This physician decided
This physician decided

Moonlighting: Physicians in the driver’s seat

Read PracticeLink articles from Michele Gutermuth.
Michele Gutermuth

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The old way of thinking is that moonlighting was done when you wanted to change direction or try out a new employer. In 2021, moonlighting during residency is common and sometimes necessary to keep up with the staffing demands because of the primary care physician shortage. 


I know some physicians reading this might immediately say they are not interested in moonlighting, but I would caution you not to say no quickly. Even if your interest isn’t moonlighting full time or regularly, having yourself available in an emergency for a hospital can provide you with many benefits – and the community with a much-needed physician. 


Think about it. What if you are at home on a Saturday with nothing to do and the phone rings. It’s the local hospital, and they have an opening for a shift from 11 pm – 7 am in their low-volume emergency department, and you can use the money. If you had already told all the local hospitals you do not want to moonlight or that you would not moonlight under any circumstances, you would not be available to take advantage of this opportunity. But on this night you could say no, or not answer your phone because you have a lot of studying to do. Either way, you would be in control. 


Moonlighting pros

Do extra shifts mean extra money? Most of the time, yes. 


Also think about the knowledge and the experience you are receiving by doing this extra work. You will more than likely have more confidence than someone who chose not to moonlight during their training program.


In addition, if you are considering permanent employment after training with one of the places where you are going to moonlight, you will have a step ahead of the rest of the applicants. 


Physician beware

Read the fine print! Most likely, you will know where you can moonlight during your training program, but read the fine print. You may be able to work as a physician, working in another clinic, OR you might only work inside your university or training facility. 


Also, you might not be allowed to moonlight as a physician anywhere, so read your residency agreement. Are you able to give a lecture and be paid for that? Can you provide any service based on your expertise and knowledge, not seeing patients, and be paid? 


Be sure of these things:

Consider malpractice insurance coverage. Make sure you have enough malpractice insurance coverage to moonlight. Speak with a health care attorney about this. Check your policy to see how you are covered. Review the moonlighting agreement and see how you are covered. And keep good records. This is the most important advice overall – in addition to getting a good health care attorney.


Know what you are giving up. You are going to be giving up study time, sleep, time with family. You have made excellent decisions to this point; do not fail yourself now. 


Keep inside the maximum allowed rules of 80 hours per week (again, if your residency program allows moonlighting).


If your income goes up, so may your student loan payments. Be sure to talk to an expert about this. Student loan payments are complicated. You may not want to defer your loan payments while you are in residency; you instead may want to have an income-driven payment plan. And I always suggest living like a resident past your residency training. 


There are many benefits to moonlighting, but make sure the benefits do not add extra stress that makes your performance in your residency program slide or negatively impacts other areas in your life. Although this may sound like an oxymoron during residency, remember to find time to rest, recharge and renew your commitment to becoming the best health care provider you can be.

Read PracticeLink articles from Michele Gutermuth.

Michele Gutermuth

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