Moonlighting $$

[castaway]

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I was told moonlighting wages can vary quite a bit. Just wanted to get a sense of what to expect from those of you out there who have moonlighted. Thanks!

 

[EctopicFetus]

Depending on what you do $35 (In orlando) to $75 per hour..

 

[EM_Rebuilder]

I was told moonlighting wages can vary quite a bit. Just wanted to get a sense of what to expect from those of you out there who have moonlighted. Thanks!

Here in west Texas near Lubbock, TX all the FP residents (we have no EM) get 50-85 an hour pretty much depending on how far away they want to travel from our city...

They tell me in podunkville they sit for hours and are lucky to see one patient ever 3 or 4 hours. Their favorite is the '$3200 weekend' which is something like friday night through sunday night...

 

[EctopicFetus]

In orlando what they do is sit there for a 24 hour shift making $35/hour with a bed and tv (they said they usually read). All they did was run codes when patients in the hospitals coded. The said they only had to run one every 2nd or 3rd "shift".. Not bad.. you get left along and make $800...

 

[ElZorro]

saw an ad yesterday for a moonlighting position in east TX for $57 an hour. Job was running a rural ED- average daily census: 16!

 

[anonymousEM]

EM residents who are practicing on their own licenses as independent contractors make 95-120/hour in N.FL and S. GA. This is working on your own (maybe double coverage) in EDs that see up to 40,000 pt/yr. and keeps everyone busy.

 

[castaway]

Thank you all.

AnonymousEM: what does it mean to practice as an independent contractor (I thought once you had a license you had to moonlight as an IC)?

A moonlighting agency that operates in Louisiana and TX areas offers $65-70 and then goes up as you advance through your residency. I think they said everyone worked as an IC.

 

[USCDiver]

The moonlighting opportunities around here in eastern NC are usually about $100/hr. That means working 24 hours in a month (2 shifts) you can basically double your resident salary. Not too shabby

 

[vtucci]

when you are moonlighting, how is malpractice insurance working? Do you need your own policy for this?

 

[nocallaochicas]

when you are moonlighting, how is malpractice insurance working? Do you need your own policy for this?

can someone please answer vtucci's question?

what exactly do you need to moonlight? please answer for the very moonlighting ignornant

 

[Radiohead]

This is from a PGY I, starting in July.

There are 2 forms of moonlighting possible, in house and external. Not all institutions offer in house moonlighting, but mine, Carolinas, offers shifts in the fast track at $60/hour (10 hour shifts). You can do this as a first year, as long as you have completed 1 month of EM, and stay within the 80 hour work week. Other programs have things where you can teach ACLS, do code call, take admissions for other services,etc. All of these, as long as you are working under the auspices of your home institution, don't require you to get your own malpractice insurance. Nor do they require you to get a permanent medical license.

Now, on the other hand external moonlighting is quite different, because you are essentially going out on your own and working in an ED independent of your residency program. There is a big debate as to whether working independently in an ED while still being a resident compromises the validity of the specialty. I'll leave this alone. Anyway, there are certain requirements to being able to moonlight. 1) You need your permanent medical license. Thus, you must have completed 1 year of post graduate training and pass step 3. (This is different for FMG's and DO's in some states) 2) You will need seperate malpractice insurance. This is usually picked up by which ever institution you are working for. Getting your medical license is expensive, but well worth it when you are pulling in an extra 30,000 a year in some cases.

In addition, some programs use a cutoff for the inservice exam for moonlighting. It varies among programs. I hope this helps.

 

[anonymousEM]

Some places (not mine) offer opportunities for inhouse moonlighting. Some of this is filling in shifts for PAs, uncovered spots in teh ED schedule, ICU shifts whatever that are still covered by the attending's license. These usually don't pay a ton (maybe 50-60/hr though) but you also don't have to do anything extra except fill out paperwork at your own institution.

For those of us working as independent contractors with another hospital (I suppose you might find somewhere that hired you as an employee of the group but more rare) it is important to find out up front how malpractice will work. Make sure they are providing you a policy with acceptable limits AND A TAIL if it is claims made insurance. (OTHERWISE YOU WILL HAVE TO COUGH UP CASH WHEN YOU LEAVE TO COVER YOURSELF FOR THE REMAINDER OF THE STATUTE OF LIMITATIONS POSSIBLE ON EVERY PT YOU SEE-which in peds is often a couple of years AFTER Their 18th birthday) The other type of insurance is occurance and it is pretty rare these days. Some places friends of mine looked into didn't provide anything and we can't afford to get our own policies given the amount we'd be working.

