X.G. Moonlighting Policy

Moonlighting is any medical-type professional activity that is not part of the course and scope of the resident or clinical fellow's educational Program. Moonlighting must not interfere with the ability of the resident or clinical fellow to achieve the goals and objectives of the educational Program. All medical and non-medical type outside employment should be reviewed and approved by the Program in accordance with LSU System Permanent Memorandum – 11. http://www.lsu.edu/administration/policies/pmfiles/pm-11.pdf

• All moonlighting activities must be reported by each House Officers as work hours within the New Innovations Software Program.
• All moonlighting must be counted toward the 80-hour weekly work hour limit.
• House Officers cannot be required to engage in moonlighting activities.
• PGY - 1 House Officers are not permitted to engage in any moonlighting activity.
• House Officers employed under a J-1 visa are prohibited by law from participating in moonlighting activities.
• House Officers are not permitted to participate in any moonlighting activities at pain or weight loss clinics.
• Individual ACGME-accredited Programs may prohibit moonlighting by the Program's House Officers.
• Each House Officer must submit to his/her Program Director, a prospective, written request for approval of all moonlighting activity, which must be signed and approved by the Program Director and/or Department Head and maintained as part of the House Officers permanent training record. Each request for moonlighting must include the nature, duration and location of the moonlighting activities and must be accompanied by a completed Disclosure of Outside Employment Form in accordance with LSU System Permanent Memorandum - 11. http://www.lsu.edu/administration/policies/pmfiles/pm-11.pdf
• House Officers participating in moonlighting activities must be fully licensed to practice medicine in each state where he/she moonlights and must have their own Federal DEA # to support any moonlighting activities. Neither a training license nor a training DEA # may be used to support any moonlighting activities.
• House Officers moonlighting will not be covered for medical malpractice under the LSU Health Sciences Center's Professional Liability Insurance Policy. House Officers must maintain adequate professional liability coverage or ensure that his/her outside employer provides adequate professional liability coverages. It is the responsibility of the House Officer and his/her outside employer to determine what level of coverage is "adequate". It is further the responsibility of the House Officer and his/her outside employer to determine whether the House Officer has the appropriate licensure, and the appropriate training and skills to carry out his/her assigned duties.
• Each Program Director shall be responsible for ensuring that moonlighting activities do not interfere with the ability of the House Officer to meet the goals, objectives, assigned duties, and responsibilities of the educational Program. Each Program Director shall monitor all moonlighting activities in his/her Program. If, at any time, moonlighting activities are seen as producing adverse effects on the House Officer's performance in the Program, the Program Director may withdraw permission to moonlight.
• Permission for moonlighting may be withdrawn at any time by the Program Director, Department Head, and/or the Associate Dean of Graduate Medical Education.
• House Officers moonlighting without prior written approval will be subject to disciplinary action.

Any House Officer violating any School of Medicine moonlighting rule, policy or procedure will be subject to disciplinary action.
Special Considerations Deserving Emphasis:
The following behaviors are highly discouraged and in some cases, may be illegal. The LA State Board of Medical Examiners and the DEA will independently investigate and prosecute individual House Officers if they so desire.

• Moonlighting if not fully licensed and if the House Officer does not have his/her own malpractice and DEA number.
• Pre-signing of prescriptions.
• Using facility prescription DEA numbers outside assigned facility (number is site specific).
• Signing documentation saying a patient was seen when the patient was not.
• Failure to put all narcotics prescriptions in the patient's name and address plus the date.
• Having a nurse do assigned tasks that are the physician's responsibility.
• Failure to read the fine print. (House Officers are held accountable for all things signed.)
• Failure to follow accepted practice guidelines for everything, especially weight loss and pain patients.
• Failure to be cognizant of Medicare fraud and abuse guidelines.
• Treatment of family members.

Note: If a House Officer treats anyone he/she must create a medical record which includes a history, physical and appropriate laboratory and diagnostic tests in keeping with the standard of care. This activity is considered moonlighting and requires licensure, DEA and malpractice insurance independent of those provided as part of the training Program. It is far better to refer family members and friends to another practitioner.
Once a House Officer has treated someone, a doctor-patient relationship has been created and all the legal and professional issues that entails. This includes HIPAA laws precluding discussing it with the Program or anyone else.