Q: I practice in an area that gets a lot of beach tourism, which comes with a lot of overindulgence in adult beverages. A company that sends out “hangover buses” offered me a gig on weekends as a supervising doctor. They said that their insurance covers me for this work as an employee and that it isn’t really practicing medicine anyway because these are clients, not patients. Since it is only hydration, light sedation, and a vitamin infusion, which is a lot less than I have to face doing on an ER shift, I feel pretty safe about this. Is there anything I need to be concerned about?

A: Let’s start with the claim that you are not practicing medicine, since if that were the case there would be no physician-patient relationship on which to base a professional negligence claim.

The issue here, though, is that your title as a “supervising doctor” actually specifies that you are there as a doctor and that your role is to supervise procedures – in other words, a literal description of you practicing medicine.

You would have to rely on a claim that if the company itself is not practicing medicine then, as a downstream effect, you are not doing so either. If you ever have to try to get a case against you thrown out after a college kid codes in the bus that really won’t go very far when considered against your status as a physician who was specifically solicited to be there for safety purposes. In fact, your presence as a physician is more likely to “pierce the corporate veil” as to the company actually practicing medicine than for the company’s claim to shield you.

Even if the company gets a release signed by the “client” that says that they agree that there is no physician-patient relationship that is not enough –  after all, those “clients” are only there because they are in an impaired state and what they may scribble on a legalese form will not be held to have much value.

In summary on this point, then, assume that if you do this you must get coverage under your own malpractice insurer if the company will not provide it.

Now, let’s consider what you are required to do.

The fact that your job description is to be a “supervising doctor” means more than just that you are supposed to check that the employees put in the iv line correctly or that they sit barfing people up so that they don’t aspirate. You are there as a doctor to actually oversee what care is being rendered, to recognize who it is appropriate for, and to deal with complications. For example, someone who is actually suffering from severe alcohol intoxication and whose respiration is depressed, or someone who is actually entering withdrawal and begins to seize, will be your responsibility to deal with. If the bus does not have a crash cart don’t accept the job and if the bus does have a crash cart bear in mind that it is there because it may well be needed and ask yourself if this is a setting that you feel comfortable managing such a case in.

So – be careful in deciding what to do about this offer. You would probably be far better off just enjoying an adult beverage on the beach yourself in your spare time…