Moonlighting as an Attending

[bandc21]

This may not be the right forum, but I figure it will get more traction here and it is somewhat related to residents/fellows getting their 1st time/signing a contract.


Does anyone know if there are limitations on an attending having a separate part-time practice independent from their main job? Or maybe something like review insurance claims, utilization review, etc at home.



I will be finishing my fellowship this year and I would like to try to make as much money as possible when I am younger to build savings, pay down my med school debt and pay my poor wife back a bit for sticking with me for med school + residency + fellowship.

I remember when I did my psych rotation in med school, I worked with an attending that had a full-time academic position in an inpatient psych unit, but then also had a small part time outpatient practice in the evenings and weekends. I know there are several other possibilities by specialty. The outpatient IM doc that covers admits for a weekend, the gyn doc that covers L&D, etc.


I would imagine there are restrictions on this in an an academic setting, but what about in private practice? I can see why there are moonlighting restrictions in training, both to prevent limitations in learning/reading and because of the ACGME restrictions. However, as many of my attendings are found of pointing out, there are no work hour restrictions on practicing docs out of training. I guess private practices can put whatever they want in their contracts, but I wondering how common that is. So my questions are:

1. Do you know different docs that have this arrangement of two (or more jobs)?
2. Is it common to limit/prevent this sort of thing in a contract and if so any difference between academic vs private?
3. If it is not specifically addressed in your contract, can I assume you have the ability to do what you want (assuming your performance at the main doesn't suffer)?

Thanks!

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[Lostin_space]

This may not be the right forum, but I figure it will get more traction here and it is somewhat related to residents/fellows getting their 1st time/signing a contract.


Does anyone know if there are limitations on an attending having a separate part-time practice independent from their main job? Or maybe something like review insurance claims, utilization review, etc at home.



I will be finishing my fellowship this year and I would like to try to make as much money as possible when I am younger to build savings, pay down my med school debt and pay my poor wife back a bit for sticking with me for med school + residency + fellowship.

I remember when I did my psych rotation in med school, I worked with an attending that had a full-time academic position in an inpatient psych unit, but then also had a small part time outpatient practice in the evenings and weekends. I know there are several other possibilities by specialty. The outpatient IM doc that covers admits for a weekend, the gyn doc that covers L&D, etc.


I would imagine there are restrictions on this in an an academic setting, but what about in private practice? I can see why there are moonlighting restrictions in training, both to prevent limitations in learning/reading and because of the ACGME restrictions. However, as many of my attendings are found of pointing out, there are no work hour restrictions on practicing docs out of training. I guess private practices can put whatever they want in their contracts, but I wondering how common that is. So my questions are:

1. Do you know different docs that have this arrangement of two (or more jobs)?
2. Is it common to limit/prevent this sort of thing in a contract and if so any difference between academic vs private?
3. If it is not specifically addressed in your contract, can I assume you have the ability to do what you want (assuming your performance at the main doesn't suffer)?

Thanks!

It really depends on your contract. I know for sure I will be doing review utilization and things like that, and am in the work/process of setting up an independent, cosmetic type dealio also. But overall it really depends on your group and contract.

 

[gyngyn]

You can do anything that you have been trained to do (and for which you have liability coverage) that is not specifically restricted in your employment contract.

 

[keifernny2]

Ask when you interview for primary jobs to make sure that you find something that lets you moonlight.


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[B-Bone]

Many jobs, especially in subspecialties where you have your own patient panel, include non-compete clauses that would specifially forbid this.

 

[michaelrack]

Most psychiatrists moonlight/have more than 1 job. There will often be a geographic non-compete clause with your main job- check your contract about distance. You will need malpractice coverage for moonlighting

 

[AdmiralChz]

It's been called into question on these forums how noncompete clauses hold up when challenged in court... personally, I wouldn't be so thrilled to rock the boat like the as a new hire to a practice but to each their own.

 

[bandc21]

Thanks for the responses everyone. I certainly wouldn't want to ruffle any feathers with my first job and I would of course stay within my scope of practice. I was just curious how often these things are put into contracts. I didnt think about the non-compete clause. I wonder how that would apply to docs without a typical patient panel like radiologists, EM, Anes, etc. Come to think of it though, I guess what is why I have heard some docs who cover call for weekends here and there, etc far away from their home base location. Also, I doubt they could limit non-clinical work, such as insurance reviews or even non-medical work. Thanks again!

 

[michaelrack]

I have seen a contract (not mine) that doesn't allow any outside clinical work (I dont remember if it covered non-medical work).

Everything is negotiable. I negotiated my non-compete so it didn't interfere with my plans and side-jobs. If you can't negotiate it to your satisfaction, then walk away.

 

[B-Bone]

They can write whatever they want into your contract. Whether it's enforceable (or whether you want to test that with your new employer) is a whole other question. A contract is simply an agreement between two entities. If they write it in and you agree to it (and sign), there's some chance it will be enforced. If your contract forbids outside work (even non-medical), the group probably doesn't want you to work outside your job, whether that's legally enforceable or not. So while they may not legally be able to prevent you from doing something, they can still be pissed off about it. I personally try to avoid things that piss off my employer/partners.

I am an anesthesiologist. There is a very strict non-compete clause in my contract which bars me from practicing within the ELEVEN COUNTY METRO AREA FOR ONE YEAR after leaving. I can't even say which eleven counties are included, but it's a huge swath of my state. Granted, the purpose of this is to prevent an outside entity (such as a large management company or even the hospital) from trying to take over our practice and hire all of us back (kind of a mutually-assured destruction pact), so it's never been enforced for either moonlighting or switching jobs. Nevertheless, some practices are dicks, so be forewarned.