Before you moonlight: The ins and outs

More doctors are taking clinical side jobs to make ends meet or determine the next career move. But how do you make sure it doesn't affect your day job?

By Larry Stevens, AMNews correspondent. Oct. 22/29, 2007.

Moonlighting isn't just for residents anymore. Many of the same factors -- a desire to supplement income, network for future positions and get a wider range of clinical experiences -- that drive residents to step into separate clinical positions increasingly are pushing practicing physicians into doing the same thing.

The career path of Philadelphia internist Alison Alexander, MD, has included numerous moonlighting gigs. During her residency, Dr. Alexander moonlighted within her residency program a few weekends a month. That, she said, allowed her to improve her training by seeing more patients and to supplement her residency income.

When she completed her residency, Dr. Alexander joined forces with another doctor to form a group. To supplement the practice's revenue, increase its patient base and provide continuity of care for patients, she took moonlighting jobs as medical director of two nursing homes.

"I had to work weekends and evenings, but it provided a number of benefits for our patients and those in the nursing home," Dr. Alexander says. For example, she says a surprisingly large number of patients entering the facilities did not have a doctor. Because they got to know her, Dr. Alexander ended up taking them on as patients. "It was a good way to help build my practice, and it gave the patients continuity of care from the nursing home to outpatient treatment," she says.

Dr. Alexander liked moonlighting so much that she decided to become a full-time moonlighter, leaving her practice to become a locum tenens physician. But most moonlighting physicians are sticking by their current positions as they fill the healthy demand for their skills.