7 Physician Side Hustles – The White Coat Investor

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7 Physician Side Hustles - The White Coat Investor


[Editor’s Note: The following guest post was submitted by emergency medicine physician, Dr. David Beran. He’s made a hobby of pursuing physician side gigs to balance his clinical workload and says he’s always looking to try new ones. I love this post because the side hustles are all medical/clinical rather than the usual ones we hear about like real estate and blogging. We have no financial relationship.]

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Like many physicians, I hit a point where I realized that I didn’t want to see patients as much.  I didn’t want to never see them but I didn’t want to spend all of my time seeing them either.

So I began looking for ways to use my medical experience to make money on the side.  I began looking for a side hustle.

I started with a Seak conference. Honestly, there was very little I learned there that wasn’t available for free online, but I didn’t really know where to start looking and Seak helped with that.  After those introductions, the rest of the work was up to me.

What I found online, however, didn’t give me the detail I wanted. I knew I could do “file review” or “consulting”, for example, but I had no idea what that would look like or how it could fit into my daily schedule.

And so I wrote this post, seven side hustles later.  It provides at least some detail of the mechanics I’ve experienced with these physician side hustles.

Getting Started

I’m boarded in emergency medicine and have an MPH in Health Systems Management. I finished residency in 2010.

Everything in terms of pay in this article I’ve put in terms of clinical hours. So, if I hypothetically made $1.00/hr while seeing patients, below I’ll say that I made 75% of a clinical hour doing a job, meaning I made $0.75/hr. This is just to give a sense of how these positions compare to a clinical hour.

I found all of my side hustle work through LinkedIn. I simply searched for the category of job (like “physician file review”) and/or set my job interests for these categories to receive email alerts when the jobs came available.

It’s by no means an exhaustive list; just stuff that I’ve had experience with. “File review” can mean a ton of things and I’m sure people have had a wide variety of experiences with expert witnessing.  Below are just my experiences.

Online resources I have used to research for non-clinical options have included the Seak conference, The Society for Physicians with Non-Clinical Careers, The Drop Out ClubDoximity and LinkedIn.

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I hope you find this helpful — if you’re looking for more specifics, I’m happy to answer questions — just contact me in the comments below!

The Basic Mechanics of 7 Physician Side Hustles

Side Hustle #1:  File Review for Medications

How it Worked

I was hired as an independent contractor by a company who wanted physicians to review medications. The company’s major focus was to minimize the use of opioid prescriptions and maximize non-opioid therapies for chronic pain patients.

I was sent charts electronically and had a template of questions to answer about each patient. Part of the template involved a phone call with the prescribing physician to get their take on medication regimen. Eventually, I asked the company to allow me to discontinue the phone call part and only do the chart review part. They allowed this to happen.

Pay

The pay depended on the template of questions. Some were short, medium or long. The long ones were similar to the pay for a typical clinical hour I work. The short ones were about half of a typical clinical hour.

Pros

Flexible. Easy to do. Decent pay and consistent work. You could count on some amount of income. I learned about pain management, opioid prescription, monitoring, diversion and abuse to a new level.

Cons

“When the ax came into the forest, the trees said: “The handle is one of us.”

-Alice Walker

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Dr. David Beran

You’re the ax. Making phone calls was painful — the physicians were typically defensive and irritated, as I would have been. The company clearly has an interest in getting people off opiates and would give you pushback if you suggested that the patient may need opiates and has legitimately exhausted every option.

Though the work was consistent, it wasn’t as abundant as I would need it to be. I would typically get about four hours of work per week.

It was also mind-numbingly redundant. Same template, chronic pain patients over and over.

Would I do it again?

Well, I quit doing this. I would reconsider it if there was some variation to the medications being reviewed or if there wasn’t such a black and white agenda.

*It’s important to note that not all file review for medications work like this, this was just my experience.

Side Hustle #2  File Review for Peer Review

How it Worked

I was an independent contractor for a company that did external peer reviews. Essentially, a hospital would need a review of a physician’s care and would seek this company to conduct the review.

The company would contact me when cases would arise within my scope of practice. They would send me an electronic version of the chart with a series of questions about the care.

I would fill out the questions in a report format within a set time frame.

