GME won't let me moonlight - and I'm boarded!

[GMEsucksit]

Here's the scenario:

I'm boarded in a primary specialty.

I'm doing a fellowship. The Institutional GME office at my university will NOT let me moonlight at another institution in my primary specialty.

Is it legal for them to threaten me with expulsion from my fellowship if I don't stop moonlighting?

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[exPCM]

How does your GME department know whether you are moonlighting at the other institution?
Is there anything in your fellowship contract or housestaff manual that prohibits moonlighting?
Why can"t you just moonlight and hope that they don't find out?
Even if they do find out why can't you just plead ignorance?

The ACGME does not prohibit moonlighting.
See:
http://www.acgme.org/acwebsite/navp...urs_MoonlightingandExceptions_Explanation.pdf

 

[Pilot Doc]

Look at the contract you signed. It may well prohibit moonlight.

Regardless of what your institution can or cannot do, they can definitely fire you from your fellowship and/or refuse to process your paperwork in such a way that your fellowship training will count.

Potentially you could sue them if their actions are illegal, but that would require you to hire a lawyer, etc. You might have more leverage if you are a protected class (female, minority, etc.)

If this is really an issue for you, talk to a lawyer.

 

[Doctor Grim]

If this matters to you a lot, like pilot doc has suggested, talk to a lawyer.

But your program does reserve the right to do so, especially now that they've told you that you couldn't moonlight.

When I was a clinical fellow, we couldn't moonlight at our main hospital (university) or any affiliated institutions (VA or community hospitals that were affiliated with us). But one could go out to the community and moonlight provided that your total work hours were less than 80 and that it didn't affect the fellow's work. And to moonlight, we HAD to inform the program director and program coordinator and it had to be approved. You'd have to provide full details of your clinical responsibilities and hours/wk.

In my research fellowship now, I'm not allowed to moonlight on weekdays during business hours. It wasn't written, but I was verbally told by my mentors.

 

[gutonc]

How does your GME department know whether you are moonlighting at the other institution?

Since to get credentialled by an institution you need to provide them with a list of all your former/current employees, most places will ask for a letter showing that you are in good standing w/ your current employer/institution. So your GME people or your fellowship/residency program will definitely find out.

I just got credentialled to moonlight at a hospital in town and discovered this when GME sent a letter to my PD asking for that letter and approval.

 

[dragonfly99]

Your GME office is sucky...basically.
But you had better be careful to not run afoul of them.
They can always hurt you more.
I suggest maybe going to the House Officers Association (if there is one) and try to get them to work on this problem at an institutional level. Can they negotiate with the GME office to create some sort of policy (for example one that says it's OK to moonlight as long as you don't go over 'x' hours or OK to moonlight but only during vacation and/or research years and not during the 8am-5pm period during your research years, etc.).

 

[pgg]

Seems like this would have been a good question to ask prior to starting the fellowship.

Fellows, like residents, are the property of GME. You play by their rules, you serve at their pleasure, or you open yourself up to the whims of their power. It's like arguing with an attending. Even if you're right, even if they're acting in a grossly inappropriate manner, even if you ultimately "win" ... it's not worth the hassle and no good can come of it. Choose your battles.

 

[Winged Scapula]

As others have said, they can do pretty much what they want as long as you signed the contract (ie, not allowing you to moonlight isn't in any violation of restraint of free trade, etc. AFAIK).

My fellowship required me to sign a form stating that I had my PD's approval to moonlight. He did so as long as I did not do so on Sunday or any weekday nights which would interfere with my fellowship training. I agreed with him and ended up doing a lot of Saturdays.

So, check your contract...if you agreed, it would be very foolish to sneak around.

 

[GMEsucksit]

As others have said, they can do pretty much what they want as long as you signed the contract (ie, not allowing you to moonlight isn't in any violation of restraint of free trade, etc. AFAIK).

My fellowship required me to sign a form stating that I had my PD's approval to moonlight. He did so as long as I did not do so on Sunday or any weekday nights which would interfere with my fellowship training. I agreed with him and ended up doing a lot of Saturdays.

So, check your contract...if you agreed, it would be very foolish to sneak around.

Wow.

I am surprised by the meek answers I've received.

Truth is, I know where I stand on this issue, and I've already got a lawyer lined up if I decide to push the issue. I'm not sure I will as I may be seeking to stay at the institution, but the bottom line is, they don't own me. I don't go over 80 hours, and they can kiss my ass if they think they can dictate what I do outside their doors. They may not "like it" but they don't have a leg to stand on after they're done with their hubris.

I'm board certified, licensed, and in no way betrothed to them. And there was nothing said that I couldn't moonlight, but this isn't moonlighting anyway (I shouldn't have used that phrase) -- I'm a full fledged member of another physician group. No part-time, still-in-training status for me. I could be teaching kite surfing, it's the same thing, I do what I want with my time. I can spend my time working extra just as sure as s h it as the next resident can spend taking care of their children, or waxing your car.

