Anesthesia fellow moonlighting

[james775]

Hey, I’m a Ca-3 doing a cardiac fellowship. Just found out fellows can moonlight outside the main academic hospital. I would like to setup some Locum opportunities in the same state. I have applied for my license in that state but not gotten it yet. My question is, at what point can I contact hospitals about locums? Should I wait until I finish residency? Also what else do I need to do to setup myself for locums? Make an LLC? Get my own malpractice? Really starting out fresh here so any advice would be appreciated.

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[IMGASMD]

Hey, I’m a Ca-3 doing a cardiac fellowship. Just found out fellows can moonlight outside the main academic hospital. I would like to setup some Locum opportunities in the same state. I have applied for my license in that state but not gotten it yet. My question is, at what point can I contact hospitals about locums? Should I wait until I finish residency? Also what else do I need to do to setup myself for locums? Make an LLC? Get my own malpractice? Really starting out fresh here so any advice would be appreciated.

I’d make a suggestion if you’re only doing this somewhat on a semi-regular basis, just find an agency.
They will take care of the malpractice, lodging and travel. It maybe cheaper and less time consuming than doing that on your own during fellowship.

 

[james775]

I’d make a suggestion if you’re only doing this somewhat on a semi-regular basis, just find an agency.
They will take care of the malpractice, lodging and travel. It maybe cheaper and less time consuming than doing that on your own during fellowship.

For some background. The hospital I have in mind is 2 hours away from my fellowship. It’s where my parents live and I can stay with them. I know the hospital needs locums because the current cardiac fellow mentioned one of the staff does locums work there and are looking for people. I’m not sure if this hospital is offering locums through an agency. Seems like it maybe just a word of mouth thing at this point. I’d honestly rather go through an agency but not sure that’s an option for this particular place?

 

[Harpoon1]

For some background. The hospital I have in mind is 2 hours away from my fellowship. It’s where my parents live and I can stay with them. I know the hospital needs locums because the current cardiac fellow mentioned one of the staff does locums work there and are looking for people. I’m not sure if this hospital is offering locums through an agency. Seems like it maybe just a word of mouth thing at this point. I’d honestly rather go through an agency but not sure that’s an option for this particular place?

word of mouth jobs are going to be your best bets imo. Personally, I would just contact them directly, forget the agency (you are going to be filling out the same paperwork either way). You can negotiate a higher rate for yourself which will still be lower than what the hospital was going to be paying through the agency.

 

[IMGASMD]

You’d have to pick up your own malpractice…. Can be very costly.

The last time I checked, and I wasn’t even getting a quote for full time locum jobs…. Occurrence + tail was, at least for me, 20K.
Even at $100 more per hour. You can do the math…….

You should ask the fellow who did it…. How did they handle it?

 

[periopdoc]

When I was a fellow, all moonlighting hours had to be reported to the fellowship director, and counted against my work hours restrictions.

That prevented me from credentialing, since that would have alerted my director to start monitoring my hours worked outside.

Thankfully, I had to be credentialed at an outside hospital, because we provided all cardiac anesthesia services to them. Their group needed someone to in-house moonlight on the weekends, so I squeaked it by. Almost got caught a time or two, when I was in house and one of the cardiac attendings came through to round.

 

[james775]

You’d have to pick up your own malpractice…. Can be very costly.

The last time I checked, and I wasn’t even getting a quote for full time locum jobs…. Occurrence + tail was, at least for me, 20K.
Even at $100 more per hour. You can do the math…….

You should ask the fellow who did it…. How did they handle it?

Can the hospital i do locums for supply malpractice insurance or is that rare?

 

[jon stewart]

check your institutions policy for moonlighting, some dont "allow" external moonlighting. Now that doesnt mean you cant do it but would just be careful.

 

[IMGASMD]

Can the hospital i do locums for supply malpractice insurance or is that rare?

If the hospital carries insurance already, (anesthesia dept is hospital employee…) maybe.

I worked for an AMC, who told me that I can be their W2, then they’d include me in their malpractice insurance…. But if I do 1099, I’d have get my own.

 

[james775]

If the hospital carries insurance already, (anesthesia dept is hospital employee…) maybe.

I worked for an AMC, who told me that I can be their W2, then they’d include me in their malpractice insurance…. But if I do 1099, I’d have get my own.

Gotcha, yeah they are all hospital employees. There are two hospitals in the city actually. One of them was bought out by the academic I’m doing fellowship at. So it’s now under the flag of my academic hospital. I’m not sure if that changes things.

I appreciate everyone telling me to be careful. The current fellow told me it shouldn’t be a problem but I’m paranoid and reached out to my PD just to make sure everything is fine

 

[psychbender]

Some groups may have a policy with a locums rider that basically says that as long as you're working for them for fewer than 30 days a year, you are covered by their policy. At least, this was what a buddy and I understood when we did some local moonlighting while active duty.

 

[deleted875186]

I would reach out to the hosptial direct or first, they may be able to provide malpractice insurrance for you. If no luck, I would contact an agency and let them do everything. Give yourself at least 3-4 months for credentialing. Make sure you get a full medical license in that state ASAP and DEA license, and state controlled substance so as to not hold anything up.

 

[deleted545787]

try to moonlight at your home institute, it will likely be noncardiac (as you have not graduated your fellowship) and the rate will be what the in house physicians are getting paid to do per diem/extra shifts while practicing under your institutes insurance policy. This way you will not need to get Malpractice and all the extra costs incurred as a locum (it won't pay off unless your doing several shifts) . The year is busy and clinically heavy, so doing non cardiac cases will refresh you and your knowledge during this heart heavy year. Also, make sure you get enough rest in between reg scheduled shifts and moonlighting, you don't want to get burnt out. Additionally, I would hold off on moonlighting until the at least 3- 4 month into fellowship as you may need time to adjust to the heavy schedule, and learn echo.

