Moonlighting during Fellowship?

[ratched]

Hi all -- has anyone heard of a moonlighting arrangement where an IM Fellow (e.g. cards or GI or pulm) contracts with a solo attending or a private practice group to round on their admitted patients over the weekend?

I imagine that new consults or cases involving a procedure (like a scope or a cath) would need to be seen directly by one of the attendings/private practitioners, but could the other patients only be seen by the moonlighter?

I'm actually a psychiatrist, but I know an older gentleman in NJ who may be looking to take on a moonlighter for his practice in this capacity, so I'm doing some of the legwork for him.

Any help would be MUCH appreciated! Also, if this is not the right forum to be posting this inquiry, please let me know.

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[gutonc]

Hi all -- has anyone heard of a moonlighting arrangement where an IM Fellow (e.g. cards or GI or pulm) contracts with a solo attending or a private practice group to round on their admitted patients over the weekend?

I imagine that new consults or cases involving a procedure (like a scope or a cath) would need to be seen directly by one of the attendings/private practitioners, but could the other patients only be seen by the moonlighter?

I'm actually a psychiatrist, but I know an older gentleman in NJ who may be looking to take on a moonlighter for his practice in this capacity, so I'm doing some of the legwork for him.

Any help would be MUCH appreciated! Also, if this is not the right forum to be posting this inquiry, please let me know.

There are plenty of similar situations where a hospitalist group hires moonlighters to cover weekends for them, most of whom are IM fellows. Because fellows are, by definition, BC/BE internists (i.e. have completed the same training as the hospitalists) they don't need to have anything "staffed" because they are "staff." As long as the hospital will credential the moonlighter, they're good to go.

Now, there is a bigger issue for specialists and the need for scope/cath/bronch but any sub-specialty group that tries to get non-specialists to cover them won't keep hospital privileges/contracts for long. This is why many places are moving to the hospitalist model for all admissions.

 

[ratched]

Thanks so much for the response! May I ask a follow-up for a little clarification (and I'll use an example)....

Let's say a GI group in private practice all cross-cover one another over weekends. Responsibilities include rounding on all admitted patients (who were admitted during the week by the primary GI doc), fielding calls from and seeing existing outpatients (who are already in one of their practices) and possibly admitting if necessary, fielding nursing calls (for orders, etc) on inpatients, doing new GI consults in the ER or on existing inpts who are on other services, scoping any of the above PRN.

Which of the above responsibilities could be performed by a 2nd or 3rd year GI fellow (perhaps under the license of my colleague who is a BC-gastro) w/o my colleague having to do a thing on the case? Let's assume, of course, that he would stay in town and be entirely accessible to the moonlighter should any matter require his personal attention.

Any/all replies would be very helpful. Thanks.....

 

[gutonc]

My understanding (which may be incorrect) is that all of that could be done by a GI fellow however none of it could be billed for (except maybe the daily progress notes if they're admitting their own patients rather than having the hospitalists admit them) unless the BC GI doc saw them as well. It's also possible that the consulting docs (ED, Surg, Hospitalist) would raise holy hell...but perhaps not.

All of this would also be subject to the hospitals willingness to credential said moonlighter for these duties. Your buddy can't just hire some random GI fellow to pretend to be him without having the hospital credential that person.

 

[ratched]

Thanks, gutonc. Would welcome any thoughts/insights from others, as well......