Pay

I would negotiate an hourly rate with the company. This equated to about 75% of an average clinical hourly rate in my region. I was told that my rate was high compared to other people in my specialty, with others offering to do the reviews for what would have been about 50% of an average rate in my area.

Pros

It was intellectually stimulating work. You’re reviewing a case from someone else in your field and being asked to base your thoughts on evidence (that you would have to reference in the report). It was interesting to see cases play out from an outsider’s perspective.

Cons

Work was choppy.  I would hear from the company every few months.  This may have been because my pay was too high, but it was still low compared to just picking up a clinical hour.

Would I Do it Again?

Yes. I continue to do this. The work is pretty infrequent but I enjoy the challenge when it comes.

Side Hustle #3  Administration

How it Worked

I assumed increasingly larger administrative jobs until I was able to secure an administrative title. It began with becoming proficient with report writing in our electronic medical record. Soon, I was the only one who knew how to make reports. I did this enough and provided enough people feedback on their performance (a niche that wasn’t being filled at the time) that I eventually became “the go-to person”. This role defined me and I was given an assistant medical director position. When the medical director moved up, so did I.

Pay

The pay has varied between 50% and 75% of clinical pay, hour for hour. The rate is negotiable. Other places where I have worked administratively paid me a stipend, valued at about 30% of what I would make a year if I were purely clinical.

Pros

Getting paid to strategize and work at the system level. Schedule normalization (I have been able to build a clinical schedule around an administrative schedule, thereby giving me a more normal work week.) Taking your clinical knowledge and applying to processes in a way that makes the most sense. It’s a new application of your skill set. It will make you a better physician to see things from an administrative perspective.

Cons

Every con you’ve heard about management. To paraphrase: The grass is only greener in administration because there’s more crap to fertilize it. You have to work with administrators who have profound limitations in their clinical experience or knowledge but significantly more authority than you. You have to wrangle with the behavior of physicians who have been maladaptive their entire lives. You are a manager but the people you’re managing are typically very educated and intelligent (read: good at being manipulative).

Would I Do it Again?

I’m still doing this. I have every intention of continuing to do this. I enjoy the strategy, the analysis, the data, and the evidence basis of it. It has put clinical medicine into a different light and I continue to learn by doing it.

Side Hustle #4  Pharmaceutical Research for Third Parties

How it Worked

I put my information on LinkedIn and was contacted by a third party, doing research for a major drug company. These third-party companies specialize in things like converting prescription drugs to OTC, or proving that generics are equivalent to brand names.

This company needed physicians to do histories and physical examinations for one of these functions. I was hired as by this third party to carry out these H&Ps in my area.

Part of the experience involved diagnosing conditions in patients that were pertinent to the drugs being studied. I provided no treatment to the patients, just recorded their information.

Pay

This paid about 150% of a normal clinical hour, for the actual time of training and work. There was also a flight, an overnight stay in a hotel, and meals during training that were covered by the company.

Pros

Pay. Learning a new skill set, insight into the research industry. It was a side gig I can say was something very different and new to me. The H&P part wasn’t, just the processes, the rules, the aims — you genuinely learn something very new.

Cons

Like most physicians, when I hear “pharmaceutical company”, I become skeptical. Even though I read the study and knew what I was signing up for, didn’t feel that anything was unethical, there’s still this sense that you’ve somehow sold out. This ethical dilemma is a new one (different from the typical ethical dilemmas we experience in medicine) and took some sorting out and additional reading on my part.

Would I do it again?

Yes, if I agreed with the research being conducted ethically. It was interesting, convenient, paid well and was a new experience.

Side Hustle #5  Expert Witnessing

How it Worked

I put my name on the AMFS (American Medical Forensic Specialists) website. You essentially upload a bio where you put your specializations and things you are an “expert” in. And then you wait.

Eventually, I was contacted by law firms interested in hiring me as an expert for different cases. They would contact me, we would agree upon an hourly rate and they would then transmit me a medical record in a secure fashion. I would then be questioned by the attorney or attorneys on the case.

This process is different but similar to being paid as a witness on a case. I have been separately contacted by law firms for cases where the patient is suing someone (not me) and because I saw the patient, I have insight into the suit and serve to support one argument or another. For example, a patient falls in Wal-Mart and hurts their back. They come to the emergency department, get care and then sue Wal-Mart. The patient’s (now the plaintiff’s), attorney contacts me to depose me that his back injury is because of Wal-Mart, his injury there, their negligence, etc.