So most of us work about 75 miles away from the hospital in a small town with some really sick people. the hospital sees about 40k/yr and we get experience being the only doc in the hospital and arranging transport etc stuff we don't do so much administratively.

ALSO BE SURE YOU"RE COMFORTABLE WITH THE ARRANGEMENT FOR SUPERVISING PAs. At this point in my career I am not comfortable with just signing the charts on pt's I never saw for PAs I don't know so I choose not to work shifts where they are working. To me it's just not worth it. Others have great arrangements and are very comfortable, see each pt quickly after the pa presents if the pt isn't super straightforward and have no issues with this...just another thing to keep in mind.

 

[Seaglass]

Generally these days malpractice is covered by whoever is hiring you to moonlight. You need a state license and your own DEA to moonlight on the outside. Here in western NC it pays in the 90s-100s per hour for EM trained.

 

[design]

Generally these days malpractice is covered by whoever is hiring you to moonlight. You need a state license and your own DEA to moonlight on the outside. Here in western NC it pays in the 90s-100s per hour for EM trained.

Anyone from NY moonlighting? Whats the going rate 😳

 

[macdaddy23]

Probably a whole different topic:

It is true that as an independent contractor(IC) the company you work for generally provides the malpractice insurance and tail coverage; however, be careful as to who you work for.
Make sure they are a strong company financially and will be around for a while. A promise to pay tail insurance means nothing if the company files for bankruptcy.

There was a company in the south a few years back who paid residents well but they went bankrupt and the residents were sent letters that they were now responsible for tail coverage (much more money than any of them made).

 

[faviola]

I was told moonlighting wages can vary quite a bit. Just wanted to get a sense of what to expect from those of you out there who have moonlighted. Thanks!

I know moonlighted wages are for the most part over $40/hr..makes it quite worth it

 

[Apollyon]

Probably a whole different topic:

It is true that as an independent contractor(IC) the company you work for generally provides the malpractice insurance and tail coverage; however, be careful as to who you work for.
Make sure they are a strong company financially and will be around for a while. A promise to pay tail insurance means nothing if the company files for bankruptcy.

There was a company in the south a few years back who paid residents well but they went bankrupt and the residents were sent letters that they were now responsible for tail coverage (much more money than any of them made).

When you're an independent contractor, the company you work for is yourself.

 

[TysonCook]

You also need to be careful about your loan arrangements. Several residents I spoke with managed to make enough $$ that they no longer qualified for the economic hardship deferrment, which then bumped them back into repayment.

 

[nocallaochicas]

This is from a PGY I, starting in July.

There are 2 forms of moonlighting possible, in house and external. Not all institutions offer in house moonlighting, but mine, Carolinas, offers shifts in the fast track at $60/hour (10 hour shifts). You can do this as a first year, as long as you have completed 1 month of EM, and stay within the 80 hour work week. Other programs have things where you can teach ACLS, do code call, take admissions for other services,etc. All of these, as long as you are working under the auspices of your home institution, don't require you to get your own malpractice insurance. Nor do they require you to get a permanent medical license.

Now, on the other hand external moonlighting is quite different, because you are essentially going out on your own and working in an ED independent of your residency program. There is a big debate as to whether working independently in an ED while still being a resident compromises the validity of the specialty. I'll leave this alone. Anyway, there are certain requirements to being able to moonlight. 1) You need your permanent medical license. Thus, you must have completed 1 year of post graduate training and pass step 3. (This is different for FMG's and DO's in some states) 2) You will need seperate malpractice insurance. This is usually picked up by which ever institution you are working for. Getting your medical license is expensive, but well worth it when you are pulling in an extra 30,000 a year in some cases.

In addition, some programs use a cutoff for the inservice exam for moonlighting. It varies among programs. I hope this helps.

Thanks radiohead. That was exactly what I was looking for. ncc

 

[southerndoc]

You also need to be careful about your loan arrangements. Several residents I spoke with managed to make enough $$ that they no longer qualified for the economic hardship deferrment, which then bumped them back into repayment.

I don't qualify for economic hardship (from my base salary alone, not including moonlighting). I'm not repaying my loans yet.

Even if you do not qualify for economic hardship, there is residency forbearance and fellowship deferments that are available. Your loans are no longer subsidized during this period.

