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Moonlighters and Medical Malpractice

In the medical world, moonlighting refers to the practice of a doctor working a different job at night to earn extra income. Some medical facilities, such as emergency rooms and intensive care units, cannot simply close at night, and must be continuously staffed. To ensure that there is a doctor on duty at all times, hospitals and clinics hire temporary doctors, who may need to make a little extra cash or who want to develop experience in a new area, to take over for the night. This practice may in some regards be practical, but it means that patient care suffers severely in the nighttime.


In a recent article in the New York Times health blog, a doctor who moonlights recounts her experiences and explains the practice of moonlighting to the reader. Dr. Daniela Lamas works three or four nights per month in an intensive care unit in addition to her normal job. At the beginning of a 12-hour shift, the daytime doctor will walk her through the I.C.U. and give her the patient information she needs for the night. She is then left to care for the patients, whom she rarely sees twice, and attend to any needs that may arise in the off hours.

Continuity of Care

Unfortunately, moonlighting brings with it several problems. One serious consequence is a lack of continuity of care for patients. Many medical malpractice cases begin with a loss of connection with the patient, and the changing of doctors every night can exacerbate that problem.

Continuity of care is especially important for high-risk patients and those whose diagnoses are uncertain. In the context of moonlighting, if a doctor on duty has never met the patient before it often makes it harder to provide appropriate care. Doctors who moonlight must take extra care to learn about each patient’s condition, beyond what is listed on the patient chart, so that they are prepared to take on any necessary treatment or any emergency that may arise.

Drowsy Doctors

Dr. Lamas, like other moonlighting doctors, has a day job. This means that when she works these moonlighting shifts, she is likely tired. Not getting enough sleep can significantly impair brain function, which is especially problematic for doctors who hold lives in their hands. According to a study published by the American Medical Association, patients who suffer heart attacks at night have a survival rate that is nearly 20 percent lower than those who have heart attacks in the daytime. Even the normal fatigue that happens over the course of a day’s shift can significantly raise a doctor’s risk of committing malpractice.


Some hospitals are hiring nocturnists, or doctors who work exclusively at night, to cut down on the malpractice risks associated with moonlighting. Because they keep a regular night schedule, instead of adding night shifts on top of a normal day job, nocturnists suffer much less fatigue than moonlighters. They are also often more experienced than moonlighters, as they are not limited to those who need extra cash to pay off student loans.

Contact a Malpractice Attorney Today

If you or a loved one has suffered medical malpractice because of nighttime negligence, please contact an experienced New Jersey medical malpractice attorney today to schedule a consultation. Our attorneys at Cohen, Placitella & Roth, P.C. are available to discuss your case immediately.


Contact us for your consultation (215) 567-3500