Moonlighting as an Attending (While an Attending)

[Medstudent9]

Hey all,

I have seen plenty of threads that address moonlighting while a resident or fellow but not my particular situation.

I am a general OR attending at an academic medical center but I completed a fellowship in ICU. For various reasons, my dept on hiring said I would get ICU time eventually but for lots of reasons/excuses that hasn't happened (overstaffed, I get other nonclinical time for clinical research, etc).

But I don't want my ICU skill set to get old and I need to maintain my certification which I think requires a certain amount of ICU commitment.

So, TLDR:

I am looking for ICU moonlighting gigs in my area. I would rather not inform my chair at present but I will if I have to. Do these places gigs generally cover med malpractice for my work there? I work at an academic medical center and I don't have any particular restrictions on my contract, but could I get burned for not informing the chair of my dept? I kinda feel like if I want to work at a community hospital ICU on the weekend in my free time it's my own business.

Anybody done this or have a take on it?

Thanks much!

---

Members don't see this ad.

 

[Mman]

a primary concern of mine would be malpractice insurance. I kind of assume your department pays your malpractice insurance. I also kind of assume you have some sort of obligation to inform the malpractice company if you are practicing medicine in some other location, either so that they can cover your work there (doubtful if department is footing the bill) or alternatively so you can provide proof to them of someone else covering you for that.


Basically I think trying to doing it without your department chair knowing is a bad idea. I'd meet with them and provide your valid reasons for wanting to do some ICU work on the side and mention that you can accomplish it on your off time somewhere else without conflicting with clinical duties in your department.

 

[urge]

It is easier to ask for forgiveness than permission.

 

[Mman]

It is easier to ask for forgiveness than permission.

from the PD perhaps, but at minimum I'd call my malpractice carrier and ask them if I'm covered under current policy to do it and if not what else I'd need to do to be covered.

 

[urge]

from the PD perhaps, but at minimum I'd call my malpractice carrier and ask them if I'm covered under current policy to do it and if not what else I'd need to do to be covered.

There is no way he would be covered by his academic insurance. The new job would have to provide insurance or he would have to get it himself.

 

[Mman]

There is no way he would be covered by his academic insurance. The new job would have to provide insurance or he would have to get it himself.

I'm fairly certain that's true. I'm just wondering if they have a requirement that he notify them if he will be working in some other location, even if it's covered under another policy.

 

[Vandalia]

Depends on what exactly you mean by "academic." If you mean tenure-track faculty at a university, then the standard faculty contract today usually says the school gets any income you generate in your profession. Universities in recent years have been aggressive about going after that income across the institution, so they will use the excuse they can't discriminate as the reason to go after you.

The devil is in the details. Check your contract carefully. It isn't likely in a "clinical" contract, but if your contract incorporates parts of the "standard" university faculty contract, you could be hit and they could demand any earnings you receive from outside work in your "profession." Especially if not previously cleared by your chair/dean.

The chances of it happening are probably about the same as winning $10K in the lottery, but dig out your contract and have a quick read to be safe.

 

[urge]

Depends on what exactly you mean by "academic." If you mean tenure-track faculty at a university, then the standard faculty contract today usually says the school gets any income you generate in your profession. Universities in recent years have been aggressive about going after that income across the institution, so they will use the excuse they can't discriminate as the reason to go after you.

The devil is in the details. Check your contract carefully. It isn't likely in a "clinical" contract, but if your contract incorporates parts of the "standard" university faculty contract, you could be hit and they could demand any earnings you receive from outside work in your "profession." Especially if not previously cleared by your chair/dean.

The chances of it happening are probably about the same as winning $10K in the lottery, but dig out your contract and have a quick read to be safe.

I believe slavery was abolished a few years ago.

 

[Medstudent9]

Depends on what exactly you mean by "academic." If you mean tenure-track faculty at a university, then the standard faculty contract today usually says the school gets any income you generate in your profession. Universities in recent years have been aggressive about going after that income across the institution, so they will use the excuse they can't discriminate as the reason to go after you.

The devil is in the details. Check your contract carefully. It isn't likely in a "clinical" contract, but if your contract incorporates parts of the "standard" university faculty contract, you could be hit and they could demand any earnings you receive from outside work in your "profession." Especially if not previously cleared by your chair/dean.

The chances of it happening are probably about the same as winning $10K in the lottery, but dig out your contract and have a quick read to be safe.

That's a good point I will check. It's a medical center (one of several) affiliated with a medical school but I also have an appointment at the medical school at the instructor level. The anesthesia department is technically staffed by a faculty associate group rather than the medical center directly. So I think it is probably the tenure-track faculty route.

It just felt a bit like a bait and switch that when I started I was told I would get ICU time after about a year in the OR (I am a new attending so this seemed reasonable). Then I got told maybe another year because we are giving you research time... Then I hear they are hiring a bunch of current fellows to be ICU attendings next year so it seems like it's not serious.

So I am partially wanting to maintain/up my ICU skills in case I want to start job hunting again in the fall. And the fact is that my chair keeps telling me "no" so I can focus on my research so I am not sure how supportive he would be.

 

[deleted171991]

Hey all,

I have seen plenty of threads that address moonlighting while a resident or fellow but not my particular situation.

