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ccthedoc

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Hi, I am a second year resident and my program does not currently have any moonlighting opportunities. However, our current system of night coverage will be ending soon. Several of my fellow residents and I are interested in moonlighting to earn some extra cash. I was told that we would need our own malpractice insurance.

Does anyone know how to go about this and how reasonable this (the cost) would be? Is it possible to just add additional coverage to our current malpractice insurance?

What have others done in the past and what are people doing now? We would really appreciate your input and advice!

Thanks!
 

Annette

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A lot of places that hire residents for moonlighting will provide malpractice insurance, or hook you up with an insurance company. Make certain that you know what kind of insurance it is, though. Occurance vs claims. With claims, you will need tail insurance.
 

Von Hohenheim

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Annette said:
A lot of places that hire residents for moonlighting will provide malpractice insurance, or hook you up with an insurance company. Make certain that you know what kind of insurance it is, though. Occurance vs claims. With claims, you will need tail insurance.
What an interesting post. Any chance you could explain some of those terms? Thanks.
 
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f_w

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- you will need a medical license
- you will need malpractice coverage. Typically the facility/physician group hiring you will get their regular carrier to cover you as locums. Be very careful that for every time you provide services you receive a letter/fax from the insurer that you are covered for a particular time period
- your residency programs policy won't cover you
- later on, extensive moonlighting during residency makes it more difficult/expensive to obtain malpractice coverage as an attending. In 'claims made' policies a 'young physician' typically only pays 10% of the occurence premium for the first year. If you have moonlighted (or is the correct word 'moonlit' ?), this might go up to 30-40% as your history is not 'naive'.
- check the moonlighting policy of your institution. While the ACGME work hour limits don't count moonlighting (NY State does), your program director might have to be notified.
 

mosche

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One other thing to be aware of: if you do extensive moonlighting, your student loans can fall out of deferral elegibility (i.e. if you make enough money, the loan guarantor will assume that you are in a financially secure position and expect payments). Therefore, keep an eye on the money that you are making, otherwise you can actually damage your financial situation.
 

Winged Scapula

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mosche said:
One other thing to be aware of: if you do extensive moonlighting, your student loans can fall out of deferral elegibility (i.e. if you make enough money, the loan guarantor will assume that you are in a financially secure position and expect payments). Therefore, keep an eye on the money that you are making, otherwise you can actually damage your financial situation.
Do not take this lightly...because of the money I made moonlighting 2 years ago (when we were allowed to) my student loan company thought I could afford nearly $700/month in payments when I had been paying $333/month. I am only now getting them to let me pay less (after submitting current paystubs showing I don't make all that money that I did previously).
 

OldPsychDoc

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mosche said:
One other thing to be aware of: if you do extensive moonlighting, your student loans can fall out of deferral elegibility (i.e. if you make enough money, the loan guarantor will assume that you are in a financially secure position and expect payments). Therefore, keep an eye on the money that you are making, otherwise you can actually damage your financial situation.
Watch the tax situation, too. I was paid as an independent contractor, which meant there was no withholding, AND I was subject to the self-employment tax--which basically makes up for the absence of the employer's half of FICA withholding.
 

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OldPsychDoc said:
Watch the tax situation, too. I was paid as an independent contractor, which meant there was no withholding, AND I was subject to the self-employment tax--which basically makes up for the absence of the employer's half of FICA withholding.
And all this time I thought moonlighting was a HUGE plus! Oy! :scared:
 

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OldPsychDoc said:
Watch the tax situation, too. I was paid as an independent contractor, which meant there was no withholding, AND I was subject to the self-employment tax--which basically makes up for the absence of the employer's half of FICA withholding.
Translation please :)



I can only guess from your use of the word "watch" that this is a bad thing. Otherwise this is incomprehensible. We don't all have accounting degrees y'know. :(
 

f_w

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The big plus of moonlighting as an independent contractor is the ability to write off half of your life as business expense. (eating out, travel etc.) You form a small LLC to run the moonlighting income through it. Now you can write off that 6000lbs SUV and reduce your tax liability to 0.

Yes, there is good money in moonlighting. You just have to be aware of the potential pitfalls. Don't look at the hourly number, get an idea how much it will cost you in 'overhead' such as taxes, insurance and potentially increased student loan payments (if that applies to you).
 

f_w

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This definitely sounds illegal.
It sounds illegal, but it is not. As a freebie for the oil and SUV cartel, the current regime decided to allow small businesses to write off new trucks with a GVW of 6000lbs at purchase value during year 1. This way, your corporation runs considerable loss during year 1 which will reduce your personal income (your residency stipend) below the amount which is typically taxed.

I believe they have done away with the SUV writeoff, but you get the idea (without the special SUV writeoff, you have to write your company vehicle off like any moveable asset, I don't know how many years that is).
 

GoPistons

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f_w is definitely correct on this one... I have family that have done exactly this... and paid no tax...
 

docB

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Orange Julius said:
Translation please :)



I can only guess from your use of the word "watch" that this is a bad thing. Otherwise this is incomprehensible. We don't all have accounting degrees y'know. :(
Try the search. This has all been covered before.

Briefly:
Independent contractor - a situation where you get paid everything you earn without any witholding for taxes. That means that you will be liable for a hefty tax bill come April (best case) or, if you're making enough, you will need to start paying the IRS quarterly to avoid penalties and fines. Employees (as opposed to independent contractors) fill out W2s and have some of their pay witheld by the government.

Occurance malpractice coverage - The best, expensive, difficult to get coverage. This means that you are covered forever for the time you spent working under this policy. If you quit that particular job and move on and get sued years down the line you will still be covered.

Claims made coverage - The much more common type that covers you for any claims made while you are still under the policy. If you quit and move on and get sued for something you did while under the policy you are on your own unless you bought a tail.

Tail - An expensive policy that you buy to cover you for getting sued in the future for something you did while under a claims made policy.
 

cytoskelement

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Orange Julius said:
Translation please :)



I can only guess from your use of the word "watch" that this is a bad thing. Otherwise this is incomprehensible. We don't all have accounting degrees y'know. :(
Essentially all of the money you pay in taxes, outside of federal, state and local, which if you look at an old pay stub is listed as FICA (ie social security, etc.) is matched by your employer. this is never listed on a pay stub - it is a cost of business that employers pay to have employees. if you are you're own business, you may have to pay that "matching" as an employer - even though you are the only employee. it is the price of having a business tax ID number.
 

carrigallen

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How do malpractice carriers stratify liability for moonlighting? is it based on region, gender, hours worked, claim history?
 

docB

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carrigallen said:
How do malpractice carriers stratify liability for moonlighting? is it based on region, gender, hours worked, claim history?
Yes.
 
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