement projects unrealistic, even though locum physicians can still create meaningful specialty‑wide impact (through national committee work, education, and policy).

And because locums equals small business, the Section spends time teaching physicians how to set up limited liability companies, handle accounting, and file taxes—the practical pieces that can make (or break) sustainability.

What’s the Right Path?

Is a nontraditional path right for you? Drs. Neuenschwander, McGann, and Goldsmith said you’ll thrive on a nontraditional path if you are mission‑driven and clear on your “why,” can adapt fast to different EMRs, teams, and local cultures, are teachable, not territorial, want to focus on the medicine and not the politics (at least for long stretches of your career), and value time autonomy as highly as compensation—and are willing to run your practice like a business.

You’ll struggle with a nontraditional path if you need daily validation from the same team, bristle at learning new systems or sharing control with a site’s established workflows, or see the model as “just for the paycheck,”—an element that every one of these physicians called out as a fast track to disappointment.

The Fun Part: You Design It

For Dr. Neuenschwander, it’s semi-retirement, combined with meaningful work near family. For Dr. McGann, it’s a national bench of travel‑ready clinicians who can jump from busy tertiary centers to hurricane shelters overnight. For Dr. Goldsmith, it’s total schedule autonomy that lets her be fully present both in the emergency department and at a Wednesday swim lesson.

If the standard three to four shifts a week no longer fits your season of life, you’re not stuck. ACEP’s Locum Tenens Section, internal travel programs like Envoy, and physician‑friendly contract groups offer legitimate, structured alternatives—complete with community, mentorship, and policy advocacy. And if you can’t find a path that matches your goals? Take Dr. Goldsmith’s advice: Bet on yourself and build it. Someone else is probably waiting to follow.

Leona Scott is a freelance writer based in Dallas.