Staying credentialed at multiple hospitals?

[herewego]

Time sensitive question: PGY3 here, graduating in June, and got my primary job lined up at a hybrid community hospital in the city with some academic ties. Schedule is gonna be around ~1400 hours a year for full time.

Is there benefit to having a moonlighting gig at this point in my career ? The group I'm signing with has a pretty stable contract, but it's a small independent group so who knows what could happen. I was thinking of signing up for some moonlighting with a larger democratic group that staffs multiple ((4) hospitals out in the burbs. I like them and like the way they run, have some alumni that I trust who tell me good things.

To me this would
1) give me a chance to pick up extra cash
2) keep some ties to another group
3) stay credentialed at multiple hospitals incase something goes south
4) change of pace

Cons are:
1) eat my time
2) going to multiple extra sites and not knowing their systems well

Any thoughts? Would appreciate some help from you guys who have been out there in the real world. Any help would be appreciated though.

---

Members don't see this ad.

 

[gutonc]

Not EM, so take my reply with a grain of salt.

If you like the primary gig (on paper), sign up and work for a year. If you want the moonlighting option after a year or so, it will still be there, sign up for it then. Don't spread yourself too thinly at the get-go. The likelihood that things will go south in a year is low (not zero though, I recognize that).

 

[deleted109597]

OTOH, it hurts you nothing to credential there. Apart from mandatory "training" and whatever forms you have to fill out, you don't have to actually do anything. But, you're available, and if you want extra work, you can always go pull an extra shift. If you don't want extra work(money), don't. Don't sign a contract that makes you work a certain number of hours and you'll be fine with moonlighting. It's all I do now, and I can work as little or as much as I want.

 

[herewego]

I appreciate the replies. I'm leaning toward exactly what you mentioned.

 

[HunterGatherer]

Agree with DrMninja. also I suggest getting credentialed within different groups not just different hospitals. Many times being credentialed at one hospital in another system streamlines your ability to work at other hospitals in that system .

 

[heroesinahalfshell]

OTOH, it hurts you nothing to credential there. Apart from mandatory "training" and whatever forms you have to fill out, you don't have to actually do anything. But, you're available, and if you want extra work, you can always go pull an extra shift. If you don't want extra work(money), don't. Don't sign a contract that makes you work a certain number of hours and you'll be fine with moonlighting. It's all I do now, and I can work as little or as much as I want.

Do you guys use any specific service that streamlines the application process? In regards to previous places of employment, references, etc. Likewise I believe there is a service for state licensure for this as well? Anybody have experience with them?

 

[deleted109597]

Do you guys use any specific service that streamlines the application process? In regards to previous places of employment, references, etc. Likewise I believe there is a service for state licensure for this as well? Anybody have experience with them?

No. It's not that hard, I promise. Especially in Texas. Save your standardized credentialling form as an editable .pdf, and print it out and sign it. Getting credentialled at a hospital takes literally less than 30 minutes of my time. The hospital may take days to months, depending on how desperate they are.

 

[Groove]

Time sensitive question: PGY3 here, graduating in June, and got my primary job lined up at a hybrid community hospital in the city with some academic ties. Schedule is gonna be around ~1400 hours a year for full time.

Is there benefit to having a moonlighting gig at this point in my career ? The group I'm signing with has a pretty stable contract, but it's a small independent group so who knows what could happen. I was thinking of signing up for some moonlighting with a larger democratic group that staffs multiple ((4) hospitals out in the burbs. I like them and like the way they run, have some alumni that I trust who tell me good things.

To me this would
1) give me a chance to pick up extra cash
2) keep some ties to another group
3) stay credentialed at multiple hospitals incase something goes south
4) change of pace

Cons are:
1) eat my time
2) going to multiple extra sites and not knowing their systems well

Any thoughts? Would appreciate some help from you guys who have been out there in the real world. Any help would be appreciated though.

My rules of thumb:

1) Always keep your options open and never burn bridges.
2) Keep privileges active in more than one hospital.
3) Keep at least two active state license at all times.

Always keep your options open. I can't say it enough. I don't care how perfect your gig is touted to be, hospital politics can be frustratingly unpredictable. The ED contract or environment can change on a dime and you might be looking for a new place to work. The last thing you want is to be frantically trying to get credentialed somewhere new (2-3 months) without a paycheck. Always plan on disaster scenarios and be ready to smoothly pivot to "plan B". It's not uncommon for people to sign PRN contracts and moonlight on occasion to keep their privileges active. Honestly, most people will still keep you credentialed at their hospital even if you aren't working at all, simply for the sake of keeping you on staff in case they ever need you in a pinch.

That's the practical side of staying credentialed in another hospital. There's also a psychological advantage. It's more difficult to brow beat you into changing your practice or accepting substandard policies, etc.. when you have an alternative place to work where you don't necessarily have to put up with X, Y or Z. You're never really worried about losing your job or being out of work because most of the time you can be on the other EDs schedule next month with one phone call or email.

Also, it's worth mentioning that if you live in an area where some surrounding EDs are difficult to staff, you can regularly pick up shifts at higher than market rates as they are desperately trying to fill the empty shifts every month which not only keeps you active and in good relations with the hospital/ED contract group, but can be very lucrative.

If you ever decide to quit working for someone, try to do it gracefully. You never know when it may be opportunistic to work for them again in the future. Also, the world of EM is not that big and it's very likely that if you stay in a single area, you'll find yourself working with the same people again at some point. Cultivating a positive reputation in your area among your peers can go a long way for future opportunities.

 

[dchristismi]

Groove has hit the nail on the head.
You really never know.

I'm credentialled at 3 different hospitals (2 different systems, 3 different groups.) Have all your documents in digital format, and you can upload things pretty fast. Most of the time, there is a credentialling person who does most of the nitty gritty, but since it can take months, having an extra site or two can provide a sort of insurance against the whims of modern healthcare. (I'd say "medicine," but who are we kidding. This is business.) I went through loss of contract at my main site and it was, well, painful might be an understatement. After that, I figured better safe than sorry.

Credentialling is a pain, but it's a relatively cheap insurance policy if you look at it like that.

 

[herewego]

Appreciate all the replies, super helpful

 

[shookwell]

Some hospitals will try to charge you a fee to credential to prevent you from credentialing if you don't plan on working there, but it's usually not that much, in the range of $200-300. For places I've credentialed that I actually planned on working, I usually tell them I'm not willing to pay a fee to credential and I've never had an issue. They usually need you more than you need them. I'm currently credentialed at 5 hospitals, 3 of which I work at regularly. I was credentialed at another 2 hospitals but really disliked working there after an administration change so I resigned.

A better option may be to do internal credentialing at a good locums company that has multiple contracts in your area. If you have a full time job and don't need benefits, you will make more working as an IC for a locums company. The locums company will also do all the legwork and paperwork to credential you at their hospitals if you pick up shifts for them.

 

[Apollyon]

I'm currently credentialed at 5 hospitals, 3 of which I work at regularly. I was credentialed at another 2 hospitals but really disliked working there after an administration change so I resigned.

If you resigned, how do you remain credentialed at this locations?

If you meant 7 in total, then my apologies.

 

[shookwell]

I was credentialed at 7. Resigned from 2 (same network). Another 2 I don't work at much anymore since they cut their rates but I maintained credentialing because I'm willing to take shifts when they offer higher rates for last minute coverage.