What Do Physician Employment Contracts Say About Moonlighting?

If you are a physician interested in moonlighting, it is important to understand how your employment contract addresses outside clinical work. Physician employment agreements often include specific provisions outlining whether moonlighting is permitted, restricted, or prohibited. Here is what physicians should consider if they are interested in moonlighting. 

What Parts of Contracts Could Exclude Moonlighting?

It is important to review the employment contract closely before moonlighting to avoid breaching it. A physician’s employment contract can lay out restrictions or outright bans on moonlighting. Here are some contractual provisions that physicians will want to look extra closely at:

Exclusivity Clauses

An exclusivity provision generally requires the physician to devote professional services exclusively to the employer during the term of employment.

Depending on the language, this clause may prohibit:

• Working for another hospital
• Practicing with a competing physician group
• Accepting telemedicine patients
• Performing consulting work
• Serving as a medical director elsewhere

Some exclusivity clauses contain exceptions for volunteer work, teaching, or charitable activities. Others require written approval from the employer before engaging in any outside professional activity.

Non-Compete Provisions

A non-compete provision is a contract term that restricts a physician’s ability to work for or provide services to a competing organization. Moonlighting may create concerns if the outside employer is considered a competitor. For example, a physician employed by a hospital system who provides weekend coverage at another nearby facility could face objections if the employer believes the arrangement may create a competing relationship. It is important to note that non-compete provisions are not always enforceable depending on the state.

Confidentiality Clauses 

Confidentiality and proprietary information clauses protect an employer’s sensitive information and prevent physicians from using or disclosing it outside the employment relationship. These provisions may restrict the use of patient information, clinical protocols, operational processes, pricing details, business strategies, referral patterns, and other non-public information gained through employment. Moonlighting may raise concerns if a physician’s outside work involves a competing organization or creates a risk that confidential information could be shared, intentionally or unintentionally. 

Non-Solicitation Clauses 

Non-solicitation clauses are designed to prevent physicians from using relationships developed through their employment to benefit another practice or organization. These provisions may restrict a physician from soliciting the employer’s patients, encouraging employees to leave, or attempting to redirect referral sources. Moonlighting arrangements can create potential issues when outside work overlaps with the physician’s existing professional network.

How Can I Moonlight Without There Being an Issue?

Many contractual disputes involving physicians arise not because they intentionally violate their employment agreements, but because they misunderstand the scope of their contractual obligations. Without careful review, physicians may inadvertently breach their contracts by accepting moonlighting opportunities or engaging in professional activities inconsistent with their primary employment agreements.

Before accepting either a primary employment position or a secondary moonlighting opportunity, physicians should have a physician employment contract attorney review all applicable contracts. A proactive review can identify inconsistencies and clarify how contractual obligations apply to multiple employment relationships. Key issues that should be evaluated include:

• Whether the employment agreement permits moonlighting or requires prior employer approval
• The scope and enforceability of restrictive covenants, including non-compete and non-solicitation provisions
• Scheduling requirements and whether outside work interferes with primary employment obligations
• Compensation, indemnification, and liability provisions associated with secondary employment

Frequently Asked Questions

Can a physician negotiate moonlighting rights?

Yes, moonlighting terms may be negotiated before signing an employment contract. In general, it is an excellent idea for physicians to consult with a physician employment contract attorney. A physician employment contract attorney can help identify unclear language, explain obligations, and advocate for terms that align with the physician’s professional goals and career plans. It is important to carefully review every contract and fully understand its terms before signing, as agreements can affect future opportunities and professional flexibility. A contract should clearly and explicitly state moonlighting expectations, including whether outside work is permitted, any limitations, approval requirements, or scheduling considerations. Taking time to review and negotiate these provisions helps physicians decide whether to accept the contract as is or negotiate terms.

Why does my employer care if I moonlight or not?

Employers may limit physician moonlighting to help prevent conflicts of interest, manage fatigue, and avoid competition with their practice or organization. These limits are often in place to support patient safety and ensure physicians can meet their primary job responsibilities. This is especially important in patient care and hospital settings, where physician availability, focus, and decision-making can directly impact the quality and safety of care provided.

How does moonlighting create a conflict of interest?

Moonlighting can create a conflict of interest when outside work overlaps with a physician’s primary employment responsibilities, especially if it involves a competing organization or shared patient population. For example, a hospital-employed cardiologist who moonlights at a nearby competing hospital and begins treating patients from the same community may create concerns about patient referrals, use of confidential practice information, or competing obligations between the two organizations.

Is telemedicine considered moonlighting?

Yes, telemedicine can be considered moonlighting if it is performed outside of a physician’s primary employment responsibilities. Whether it qualifies depends on how the employment contract defines outside work. Physicians should not assume that telehealth services are exempt simply because they are provided remotely. If a physician is seeing patients through a separate telemedicine platform, providing virtual care for another organization, or working outside scheduled employment hours, those activities may still fall under moonlighting restrictions.

Contact A Physician Employment Attorney 

If you are unsure whether your employment contract allows moonlighting, consulting a physician employment attorney can help clarify your rights and responsibilities. An experienced attorney can review your physician employment agreement, explain any restrictions, and identify potential issues before you take on outside work. They can also help you negotiate contract terms that provide more flexibility for your career in an employment contract. Contact us for help.