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Moonlighting: Adopt credentialing guidelines

Residency Program Connection, December 13, 2004

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Dear residency program colleague:

Moonlighting can be a contentious issue for residency programs, residents, program directors, medical services professionals, and hospital administrators. However, your organization's minimal credentialing
guidelines for employed residents can help you navigate potential   challenges in regard to moonlighting staff.

For example, your organization's minimal credentialing guidelines
should require employed and moonlight staff who provide coverage in a
specified clinical services to

• be employed by, or under contract with, the hospital to provide 
  services as a house physician 
         
• meet the basic qualifications set forth in [section] of the medical
  staff bylaws, except for those set forth in [other applicable
  section],but only if the physician is currently enrolled in an
  accredited residence/post graduate training program and has
  satisfactorily completed two years of that program 
    
• meet the basic obligations provided in [section] of the medical
  staff bylaws
  

You likely have a handle on the general qualifications of such
practitioners, but it is worth a review. All moonlighting staff should
have a current valid license issued by your state to practice medicine,
dentistry, or podiatry; and a current valid federal and state controlled
substance registration (if applicable). Remember, the practitioner must
also be employed by, or under contractual agreement with, the hospital to provide services as a house physician. Your minimal credentialing guidelines for employed residents and moonlighting staff should also require that clinical privileges are specific to the practitioner's hospital coverage requirements.

In addition, clinical privileges should be function-specific and applied to all individuals employed to provide coverage for a specific clinical area; not be expanded in response to person-specific clinical strengths as
inconsistent coverage situations would results; and be described in either a job description or separate privilege form.

Keep in mind that separate privilege groupings may be developed for
various areas requiring coverage. Examples include house staff providing
obstetrical or surgical coverage.

That's all for this week!

All the best,
Hugh Greeley

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