Best way to tell your med director that you're working 'across the street' too


Full Member
10+ Year Member
Jun 7, 2009
  1. Attending Physician
    I'm finishing residency and starting work as an IC with a CMG at a community shop guaranteeing me 120 hours. The place is just one site - no other hospitals or FSEDs in contract. No non-compete in contract.

    20 minutes away is the main rival hospital in another hospital system. Unlike my main gig, it is a trauma center, and there are medical students who rotate there. I called over there and it's another CMG, they interviewed me and hired me PRN. As someone coming right out of residency, I feel it personally important for me to 1) have variety in my practice, and 2) have options in case job #1 goes away for any reason (like, some sequelae of COVID - though my director says my hours are still good and there should be no problems). I have an interest in academia in the future, and I'm going to ask the trauma center if they'd like help with the medical students, and ask the affiliated university if they would consider making me volunteer faculty

    I come from a residency program in which the docs pick up shifts at the rival hospital 'across the street' every once in a while without any malice. I think it is reasonable for me to ensure my job safety and desire practice variety. But, I am still concerned that my director may be unhappy to hear that I'm working for 'both teams'. I have 120 hours guaranteed at my FT job, and would like to work around 160 hours - that's like 3-4 shifts at the other hospital/month.

    Question: Is it better to be up front with my director and let him/her know, as he/she will probably find out anyway? How would be the best way to communicate this to director? Would it be most prudent for me to get my house in order with my main site for the first couple of months prior to ramping up shifts at second site?

    With this being my first foray into being an attending, I would greatly appreciate any advice from all of you who have been in the real working world. Thank you


    maybe minor rocket surgery...
    5+ Year Member
    Sep 18, 2015
    Theater for ugly people
    1. Resident [Any Field]
      Why share information? You're an independent contractor. Your free time = spend it as you see fit. This person is a medical director, not your boss. If you are a W-2 employee, than they are your boss. You are your own boss. The CMG will want it both ways, but life doesn't work that way.
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      10+ Year Member
      Dec 8, 2006
      1. Attending Physician
        My $0.02. Don’t say anything unless asked / it comes up. Don’t lie but no need to make a deal of it. What you are doing is normal, prudent, and good for your skills. Going out of your way to tell your med director makes it seem like you are asking permission, which you are not.
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        Full Member
        10+ Year Member
        May 30, 2007
        1. Attending Physician
          Assume they will find out, EM is a small world and these hospitals are not far apart. But it's nothing to be ashamed of. I would get the job, get the shifts and then send an FYI text to your medical director. Better they hear it from you rather than during credentialing or other paperwork. I'm a medical director and I would appreciate it, not that I would really care. In fact, it's really helpful to have people who work at other places especially if you have to manage transfers, can learn what other shops are doing successfully. Helps to build a collaborative relationship with is more healthy. Their reaction will tell you a lot about the feel of both jobs and whether it would be a good fit long term.


            Nothing wrong about this for a lot of reasons. If it comes up in conversation, fine, I wouldn’t hide it or lie, but you’re no more obligated to tell your medical director about it than you are what you ate from breakfast. 1) You’re an independent contractor, not a W2. 2) This is EM, not cards or derm 3) A lot (most?) of people do this 4) it’s none of his damned business what you do in your free time if it doesn’t hamper you working there.

            There’s no benefit to disclosing this. I wouldn’t lie about it, but I wouldn’t go out of my was to tell him either. If he or she asks or says something you can say “yea, I pick up some shifts there while I’m paying off my student loans, it’s also nice to stay up to date on trauma.” If he or she makes a big deal out of it, it shows that they have a problem, not you.

            This is a little different in academics. If you’re supposed to be doing research or teaching in your non clinical time, you can’t just be out moonlighting because you want to make more money at the expense of your primary job. But if you’re strictly clinical, you are fulfilling 100% of your obligations by showing up. Besides, you’re a freaking INDEPENDENT contractor.

            This reminds me of the “the hospital won’t love you back” thread in WCI. We’re a lot more loyal than hospitals, to our detriment.
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