 

[Derek]

Here in El Paso several residents are making $150-170/hr depending upon their RVU's and how quickly they turn patients. Malpractice is covered by the group they are contracting with.

 

[southerndoc]

We make $65/hr with occasional $250 bonuses when internal moonlighting within our institution.

We can start external moonlighting the second half of our third year (four year program). Residents who have done external moonlighting have said they are making from $90-150 per hour.

 

[castaway]

One agency will fly you to Corpus Christi, TX and pay $100/hr. Beaches in Corpus are pretty decent.

 

[Jeff698]

One agency will fly you to Corpus Christi, TX and pay $100/hr. Beaches in Corpus are pretty decent.

Which facility in Corpus? Which agency?

Enquiring Texas minds want to know...

Take care,
Jeff

 

[jashanley]

This is from a PGY I, starting in July.
There are 2 forms of moonlighting possible, in house and external. Not all institutions offer in house moonlighting, but mine, Carolinas, offers shifts in the fast track at $60/hour (10 hour shifts). You can do this as a first year, as long as you have completed 1 month of EM, and stay within the 80 hour work week.

This sounds a little frightening to me. A first year with one month of EM experience running a fast track? Do you have attending oversight?
I work at a fast track in Chicago on my own license a 2-3 times/month and as a 4th yr resident. The stuff that comes through 98% is easy now, but I couldn't imagine doing it as a 1st yr and there is still that 2% where I'm like I have never seen that before. I hope your triage RN is good. In the fast tracks I have worked, the triage RN can screw up amd put sickies into your fast track. I have admitted my fair share of PICU patients (not just observation type), septic, thrombocytopenic, hemolytic anemias. We have had subarachnoids put into fast track. I also can't imagine a 1st yr keeping a fast track moving well. My bias based on experience.
I do think moonlighting is important. It teaches you to your own way to practice and you have to make your own decisions and stand by them.

 

[Radiohead]

This sounds a little frightening to me. A first year with one month of EM experience running a fast track? Do you have attending oversight?

Oh absolutely. Remember, I said that the FT moonlighting is In House. You work in the same capacity as you would during a normal housestaff shift, i.e. presenting to attendings, etc). The only difference is that you are getting paid extra because you are working extra to help keep the fast track covered with cheap labor. And yes, our FT is known to get ICU players, but we aren't managing them by ourselves.

 

[castaway]

Jeff,

Try emergency consultants inc. at 800-253-1795.

 

[Jeff698]

Jeff,

Try emergency consultants inc. at 800-253-1795.

Thanks for the info! I'll look into it. My family lives down there...that would be sweet.

Take care,
Jeff

 

[chitownxfer]

We have great moonlighting opportunities at Advocate Christ in Chicago. As an INTERN I earn $50/hr ($70/hr for R2&3's) working in our Emergency Cardiac Center (ECC). All cases are supervised and staffed by an attending at some point, which removes the dreaded liability associated with moonlighting at outside institutions. Our program is one of the few in the nation that allows interns to moonlight. These shifts are high yield in terms of learning and offer an opportunity to function fairly independently with no more personal risk than a normal residency shift. Additionally, if we are asked to stay after our shift or cover for someone on sick/emergency leave we are compensated at $70/hr. Several of our residents have doubled their salaries through these amazing opportunities.

 

[bartleby]

External moonlighting is a great chance to leave the ivory tower of your residency as a senior and get a glimpse of what it's like to be a working stiff. Aside from fattening your wallet, it can also help you decide what you do and don't want when you're looking for your first job.

But make no bones about the risks involved. Big pay means big responsibility. With the training wheels off, you'll have a scare or two. That can be a good thing provided you're working in a safe environment, which means _only_ moonlighting as double or triple coverage so there's always someone around to ask for help when you really need it. Suddenly that hip fx doesn't seem so obvious when you don't have the radiology resident around doing evening over-reads. Working solo is foolhardy. Malpractice claims are the modern equivalent of skeletons in the closet, and you should do everything you can to keep your rap sheet clean, particularly before you finish residency. How would you like to have to start explaining a claim against you on a job interview?

As far as the thought that moonlighting in the ED as a resident somehow sullies our speciality, I see some credence in this. However, I feel that this goes a bit deeper in medicine. Why does the anachronism which allows you to be licensed in some states after your intern year even still exist? Even though board certification and licensure are not linked, it would be hard to argue that you're at least tacitly qualified to practice medicine these days without satisfactorily completing a residency first.