 

[james775]

I would reach out to the hosptial direct or first, they may be able to provide malpractice insurrance for you. If no luck, I would contact an agency and let them do everything. Give yourself at least 3-4 months for credentialing. Make sure you get a full medical license in that state ASAP and DEA license, and state controlled substance so as to not hold anything up.

I’m in the process of getting my state license. Probably have it by the end of this month. After that I can apply for dea license I believe but not before. Should I wait for those things to come through or just go ahead and reach out?

 

[james775]

try to moonlight at your home institute, it will likely be noncardiac (as you have not graduated your fellowship) and the rate will be what the in house physicians are getting paid to do per diem/extra shifts while practicing under your institutes insurance policy. This way you will not need to get Malpractice and all the extra costs incurred as a locum (it won't pay off unless you’re doing several shifts) . The year is busy and clinically heavy, so doing non cardiac cases will refresh you and your knowledge during this heart heavy year. Also, make sure you get enough rest in between reg scheduled shifts and moonlighting, you don't want to get burnt out. Additionally, I would hold off on moonlighting until the at least 3- 4 month into fellowship as you may need time to adjust to the heavy schedule, and learn echo.

The internal moonlighting rate is 150/hr. I know it’s 0 headache but hard to accept that rate when 300/hr is achievable. I agree with your post about trying to keep my knowledge up about non cardiac. Definitely one of the reasons I want to moonlight. I also agree about waiting until a few months in to moonlight. Already know I’m gonna be slammed with boards and depth of knowledge. I just wanna get a head start on the credantling and hoops to jump through.

 

[deleted875186]

The internal moonlighting rate is 150/hr. I know it’s 0 headache but hard to accept that rate when 300/hr is achievable. I agree with your post about trying to keep my knowledge up about non cardiac. Definitely one of the reasons I want to moonlight. I also agree about waiting until a few months in to moonlight. Already know I’m gonna be slammed with boards and depth of knowledge. I just wanna get a head start on the credantling and hoops to jump through.

Honestly, as someone who took some paid shifts in residency, I understand taking some shifts at 150$/hr in training. Looking back now, I would not work extra for that rate, money much less meaningful when making an attending salary, and hours are rough during training. If you can get a better rate I would definitely do that.

 

[Remxed]

I don't know how busy fellows are at your program, but I'm at a busy program, and I value my time off outside of my clinical duties. There is a lot to learn during your one year fellowship + extra requirements (research, QI, etc). Unless you are REALLY strapped for cash, I wouldn't recommend to moonlight on a regular basis. Focus on your cardiac year and get strong clinically. It goes by really quickly. If you need money, many jobs are offering sizeable sign on bonuses that you can ask for ahead of time before you start.

 

[Potatoman1800]

I don't know how busy fellows are at your program, but I'm at a busy program, and I value my time off outside of my clinical duties. There is a lot to learn during your one year fellowship + extra requirements (research, QI, etc). Unless you are REALLY strapped for cash, I wouldn't recommend to moonlight on a regular basis. Focus on your cardiac year and get strong clinically. It goes by really quickly. If you need money, many jobs are offering sizeable sign on bonuses that you can ask for ahead of time before you start.

100 percent echo this (hah see what I did there). I valued my time off in an already really busy clinical year. The marginal gains from packing in some moonlighting aren't worth it. Trust me, you won't forget how to do general cases.

 

[vector2]

100 percent echo this (hah see what I did there). I valued my time off in an already really busy clinical year. The marginal gains from packing in some moonlighting aren't worth it. Trust me, you won't forget how to do general cases.

Thirded. Would not moonlight unless you're desperate for money.

 

[Angus Avagadro]

Can the hospital i do locums for supply malpractice insurance or is that rare?

When I did that, the group/hospital supplied a locums policy as part of our written contract, so it is possible and site dependent.

 

[james775]

I appreciate all the advice about just focusing on the fellowship. I plan to moonlight only couple times a month. Of course my main focus is getting good at cardiac, but just with expenses a little extra money in my pocket will help. I talked to the current fellow, I’m only on call once a month. That leaves 3 free weekends so I think it will be manageable.

Just as an update, I found out the hospital hires you as a W2 so you get malpractice through them. Like i said the main academic bought this community hospital so it’s under their flag. It’s technically a government agency because it’s a public academic institution. Therefore im covered by something called sovereign immunity. Kind of bummed because will not be able to take advantage of 1099 tax benefits. However, malpractice is covered and figured out by them which was gonna be a huge expense/headache.

I appreciate all the advice. The rate, with the per diem, comes out to 300/hr for 12 hour weekend shifts.

 

[deleted875186]

I appreciate all the advice about just focusing on the fellowship. I plan to moonlight only couple times a month. Of course my main focus is getting good at cardiac, but just with expenses a little extra money in my pocket will help. I talked to the current fellow, I’m only on call once a month. That leaves 3 free weekends so I think it will be manageable.

Just as an update, I found out the hospital hires you as a W2 so you get malpractice through them. Like i said the main academic bought this community hospital so it’s under their flag. It’s technically a government agency because it’s a public academic institution. Therefore im covered by something called sovereign immunity. Kind of bummed because will not be able to take advantage of 1099 tax benefits. However, malpractice is covered and figured out by them which was gonna be a huge expense/headache.

I appreciate all the advice. The rate, with the per diem, comes out to 300/hr for 12 hour weekend shifts.

300$/hr is excellent. And if your call schedule is only one weekend per month, I would definitely do one or two days of extra call per month, it will be a significant bump in your pay and make your life significantly better.