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Moonlighting: Making a Buck, Compassion, and Quality Control

Ralph B. Piening, MD
JAMA. 1990;264(4):454. doi:10.1001/jama.1990.03450040042021.
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To the Editor.—  I simply must respond to the letter about moonlighting by Dr Cohen.1 He and his ever-compassionate faculty seem to have calculated a method to make money off the moonlighting activity of the house staff. Apparently, the "faculty supervisor" is available by beeper or telephone while the house officer stays up all night and does the work. The faculty physician is then paid a commensurate amount for sitting at home and "being available."We are constantly hearing pleas for better physician role models for residents and medical students. Is it any wonder that house staff are so cynical when they are so blatantly ripped-off, as in the above scenario? These house officers have a permanent license and in the eyes of the state are permitted to practice medicine on their own. Assuming job performance is not compromised, it is none of the university's business how a resident


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