It doesn't interfere with my call or extra-clinical responsibilities of my fellowship.

But interestingly, the responses here reinforce why basically physicians as a whole in this country are a bunch of pus s ie s. Lay down and take it. The GME office has the power to make your life ill. You signed a "contract" that may or may not have been legal. Not one response about what is right, what is in line with individual freedom!

This is why reimbursement will continue to go down, mid-level providers will continue to encroach on our job prospects, and the insurance companies and government agencies will run roughshod over the profession. It is why I am, at times, embarrassed to call many of you colleagues.

Flame away, I'm pretty resilient (shrug). Some of us have to stand up for the wet noodles in the profession.

 

[gutonc]

Wow.
I am surprised by the meek answers I've received.

With one or two exceptions, everyone who answered your post stated (implicitly or explicitly) that it all depended on your contract. If it doesn't prohibit moonlighting then you're fine and should have no difficulty fighting it. They can get you on the 80 hours issue but otherwise you are in the right.

Truth is, I know where I stand on this issue, and I've already got a lawyer lined up if I decide to push the issue. I'm not sure I will as I may be seeking to stay at the institution, but the bottom line is, they don't own me.

And you're calling the rest of us weak? You're basically saying that you'd stand up for yourself except that you want to keep Massa happy (which you accuse everyone else who has posted to your thread of doing).

Unless your Dept Chair is on the GME committee, I think you'd be hard pressed to find 2 people in your department who could name a single person on the committee or who care about what they think in regards to hiring decisions. If you push the situation and lose, you won't be able to be at any institution in your chosen specialty in the future. If you push it and win, some office assistant w/ an associate's degree may remember your name down the road but you'll probably be just fine.

So what will it be? Are you going to sack up and push for what should be your right or just walk away and call everyone a wuss?

 

[GMEsucksit]

With one or two exceptions, everyone who answered your post stated (implicitly or explicitly) that it all depended on your contract. If it doesn't prohibit moonlighting then you're fine and should have no difficulty fighting it. They can get you on the 80 hours issue but otherwise you are in the right.



And you're calling the rest of us weak? You're basically saying that you'd stand up for yourself except that you want to keep Massa happy (which you accuse everyone else who has posted to your thread of doing).

Unless your Dept Chair is on the GME committee, I think you'd be hard pressed to find 2 people in your department who could name a single person on the committee or who care about what they think in regards to hiring decisions. If you push the situation and lose, you won't be able to be at any institution in your chosen specialty in the future. If you push it and win, some office assistant w/ an associate's degree may remember your name down the road but you'll probably be just fine.

So what will it be? Are you going to sack up and push for what should be your right or just walk away and call everyone a wuss?

If I stay at this institution, I'd want to please the GME because my Department at my current institution will query my current medical license in the state database as they convert me from fellow to faculty. This will actually happen during the last months of my fellowship (i.e. in the next 6 weeks) as I go through the institutional credentialing process, and thus it would be a flag to the GME (unfortunately, our Division is part of a Department, and it the Department that would flag the license and report it to GME. My division couldn't care less - they're happy for me to work in my primary specialty elsewhere. In fact, part of the reason why I've done this at another institution is because the parent Department wouldn't let me moonlight within my division even thought they have many fellows in their own main department do just that. It's ****ing hypocritical.

If I go elsewhere, presumably the new department will also query the state database, but when they see that I'm credentialed at another hospital, they won't care.

But I hear ya on the challenge to sack up or not. I intentionally took a challenging tone in my last post, and your response was certainly warranted to tell me to put up or shut up.

 

[meister]

You signed a "contract" that may or may not have been legal. Not one response about what is right, what is in line with individual freedom!

lol. Since you decided to call everyone here ******* for some reason, I'm going to go ahead and drop any pretense of being nice to you. Don't whine to everyone here about how UNFAIR life is because you probably signed a contract you now don't like. Moonlighting is something you clarify before you sign a contract or apply to a fellowship program. And, oddly enough, there is a point to signing a contract. Namely, you are legally bound to follow its terms or face punishment by your program or in civil court.

None of this has anything to do with "individual freedom," whatever you mean by that. You are free to not follow the terms of the contract, but you open yourself up to punitive action. Everyone here gave you advice based on their experiences. It seems pretty obvious you don't want to cause a ****storm because you don't like the contract you just signed and piss off your GME. The reality is, not moonlighting and sucking it up for 1-2 years is better than pissing everyone off, having a judge tell you "hey ***** next time don't sign a contract you don't like, NO MOONLIGHTING" AND being in the same exact situation you'd be in if you had never forced the issue.

If you luck out and this is just some ****** beancounter who said no moonlighting to get a power trip, then there's no legal way for them to bar you from doing it. If you signed a contract that specifically bars this, then you are ****ed. Don't worry about your individual freedom though, you can still moonlight and have your contract voided whenever you want!

