Locums, Moonlighting, and the Second Job #illumedati 1

Hey guys, sorry for the late post. I was having some issues with WordPress this morning. I’m going to talk about Locums, Moonlighting and the Second Job today.

What…? More Work?

Orc Peon from Warcraft

My close friend is leaving his job to start a new job somewhere else. Like me, he is a radiologist. His new job will be more a shift schedule where he will work consecutive days and then have some days off. For this reason, he is thinking about working a few of his days off elsewhere. So we talked about it.

First things first:

Is it worth it?

This is a personal question and requires you to do some introspection.

I currently work a shift schedule as well and a few of my colleagues previously have worked second jobs elsewhere. Usually they cover weekends or certain shifts for some of the other radiology groups here. When I first got here in April 2014, I had planned to also take some of my days off to do some moonlighting. I started putting out feelers to the groups in the area and was going to start doing some moonlighting shifts. However, because I work for the VA, I don’t need to carry my own malpractice insurance. If I was to do some moonlighting, I would need to carry my own.

For you, you may already have your own malpractice insurance through your current employer. However, I can almost guarantee that your malpractice coverage will not cover any of your moonlighting activities, for good reason of course. Your employer doesn’t want you to work outside of your primary job, and more so than that, doesn’t want to cover you for any work you do not affiliated with them.

This is the first speed bump in moonlighting. You will need to decided whether you want to carry your own malpractice insurance. For certain specialties, like OB/GYN, which I have very high malpractice insurance premiums, this may essentially prevent you from moonlighting. Your malpractice insurance premium is a pretty much a sunk cost for moonlighting. It’s simply a cost of doing business that you can’t really recover… except to do enough work to offset it. This brings me to the next step:

Make sure you are able to do enough shifts/work in order to cover the malpractice insurance. If you only work a few extra shifts for the year and make $5000, but your malpractice for the year costs $2000, then your net is $3000… and I haven’t started talking about taxes yet. Let’s say you are already in the 33% bracket from your primary job, so your take home is 67% of $3000, which is ~$2000.

Now, there are other ways to handle this extra money. For example, you can setup it up such that you can utilize a SEP-IRA, so you can contribute up to 25% of your earnings or $53,000 (whichever is less). The other types are a SIMPLE IRA and a Solo 401k. I’ll go over these different options in the coming Finance Fridays post. It’s too long for this post.

Ok, now let’s refocus.

So, now you’ve taken into account carrying your own malpractice insurance and you also figured out approximately how many shifts a year or locums assignments you want to do a year. You’ve calculated the costs of carrying the malpractice insurance and weighed it against a range of how much extra money you would earn. You’ve calculated a range of net income.

You now have to decide to yourself whether it’s worth it to you.

Here is my story:

For me, I thought it was going to be worth it. I talked to my dad about my plan and his response was surprising.

“Why do you want to work more?”

My dad is probably the hardest working person I’ve ever known (aside from maybe my mom, who raised my siblings and I while working). He’s a tenured professor, but worked a few other side jobs, and then started his own business. He’s failed retirement maybe 3-5 times in the last 5 years, not because he can’t retire, but because he didn’t want to yet. I thought he would be the last person to ask a question like this.

I was surprised, but I responded that I felt I was behind with all this student loan debt weighing me down, needing to save a down payment for a house, being 10 years behind in starting to save for retirement, etc. etc. There are plenty of reasons as to why I needed more money… right?

“Do you really need the money?”

What…? Well, no, I guess not. I mean I have a plan for how to pay down my loans, save for a house, and put enough away for retirement. But like I said, I’m behind… right?

“If you don’t have to, then don’t.”

Well.. I mean, I don’t have to... but…

“Spend the time with your kids. Do things that interest you. If you push your primary job and skills too hard, you will get bored.”

I think my dad meant “burnt out” rather than bored, but I think I understood what he meant.

Time is both valuable and finite.

Would I like more money to get rid of my loans faster, house paid off faster, and more money in retirement? Of course. 

However, my daughter won’t be a little kid forever. I won’t get that time back with her. I already spend enough weekends away from her as it is with my one job.

How much time would I have missed away from her (and now my son) if I had started moonlighting? I don’t know because I never started moonlighting. I stopped looking into it after this conversation with my dad. Don’t get me wrong, I like radiology a lot. However, I think he is right. If I pushed myself to do radiology as a 2nd or 3rd job, I would get burnt out pretty fast.

I also have other things I am interested in. For example, I created this blog which I enjoy writing. This blog has pushed me to expand my knowledge base into other areas and to learn more. I don’t post anything on here that I haven’t tried my best to research. Additionally, I’ve also learned a lot about wordpress and how it works, although I’m pretty much still a novice. I hope to work on this blog for years to come and create content people will want to continue reading. Slowly, slowly.

Thanks to a friend of mine, I’ve also gained an interest in how start-ups work and have read some books on the topic. I have another side project I’m working on as well and it’s fun and refreshing, outside of medicine. Somewhat related to this I want to learn how to code in Swift, so I bought iOS 10 & Swift 3: From Beginner to Paid Professional. It has 71.5 hours of lecture… of which I’ve watched none. Before I can start doing that course, I need to either buy a Mac or create a Hackintosh and put OS X on my PC. This is on my list of things to do for the year… Slowly, slowly.

Wait a second… aren’t those “other jobs” too?

Yes, but they are outside of medicine. And unlike a locums or moonlighting gigs, I think I can walk away from this blog or any other side project I have without much difficulty. The major reason is because this blog and these side projects don’t really make any money, they are really just their to enrich my knowledge base. If these side projects do make some money someday, that’s great. However, my kids and my family will always come first.

With moonlighting, it’s hard to walk away from something that makes you more money… especially if you’re used to having it.

Long story short, it wasn’t worth it for me.

However, for many others, it is worth it. Maybe your current job is only part-time and locums/moonlighting opportunities are plentiful in your area. Or perhaps you really want to pay off all your student loans as soon as possible and are focusing all your efforts on that. That is an admirable goal.

Just remember that it is has to be worth it. Try not to get burnt out. Your time is valuable. Talk to yourself like my dad talked to me.

As an aside, I would really recommend that if you do any moonlighting/locums work, that you create a SEP-IRA, SIMPLE IRA, or Solo 401k in order to try to save more money for retirement. To me, I think that is a huge advantage to moonlighting/locums. The likelihood of maxing out a SEP-IRA from doing locums is pretty low, as you would need to make a gross of $200k+ in order to put away the max of $53k. However, every single dollar put away into a retirement account early in your career helps. Like I said above, I will talk more about SEP-IRA, SIMPLE IRA, and Solo 401k this Friday.


Before you do any locums or moonlighting, check:

Your current employment contract. It may not allow you to.

How much malpractice insurance costs.

Estimate the range of how much you would make.

Have a plan on what to do with this “extra money”, SEP-IRA, SIMPLE IRA, Solo 401k.

Decide whether its worth it or not. Remember, it’s hard to go back to making less.



Agree? Disagree? Do you do moonlighting or locums? Do you have a SEP-IRA, SIMPLE IRA, or Solo 401k?

I’d love to hear your comments.

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