Fellows moonlighting on child psych units?

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

DrJules2016

New Member
7+ Year Member
Joined
Jul 13, 2016
Messages
1
Reaction score
0
Random question, I'm trying to moonlight as a child psych fellow in DC. The position I'm looking at is a mixed adult/child unit but my program is telling me that I CANNOT see children while moonlighting... I cannot figure out why this is, anyone have any ideas?

Members don't see this ad.
 
My program had the same rule. They said that you can't moonlight in whatever your fellowship specialty is (even though by virtue of finishing the residency that led to the fellowship you'd be allowed to see patients in that sub-specialty).
 
  • Like
Reactions: 1 user
Members don't see this ad :)
I've been moonlighting at my local state child psych hospital since PGY-3 (adult). To be fair, it's a super easy gig, I just do admits, basically just checking people in, doing an interview/physical, and dictating an H&P, I rarely touch their meds. It's a crap ton of paperwork, but no other unit duties, they have an attending on call for that stuff, or if I have any questions.

But it wasn't a problem at my program.
 
It's probably a Medicare thing--the hospital can't bill CMS for your professional services while also receiving Medicare $$ to pay for your training. It's "double dipping" and could result in the hospital having to pay back funds.
 
  • Like
Reactions: 1 user
It's probably a Medicare thing--the hospital can't bill CMS for your professional services while also receiving Medicare $$ to pay for your training. It's "double dipping" and could result in the hospital having to pay back funds.
I can see that if it's in house moonlighting, perhaps. But if that is the case how was I able to moonlight both as a resident and fellow in and outside of my program facilities? Are there new rules in the past couple of years?
I'm pretty sure almost all the patients I served were were medicaid or medicare.
 
Last edited:
It's just a control mechanism to support the guild system and keep their thumb on you.
 
  • Like
Reactions: 2 users
At my current program, subspecialty fellows institution wide can only moonlighting in their general specialty, not their subspecialty. So, for example, GI fellows can moonlight in general IM but not GI. That sort of makes sense to me if you consider that the fellowship might actually be needed in order to be competent at the subspecialty. Most subspecialties outside of psychiatry are going to emphasize procedures, including some that generalists never do. So yeah, I can see why you might not want someone who is, say, only halfway through their cardiothoracic surgery fellowship to be doing your heart surgery as a moonlighter.

But I don't see how this makes sense in psychiatry. Most of our subspecialties are more like "focus" areas rather than actual subspecialties that involve procedures or knowledge of a specific organ system. No offense to the child psychiatrists here but I think there is rather little risk to letting child fellows moonlight with kids, but hey, training is more about servitude than anything else, right?
 
But I don't see how this makes sense in psychiatry. Most of our subspecialties are more like "focus" areas rather than actual subspecialties that involve procedures or knowledge of a specific organ system. No offense to the child psychiatrists here but I think there is rather little risk to letting child fellows moonlight with kids, but hey, training is more about servitude than anything else, right?
I learned a lot in my child fellowship, and I don't see how one can competently treat a child without it. That being said, any general psychiatrist is allowed to see kids, so I don't quite get why some moonlighting fellow that has some actual child training should not be allowed to.
 
It's weird. My program treats moonlighting like an additional educational opportunity. I've been moonlighting at a state child hospital since PGY-3. To be fair, I don't do much besides check the kids in, but still.

What they won't do is allow a PGY-5 child fellow to start a new moonlighting gig at a new adult psych hospital. Because it's not "educational" since I'm now a child fellow, not adult. Weird.


Sent from my iPhone using SDN mobile
 
Top