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October 19, 2020

Working with moonlighters

At no time does a physician shortage become more apparent than during those "off” hours - the wee hours of the morning, weekends and holidays when most physicians would rather be home. Maybe that’s why "moonlighting," or picking up extra hospital shifts, is an attractive option.
Hospitals find staffing those off-hour shifts a "necessary evil," says Dan Bensimhon, M.D., who moonlighted as a cardiology fellow and who has since founded Moonlighting Solutions. "Some hospitals work with a network of local physicians, others contract with locum tenens groups," says Bensimhon.
Residents are often eager to take advantage of moonlighting opportunities to help supplement their income and pay off debt, and it can be a good way for them to test-drive a job or even consider work as a hospitalist.
But before you hire moonlighting residents - or encourage them to take on shifts - take these factors into consideration.
Know your organization’s policy
Residents practice with limited licenses, so some resident programs will not allow their residents to moonlight at all, period.
Other programs may allow residents to moonlight internally, at the facility where they are currently residents. Moonlighting at another hospital, called external moonlighting, is not usually allowed.
Check in with the program director
Residents usually must wait until their third year of residency to moonlight, although some residents may begin moonlighting as early as their second year.
Regardless of when they start moonlighting, they must have the approval of their program supervisor to do so. Make sure they have their supervisor’s support.
Watch for signs of burnout
Be aware that moonlighters, whatever their career stage, may experience burnout. "When you start moonlighting, you realize your salary is only limited by your ability to stay awake," says Daniela Lamas, M.D., who started moonlighting in her third year of residency. Eventually, Lamas found she had taken on too much work. "I realized I was becoming exhausted, and I gave up one of the moonlighting jobs," she says. "The money is great, but you can’t afford to drop the ball on your health or on the work you do in your current position."

Consider these factors before hiring a moonlighting resident.
Make sure the patient population is understood
Finally, moonlighters should research the location and the kind of patients they will see at the times they plan to moonlight. "Anything can happen at night," says Bensimhon. Residents and new physicians should make sure they are ready to handle what comes up on the job, so they won’t be over their heads professionally. Be sure you’re communicating any differences the moonlighter might find in the shifts vs. their typical experience.
Moonlighting can be a great opportunity for residents and new physicians. Just make sure they - and you - are aware of some of the caveats that go along with the opportunity.

Consider these factors before hiring a moonlighting resident.


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