I am a general OR attending at an academic medical center but I completed a fellowship in ICU. For various reasons, my dept on hiring said I would get ICU time eventually but for lots of reasons/excuses that hasn't happened (overstaffed, I get other nonclinical time for clinical research, etc).

But I don't want my ICU skill set to get old and I need to maintain my certification which I think requires a certain amount of ICU commitment.

So, TLDR:

I am looking for ICU moonlighting gigs in my area. I would rather not inform my chair at present but I will if I have to. Do these places gigs generally cover med malpractice for my work there? I work at an academic medical center and I don't have any particular restrictions on my contract, but could I get burned for not informing the chair of my dept? I kinda feel like if I want to work at a community hospital ICU on the weekend in my free time it's my own business.

Anybody done this or have a take on it?

Thanks much!

Make sure you re-read your contract, and departmental policies. If you have a colleague who's already moonlighting, check with him/her, too.

You might feel it's your own business, but you may get surprised, even if there is no official restriction. My advice is to talk to your chair FIRST. Also, try to look for moonlighting in your academic MICU, too.

I would suggest that you're approaching this the wrong way, attitude-wise. In the current market, you are a cog (as emphasized by the fact that they don't need your ICU skills currently), and it's never too late to start behaving like one. Meaning that nothing is your own business, you belong to your corporate employer, and the fewer waves you make the lower the chances your boat will sink. Just my very friendly two cents.

This is also an opportunity to point out to current residents, again, how much the combined anesthesia-CCM market sucks in certain parts of the country. It's a fantastic hobby, just don't count on it. Anybody who's good at CCM is smart enough to do fine in another more marketable fellowship.

 

[deleted171991]

That's a good point I will check. It's a medical center (one of several) affiliated with a medical school but I also have an appointment at the medical school at the instructor level. The anesthesia department is technically staffed by a faculty associate group rather than the medical center directly. So I think it is probably the tenure-track faculty route.

It just felt a bit like a bait and switch that when I started I was told I would get ICU time after about a year in the OR (I am a new attending so this seemed reasonable). Then I got told maybe another year because we are giving you research time... Then I hear they are hiring a bunch of current fellows to be ICU attendings next year so it seems like it's not serious.

So I am partially wanting to maintain/up my ICU skills in case I want to start job hunting again in the fall. And the fact is that my chair keeps telling me "no" so I can focus on my research so I am not sure how supportive he would be.

Bingo! That's exactly what they do.

It is tenure track unless you have "clinical" in the name of your rank.

 

[step213]

Make sure you re-read your contract, and departmental policies. If you have a colleague who's already moonlighting, check with him/her, too.

You might feel it's your own business, but you may get surprised, even if there is no official restriction. My advice is to talk to your chair FIRST. Also, try to look for moonlighting in your academic MICU, too.

I would suggest that you're approaching this the wrong way, attitude-wise. In the current market, you are a cog (as emphasized by the fact that they don't need your ICU skills currently), and it's never too late to start behaving like one. Meaning that nothing is your own business, you belong to your corporate employer, and the fewer waves you make the lower the chances your boat will sink. Just my very friendly two cents.

This is also an opportunity to point out to current residents, again, how much the combined anesthesia-CCM market sucks in certain parts of the country. It's a fantastic hobby, just don't count on it. Anybody who's good at CCM is smart enough to do fine in another more marketable fellowship.

I know people have mentioned that there are some areas/groups that do provide anesthesia-ccm jobs. Any leads on what cities or groups to look at?

 

[IlDestriero]

My faculty contract is definitely not set up that way. Those mofos at the medical school don't get any of my loot.
You'll have to provide your own insurance if they don't offer it to you, and you'll probably want to try to do the moonlighting at another unaffiliated system to avoid a number of potential complications.
BTW, the Chair's Bait and Switch hiring tactic is a pretty big red flag you seem to be ignoring. This dude is supposed to be helping you develop as a physician and a faculty member and aligning your goals with the department mission, collateral duties, etc.
It sounds like he promised you something very significant to your career and isn't doing **** to help you achieve your goals. That would merit me shopping my CV around ASAP.
Poor leadership will only hurt your career.


--
Il Destriero

 

[WholeLottaGame7]

Bingo! That's exactly what they do.

Yep. Unless you get it in writing in your contract, it didn't happen. They just told you what you wanted to hear to get you to sign on the line.

 

[deleted171991]

When I was a resident, I had a cardiac attending, from a top residency AND fellowship, who didn't see the cardiac OR the entire time he was with us. After like 5 years, he got fed up and left. Let's not talk about all the CCM people who hadn't seen an ICU in years.

In my experience, the fish rots from the head down. One can frequently tell the quality of a place by the kind of people running it (that goes for PP, too). Unfortunately, at interview time, they are on their best behavior. That's why nothing beats an insider (good luck negotiating a contract at an academic place).

 

[deleted171991]

My faculty contract is definitely not set up that way. Those mofos at the medical school don't get any of my loot.

My pretty standard academic one used to say that I needed the chair's approval. Since academic jobs are easily filled nowadays, I expect the OP's experience to become the rule. Btw, how the heck does a fellowship-trained guy get hired as an instructor?

I wouldn't worry about the CCM recertification yet. It requires only one day of ICU per week, on average, during any chosen period of continuous 12 months, in the 3 years before recertification. That's still far away.