Expert witnessing was similar except I wasn’t involved in the case.  It’s like being paid to be deposed.

Pay

About 125%-150% of a clinical hour. Negotiated with the law firm and paid for time reviewing the case, being deposed, etc.

Pros

As a physician, you will be sued at some point. Knowing how this process works gives you a priceless advantage. You’re getting an objective view of exactly how “the enemy” works. Seeing this will immediately improve your patient care and documentation. You get to be a fair opinion for cases — sometimes the doctor is right, sometimes they’re not. The pay is good and I’ve heard of people being paid upwards of $500+/hr to do this work. It isn’t too time-consuming overall and it is interesting work.

Cons

It seems to be an unwritten rule that there’s a cap on how much you can do this. After you make a substantial percentage of your income from this, you start to look like a hired gun.

It also makes you feel a little dirty because you’re given the sense that you are being hired specifically to say certain things. On one case, for example, when I refused to say that a physician didn’t do their job properly, I was told: “Well, then I guess I’ll have let the people at AMFS know that you’re not willing to play ball.”

I haven’t taken another case from that website again.

Would I do it again?

Yes, but with greater care for what I’m being asked to do.

Side Hustle #6  Being Interviewed by Industry for New Drugs/Processes

How it Worked

I was contacted via LinkedIn by a company that works to link investors with industry. They have hired me essentially as a consultant to answer questions about the industry as an “insider”. Hypothetical example: a company invents a new blood test that screens for stroke. They think this would be useful in the emergency department but aren’t sure how an emergency department would incorporate a new test like that into their flow. So, this company contracts with me to speak with the investors on the phone to answer questions about how this new test might be used.

I am then paid by the hour to have these conversations.

Pay

The rate is negotiable but winds up being 150% of a clinical hour.

Pros

It’s interesting work. You learn about a new industry and how new drugs, devices, etc., actually make it into hospitals or clinics. It pays well. It’s flexible (you schedule the phone calls according to your schedule).

Cons

It’s spotty work; you cannot rely on regular income from this.

Would I Do it Again?

Yes. I continue to do this.

Side Hustle #7  Medical Writing

How it Worked

I started a blog through WordPress that is just for medical writing. I write on Medium for things that are medical and other stuff I just want to write. I monetized the blog via ads and I joined Medium’s Partner Program.

I search for writing opportunities online but my goal isn’t to make money.

Pay

So far, I’ve made about fifty-three cents (real money, not percentages of clinical work). The pay ranges — one could work in a number of capacities that I have not yet explored. Freelancers, medical science liaisons, writers hired by publications, authors of books, etc., will make anywhere from $0 to millions.

Pros

You get to write and express your thoughts on things. It allows for a creative expression that medicine does not. There are tons of resources available to help you get started.

You can monetize your writing, which serves as passive income.  If you have a blog, for example, you can allow ads on your site, you can sell products, you can write posts about products, you can use it to build your own credibility so you can be paid to do other stuff like lecture.

You’ll get to learn how to make a blog, which is a new, interesting skill.

Cons

There’s no wrong or right way to do this, which is a big change from the linear path that medicine provides.  For some people, that sounds hellish.  For others, that might be exciting.

It takes a tremendous amount of work.  If you want to blog, you need to write at least daily, if not more.  Learning to run a blog is hard and you will lose money for a while before you make any back.

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Would I do it again?

Yes. I plan on continuing!

These are just my experiences and represent only a few possibilities. Medical science liaisons, independent medical examiners, consultancy, utilization review, working in healthcare industries, starting your own business for any of the above — there are loads of other options.

The slowing of clinical practice or full transition out of clinical medicine will probably occur in phases, over time. Medicine is linear, business is not — you’ll need to do research, try different approaches, be willing to fail and move forward. The key is getting started and actually trying something new. You’ll get a sense very quickly whether it’s right for you.

If you’re smart enough to become a doctor, you’re smart enough to un-become one too!

What physician side hustles have you pursued? Which side hustles have been your favorite/least favorite? Share your experiences and comment below!





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