stricted license to practice medicine independently, just like any other phy- sician wishing to practice. Residents also must get an individ- ual Drug Enforcement Administration and Texas Department of Public Safe- ty number for prescribing, and those moonlighting outside their institu- tions must secure their own medical liability insurance. Robert Cooper, MD, now finds himself in Dr. Young’s shoes. The second-year family medicine resident at TTUHSC Amarillo picks up an eve- ning or weekend shift every now and then at an ED, urgent care center, or long-term acute care facility in some of the surrounding towns. The extra income certainly helps
chip away at his six-figure student loans. “But the more invaluable part is the experience and what I’ve learned to fine-tune me for the real world when I’m on my own. You definitely gain this confidence, and you can’t put a price on that,” he said. Without moonlighters, many of the
rural hospitals he works for would have to shut down on the weekend or hire more expensive, seasoned physi- cians, Dr. Cooper adds. “That means decreased access to medicine and in- creased health care costs — two funda- mental things we are trying to fix now in Texas.”
Because of the 80-hour limit, he
knows certain rotations won’t allow extra time for moonlighting. During a lighter rotation that requires less in- patient service, however — even more likely in his third year — he informs the urgent care company of his avail- ability months in advance. Dr. Cooper did have to get permis-
sion from his program director and sign a contract agreeing to log his moonlighting hours, as he does for training. But he doesn’t consider the administrative requirements a deter- rent. “They encourage us to moonlight here, so long as we aren’t doing it at the cost of patient safety and violat- ing the duty hours. It’s somewhat of an honor system, but it’s a blanket
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