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It's been a long time since I was a moonlighter, but after doing a search I didn't see any recent threads about ED moonlighting. Considering moonlighting is a common, risky, and lucrative practice I would think it may deserve it's own sticky.
So how about a moonlighting FAQ?
When can I moonlight?
That varies by program. Most places will let you moonlight when they think you are ready or there may be a blanket policy that no one can moonlight before 3rd year.
How much does it pay?
That's going to be vary by region and type of ED. I wouldn't take less than $75/hr unless it was internal moonlighting under an attending, and I'd be suspicious of places offering way more money than your area's average. The company or group that's hiring you plans to make money off of you, so if you are being quoted a high figure expect it to earn it.
How do I find out about moonlighting opportunities?
Ask your fellow residents that are currently moonlighting. They will be your best and most accurate source of information. Be cautious of taking an offer at a hospital that has never had one of your fellow residents. I'm not saying never, but I wouldn't let myself get put down for a large number of shifts the first month or make a multi-month commitment. If you're program is only 2 years old, then talk to your attendings about other hospitals in the area they work at, and be prepared to cold call the ED directors.
Do I have to let my current program know I'm moonlighting?
In most cases your program will have a policy on moonlighting and running afoul of it could cause disciplinary action. You'll need letters of recommendation from your attendings to get credentialed at most places, so don't expect to be able to keep moonlighting totally secret. If you start missing shifts because of scheduling conflicts, expect the penalty to be harsh.
What do I need in order to moonlight?
1. A valid medical license for the state you'll be moonlighting in. This is different from your trainee's license unless you are moonlighting within your program (ie fast-track shifts).
2. An individual DEA number +/- a state controlled substance registration number(depends on state, I know Indiana and Texas require)
3. Your NPI number so Medicare pays you.
4. Pass credentialing at the hospital where you'll be moonlighting
Steps 1 and 4 can take significant amounts of time to achieve. I'd recommend applying as soon as possible during your 2nd year (which means passing Step 3 early) for your license if you plan on moon-lighting. If you are near multiple states, you'll need to make a decision about how many licenses to acquire. They aren't cheap and you'll have to keep track of them for the rest of your career, but if you wait until you hear of an opportunity to start getting the license you're looking at a 4-6 month lag time to get the license and pass credentialing.
Depending on who is hiring you, credentialing may be relatively painless or hideously painful. Contract management groups typically have people who's sole job is making sure their docs get through credentialing. If you're moonlighting for a democratic group or a hospital than expect to do most of the heavy lifting yourself.
IMPORTANT!!!!
Keep a copy of the following information for everywhere you moonlight:
1) Your dates of employment
2) The contact information for both the ED director, the Chief of Staff, and the Medical Staff office point-person
3) Your malpractice insurance carrier and proof of tail coverage
Items 1 and 2 are important in many states for licensing. Item 3 is important for getting malpractice insurance in the future. Re-acquiring this information is a pain in the rear, especially if you're out of state and maybe only worked a handful of shifts.
Have to run, but there are still a fair amount of topics left to cover such as things to look for in a good moonlighting experience and what to bring during your shift.
So how about a moonlighting FAQ?
When can I moonlight?
That varies by program. Most places will let you moonlight when they think you are ready or there may be a blanket policy that no one can moonlight before 3rd year.
How much does it pay?
That's going to be vary by region and type of ED. I wouldn't take less than $75/hr unless it was internal moonlighting under an attending, and I'd be suspicious of places offering way more money than your area's average. The company or group that's hiring you plans to make money off of you, so if you are being quoted a high figure expect it to earn it.
How do I find out about moonlighting opportunities?
Ask your fellow residents that are currently moonlighting. They will be your best and most accurate source of information. Be cautious of taking an offer at a hospital that has never had one of your fellow residents. I'm not saying never, but I wouldn't let myself get put down for a large number of shifts the first month or make a multi-month commitment. If you're program is only 2 years old, then talk to your attendings about other hospitals in the area they work at, and be prepared to cold call the ED directors.
Do I have to let my current program know I'm moonlighting?
In most cases your program will have a policy on moonlighting and running afoul of it could cause disciplinary action. You'll need letters of recommendation from your attendings to get credentialed at most places, so don't expect to be able to keep moonlighting totally secret. If you start missing shifts because of scheduling conflicts, expect the penalty to be harsh.
What do I need in order to moonlight?
1. A valid medical license for the state you'll be moonlighting in. This is different from your trainee's license unless you are moonlighting within your program (ie fast-track shifts).
2. An individual DEA number +/- a state controlled substance registration number(depends on state, I know Indiana and Texas require)
3. Your NPI number so Medicare pays you.
4. Pass credentialing at the hospital where you'll be moonlighting
Steps 1 and 4 can take significant amounts of time to achieve. I'd recommend applying as soon as possible during your 2nd year (which means passing Step 3 early) for your license if you plan on moon-lighting. If you are near multiple states, you'll need to make a decision about how many licenses to acquire. They aren't cheap and you'll have to keep track of them for the rest of your career, but if you wait until you hear of an opportunity to start getting the license you're looking at a 4-6 month lag time to get the license and pass credentialing.
Depending on who is hiring you, credentialing may be relatively painless or hideously painful. Contract management groups typically have people who's sole job is making sure their docs get through credentialing. If you're moonlighting for a democratic group or a hospital than expect to do most of the heavy lifting yourself.
IMPORTANT!!!!
Keep a copy of the following information for everywhere you moonlight:
1) Your dates of employment
2) The contact information for both the ED director, the Chief of Staff, and the Medical Staff office point-person
3) Your malpractice insurance carrier and proof of tail coverage
Items 1 and 2 are important in many states for licensing. Item 3 is important for getting malpractice insurance in the future. Re-acquiring this information is a pain in the rear, especially if you're out of state and maybe only worked a handful of shifts.
Have to run, but there are still a fair amount of topics left to cover such as things to look for in a good moonlighting experience and what to bring during your shift.
