Can psych residents moonlight in the ED and Urgent Care?

[nowaysanjose]

While on off service rotations, I always get told “I know you’re doing psych, but one day you might be moonlighting in an ER or urgent care, so you’re gonna need to know this.”

Is this actually a thing?

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[Monocles]

Hahahahahahaha.

No.

Typically almost all ERs have internists, FM, emergency med staff members doing the "medical clearance" so you can only focus on the psych part. Imagine the liability if a hospital is having psychiatrists read EKGs or CRXs when there are perfectly well trained medicine staff to do so.

 

[Sushirolls]

In theory, yes, yes you could. Find an insurance carrier willing to cover you and go get 'em tiger. ARNP do it all the time with practicing way beyond their scope. You at least have had more training.

However, realistically, repeat the monocles laugh above. No, you won't be doing this and with time you will quickly realize you don't want to do this.

 

[clausewitz2]

People getting admitted to our inpatient units through our psych ED all get medical H&Ps and some basic labs done by either a dedicated PA or moonlighting psych residents. At the same time we send people to the medical ED across the street if we have significant concerns so it is really a decision of "seems sick or not?"

 

[Mass Effect]

People getting admitted to our inpatient units through our psych ED all get medical H&Ps and some basic labs done by either a dedicated PA or moonlighting psych residents. At the same time we send people to the medical ED across the street if we have significant concerns so it is really a decision of "seems sick or not?"

This. While you likely won't be working in a strictly medical ED or urgent care center, there are psych EDs and psych urgent care centers. If you're working in one and a patient has an acute medical crisis, you're still an MD and need to know enough to at least triage appropriately. You also need to know this stuff if you're on an inpatient psych unit and/or if you're doing H&Ps.

 

[calvnandhobbs68]

This. While you likely won't be working in a strictly medical ED or urgent care center, there are psych EDs and psych urgent care centers. If you're working in one and a patient has an acute medical crisis, you're still an MD and need to know enough to at least triage appropriately. You also need to know this stuff if you're on an inpatient psych unit and/or if you're doing H&Ps.

This is true. But OP you're not gonna be "moonlighting" in urgent care. You'll find that you'll make as much or more moonlighting for psych ED coverage/inpatient/outpatient moonlighting for what is probably easier work with less throughput than urgent care. And nobody is gonna hire a psych resident to moonlight in an ED...they have plenty of family medicine/IM/ER residents that they'll go to before.

 

[Bartelby]

I agree with the above that you simply will not moonlight as an internist in urgent care or in the ER.

Still, you need to review admissions for appropriateness (and I guarantee you some of the "clearances" you will see are seriously inadequate), you need to understand when a seemingly psychiatric presentation is actually a general medical problem, you will need to assess people when working in freestanding psych units or other settings like residential when the internist is not around, and you will find yourself using your medical training in many other settings. That doesn't mean you need to know these things in the same level of detail as a medicine attending, but I would not encourage gross incompetence on these topics either.

 

[vistaril]

This is true. But OP you're not gonna be "moonlighting" in urgent care. You'll find that you'll make as much or more moonlighting for psych ED coverage/inpatient/outpatient moonlighting for what is probably easier work with less throughput than urgent care. And nobody is gonna hire a psych resident to moonlight in an ED...they have plenty of family medicine/IM/ER residents that they'll go to before.

While on off service rotations, I always get told “I know you’re doing psych, but one day you might be moonlighting in an ER or urgent care, so you’re gonna need to know this.”

Is this actually a thing?

No....just no.

Psychiatrists are not the least bit qualified to work in such settings and wouldnt get job offers to do so. people in primary care would get those offers to the extent they exist.

As a psych resident, there are some moonlighting opportunities. But they are always in psych. They are also dependent on where you are. A lot of psych residents arent going to have moonlighting opps in psych because there just aren't any there if all the community hospitals are covered already with private groups/stipends.....

 

[calvnandhobbs68]

No....just no.

Psychiatrists are not the least bit qualified to work in such settings and wouldnt get job offers to do so. people in primary care would get those offers to the extent they exist.

As a psych resident, there are some moonlighting opportunities. But they are always in psych. They are also dependent on where you are. A lot of psych residents arent going to have moonlighting opps in psych because there just aren't any there if all the community hospitals are covered already with private groups/stipends.....

I don't know what's up with you negative nancy but I think the majority of residents on here know people moonlighting in their departments. I know probably at least half of the 3rd/4th year residents in the program I'm involved with moonlight and the other ones just don't bc they don't want to work more.

 

[vistaril]

I don't know what's up with you negative nancy but I think the majority of residents on here know people moonlighting in their departments. I know probably at least half of the 3rd/4th year residents in the program I'm involved with moonlight and the other ones just don't bc they don't want to work more.

it just depends on the setting....my residency program allowed moonlighting but didnt have any in house moonlighting. There was one clinic where people could see outpts in evenings and weekends because it was a medicaid clinic. So when you are a resident you can see medicaid patients. But you cant see like medicare or blue cross outpts. So it's really limiting. And you can't bill inpatient codes at com,unity hospitals. But there are a lot of in house moonlighting opportunities depending on your program.....