EMRA Policy on Moonlighting
Section X: Education and Professional Development - Moonlighting
There is a lot of paperwork associated with moonlighting, especially if you apply to multiple places or go through a recruiter. Below is a list of the documentation you might need to submit to apply / get credentialed at an institution. It is suggested that you scan and save these documents.
- BLS, ACLS, ATLS, PALS
- DEA, State controlled substance license
- State Medical License
- Med School Diploma (shrunken to 8.5 x 11)
- Undergraduate School Diploma
- NPI letter
- Drivers License and Social Security Card
- Letter of approval from Residency Director
- Health immunizations and titers
- 3 Letters of Reference
What to ask
- What kind of coverage (single, double, MLP)
- What specialties take call at the hospital?
- What kind of follow up is available?
- Do you have responsibilities outside of the ED?
- Are you responsible for running codes on the floor and ICU?
- Are you responsible for Labor and Delivery?
- How is documentation done (T-sheet, EMR, Dictation)?
- What are the main hospitals patients are transferred to? (STEMI, ICH, psych, trauma, obstetrics)
- How are no shows handled?
- What kind of lab tests are send outs? (Lipase, lactic acid, etc.)
- What kind of imaging is available at night? Ultrasound? CT tech in house? Nighthawk?
- How many floor/ICU beds are available?
- Is there a surgeon on call at night?
What to take with you?
- References (digital, hard copies)
- Anything else you know you can’t do a shift without (pillow, toiletries)
- List of Emergency Numbers (ED administrator on-call, “emergency” attending cell numbers in case you get in trouble)
What to do on your first shift
- Find out where your crash cart is
- Check your airway kit
- Meet the nurses and try to size up their abilities.
- Let the staff know what they can pre-order for you.
- Find out what’s for lunch/dinner/breakfast
- Claims-made: You’ll need tail coverage. Who pays for it?
- Occurrence-made: Good, no tail involved
- Noncompete clauses are a no-no
- Is there a minimum number of shifts you need to work per month?
Financial issues of moonlighting
- Your taxes just got more complicated
- Independent contractor
- Set aside about 1/3 of your paycheck each month
- Food while moonlighting
- ACS, DEA licenses
- Medical equipment
- Conferences (portion not paid for by your residency)
- Home office?
- Check with your accountant
- Estimated taxes
- Unnecessary 1st year as an independent contractor
- But in your second year, quarterly payments
- 4/15, 6/15, 9/15, 1/15
- Penalties for paying too little
- Federal estimates can be based on your previous year’s income which will likely be lower
- State estimates need to be paid as well