 

[colbgw02]

Wait, so if you know where you stand on this issue - to use your phrase - and you already know what you're going to do, then why did you post at all? At present, you have a sum total of three posts, all on this thread, which means you joined SDN specifically to post this thread. Were you lonely? What's the deal?

 

[GMEsucksit]

lol. Since you decided to call everyone here ******* for some reason, I'm going to go ahead and drop any pretense of being nice to you. Don't whine to everyone here about how UNFAIR life is because you probably signed a contract you now don't like. Moonlighting is something you clarify before you sign a contract or apply to a fellowship program. And, oddly enough, there is a point to signing a contract. Namely, you are legally bound to follow its terms or face punishment by your program or in civil court.

None of this has anything to do with "individual freedom," whatever you mean by that. You are free to not follow the terms of the contract, but you open yourself up to punitive action. Everyone here gave you advice based on their experiences. It seems pretty obvious you don't want to cause a ****storm because you don't like the contract you just signed and piss off your GME. The reality is, not moonlighting and sucking it up for 1-2 years is better than pissing everyone off, having a judge tell you "hey ***** next time don't sign a contract you don't like, NO MOONLIGHTING" AND being in the same exact situation you'd be in if you had never forced the issue.

If you luck out and this is just some ****** beancounter who said no moonlighting to get a power trip, then there's no legal way for them to bar you from doing it. If you signed a contract that specifically bars this, then you are ****ed. Don't worry about your individual freedom though, you can still moonlight and have your contract voided whenever you want!

I hear all your points, but as I mentioned in one of my above posts (it might have been buried) I did NOT sign a contract forbidding moonlighting.

Basically, they're imposing a non-complete clause on me even though I have not signed a non-compete, nor do I avail of the benefits that the full time physicians of the parent hospital get (pension, etc.) since I'm classified as a trainee (I point this out because if I was getting these benefits, there is something to be said for "non-competing".

 

[meister]

No need to be smug at the end there, you're not really disagreeing with me. If there was no moonlight barring provision in your contract, and not even a non-compete clause, then they can't really do ****. I would mention it to your direct superiors and see what they think before getting an attorney involved, but if you need the cash or whatever then do all you can. I certainly wouldn't back down if I was in the right simply to not step on some administrator's toes. More power to you.

 

[Faebinder]

Wow.

I am surprised by the meek answers I've received.

Truth is, I know where I stand on this issue, and I've already got a lawyer lined up if I decide to push the issue. I'm not sure I will as I may be seeking to stay at the institution, but the bottom line is, they don't own me. I don't go over 80 hours, and they can kiss my ass if they think they can dictate what I do outside their doors. They may not "like it" but they don't have a leg to stand on after they're done with their hubris.

I'm board certified, licensed, and in no way betrothed to them. And there was nothing said that I couldn't moonlight, but this isn't moonlighting anyway (I shouldn't have used that phrase) -- I'm a full fledged member of another physician group. No part-time, still-in-training status for me. I could be teaching kite surfing, it's the same thing, I do what I want with my time. I can spend my time working extra just as sure as s h it as the next resident can spend taking care of their children, or waxing your car.

It doesn't interfere with my call or extra-clinical responsibilities of my fellowship.

But interestingly, the responses here reinforce why basically physicians as a whole in this country are a bunch of pus s ie s. Lay down and take it. The GME office has the power to make your life ill. You signed a "contract" that may or may not have been legal. Not one response about what is right, what is in line with individual freedom!

This is why reimbursement will continue to go down, mid-level providers will continue to encroach on our job prospects, and the insurance companies and government agencies will run roughshod over the profession. It is why I am, at times, embarrassed to call many of you colleagues.

Flame away, I'm pretty resilient (shrug). Some of us have to stand up for the wet noodles in the profession.

I think you should do your best and fight the good fight to the end. You are correct in every way. GME will never understand their limits till someone pushes them to it. Needless to say, I think using a lawyer is the best way to do it. Since you seem to be able to afford one, more power to you. 👍

 

[3dtp]

I hear all your points, but as I mentioned in one of my above posts (it might have been buried) I did NOT sign a contract forbidding moonlighting.

Basically, they're imposing a non-complete clause on me even though I have not signed a non-compete, nor do I avail of the benefits that the full time physicians of the parent hospital get (pension, etc.) since I'm classified as a trainee (I point this out because if I was getting these benefits, there is something to be said for "non-competing".

The ACGME frowns on non-competes and may even have an institutional requirement banning them.

But, remember, by accepting their fello-whip position, you have agreed to submit to their ministrations, hopefully in the quest to obtain that special CAQ to let you do what you want. You can buck them, you can even win, but if you win, you might also lose the war. They have many ways to make you pay, forever, as has been elaborated.

Never wrestle with a pig, if you can help it. The only thing that happens is you both get covered in pig-mud (an obvious euphemism) and the pig loves it.