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March 2015 Bulletin: Malpractice

Are You Covered for “Moonlighting”?

Kathy Schroth

— Kathleen Finnerty-Schroth, CIC

You never want to learn after the claim is made that you don’t have the proper insurance coverage, whether it involves your Auto, your Home, or your Health insurance. So too, it would come as unpleasant news that your professional liability insurance did not follow you to the part time work you were doing as a moonlighting physician. Physicians employed by large healthcare delivery systems are typically not covered for professional services provided outside of the hospital or employer’s network. They require some type of “moonlighter” insurance coverage to respond to any medical malpractice allegations that might arise from work outside of their normal employment.

The rationale for the employer’s stance on this issue is in part due to the employing organization’s careful management of risk associated with their own institution or network. The Hospital certainly does not wish to relinquish that element of control and management. Nor do they want to expand their exposure to absorb the risk presented by the gamut of moonlighting work options at other venues, from local nursing homes, urgent care centers, hospitalist shifts at competing hospitals and small practices seeking coverage for a vacationing doctor.

Residents struggling with financial stressors may find that the option to work extra hours is offered within their own network or facility, and possibly covered by their current malpractice insurance. In these cases, discuss your plan with your supervisor, keeping in mind that you are subject to the 80 hour cap for any “in-house” moonlighting you take on. However, taking advantage of opportunities to expand your clinical experience, network with other employers or earn extra dollars outside of your program setting will generally mean that you need to arrange for your own insurance protection.

The appeal of moonlighting opportunities is not restricted to residents, of course, and more “seasoned” physicians also recognize the benefit of expanding their experience and learning about other clinical opportunities –  and the benefit of additional revenue is not lost on the older physician, either.

As an employed physician, be aware of any restrictions to your medical malpractice coverage. If your protection will not follow you to work outside of your employment, a separate insurance policy for your moonlighting work may be necessary.

Before you take the plunge and agree to work part time for another employer, determine if you will be provided with medical malpractice insurance. Locum Tenens placement agencies may provide you with some coverage, though it may not be at the level you desire, and the cost for it will usually be deducted from your hourly rate. Sometimes, if you are stepping into the shoes of another physician during the doctor’s vacation or leave period, their insurance policy may be extended to cover you under the  locum tenens provisions of their policy language, and that can often be arranged at no premium charge.

For the most part, though, when you are not an “employee” and are being paid as an independent contractor, chances are you will be responsible for your own medical malpractice insurance protection. Obtain a premium quote for the cost of the malpractice insurance and weigh that expense, along with commuting costs and loss of your own personal time, to be sure that it makes sense for you to take on the extra work. Pricing for moonlighter coverage is dependent upon planned work hours, with generous discounts when you are moonlighting less than 80 hours monthly.

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