When people think of an emergency room doctor, they often picture someone who works in the same hospital every day, part of a team that knows each other well, familiar with the ins and outs of their facility. For many ER physicians, that’s true. But for those of us who practice locum tenens medicine, every hospital, every shift, and every patient encounter is different.

I chose to work as a locum tenens emergency physician because I wanted the flexibility, the challenge, and the opportunity to bring high-quality emergency care to areas that need it most. The term “locum tenens” is Latin for “to hold the place of,” and that’s exactly what I do—step into emergency rooms across the country, filling in for hospitals that need experienced physicians. It’s a unique way to practice medicine, and while it comes with its share of challenges, it has also been one of the most rewarding experiences of my career.

The Freedom and Flexibility of Locum Tenens

One of the biggest advantages of locum tenens work is the flexibility. Unlike a permanent hospital position, I have control over my schedule, deciding when and where I want to work. Some months, I take on multiple back-to-back shifts in different states, immersing myself in new environments. Other times, I take a break to focus on my family, travel, or simply recharge before my next assignment. That kind of autonomy is rare in medicine, and it has allowed me to create a career that fits my life rather than the other way around.

Travel is another major part of locum tenens work. I’ve had the chance to practice in major metropolitan trauma centers, rural hospitals with limited resources, and everything in between. Each assignment comes with its own set of challenges, and adapting quickly is a critical skill. Some facilities are well-staffed, with teams that work like a well-oiled machine. Others are struggling, desperate for extra hands to handle an overwhelming patient load. No two hospitals operate exactly the same way, so with every new assignment, I have to learn new electronic medical record systems, new protocols, and new staff dynamics—often within a matter of hours.

The Challenge of Walking Into the Unknown

Starting a shift as a locum tenens ER doctor is like walking into a moving train. The department has already been running before I arrived, and I have to jump in, assess the situation, and get to work. I don’t have the luxury of knowing the nurses and staff beforehand, so I have to build trust quickly. The ability to communicate effectively and work as a team—even with people I’ve just met—is essential.

One of the biggest challenges is navigating hospital-specific protocols. Every ER has its own way of doing things, from how they handle admissions and transfers to the specific paperwork they require. In some places, I have access to a full team of specialists at all hours; in others, I might be the only doctor in the building, making life-or-death decisions with no immediate backup. The ability to stay calm under pressure and rely on my clinical instincts is what allows me to succeed in these unpredictable environments.

Perhaps the most difficult part of being a locum tenens physician is the lack of continuity. In a permanent position, doctors develop relationships with hospital staff, patients, and the local community. As a locum, I might only be in one place for a few shifts before moving on to my next assignment. While I always do my best to provide the highest quality care, I don’t always get to see the long-term outcomes of my patients. I stabilize a critically ill patient, initiate treatment, and then hand them off to the next provider, never knowing how their story ends. That lack of closure can be tough, but I remind myself that my role is to be there when I’m needed, to provide the best care possible in the moment, and to trust that the next team will continue what I started.

Serving Underserved Communities

One of the most meaningful aspects of locum tenens work is the opportunity to serve in rural and underserved areas. Many of the hospitals I’ve worked in struggle to maintain a full-time medical staff. Without locum tenens physicians, some of these communities would have little to no access to emergency care.

I’ve worked in hospitals where I was the only physician for miles, where patients drove hours to reach the nearest ER. I’ve treated farmers injured in remote areas, children without access to a pediatrician, and elderly patients with chronic conditions who have nowhere else to turn. The gratitude I see in these patients’ eyes reminds me why I do this work. In places where medical resources are scarce, just having a doctor available can mean the difference between life and death.

The Lessons of Locum Tenens

Practicing emergency medicine on the move has taught me more than I ever expected. It has sharpened my adaptability, strengthened my decision-making under pressure, and reinforced my belief that good medicine is not about familiarity with a specific hospital, but about a doctor’s ability to think critically, communicate, and act with compassion.

It has also given me a deep appreciation for the dedication of medical professionals everywhere. Whether in a high-tech urban trauma center or a tiny rural hospital with a skeleton crew, I’ve met nurses, paramedics, and staff who pour everything they have into patient care. Their resilience and commitment inspire me every day.

Locum tenens medicine is not for everyone. It requires flexibility, an ability to handle uncertainty, and a willingness to be constantly learning. But for those who thrive on challenge and adventure, it offers a career unlike any other. I don’t know where my next shift will take me, but I do know one thing—wherever I go, I will be exactly where I am needed most. And that is what makes this journey worthwhile.