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Physician Side Gigs – What's Right For You?

Discussion in 'General Discussion' started by Mahmoud Abudeif, Mar 31, 2021.

  1. Mahmoud Abudeif

    Mahmoud Abudeif Golden Member

    Mar 5, 2019
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    Five years out of training, the so-called 7-Figure Urologist (he tells his story online and does not reveal his real name) reports making $400,000 a year on side gigs. His side gigs include working in another hospital on weekends and investing in a surgery center, a medical office building, and a lithotripsy machine.


    Another physician was one of many doctors who took to side gigs to make ends meet during the pandemic. She took weekend call at a local facility, gave mental health disability exams to veterans, and signed up with a telemedicine company.

    A third physician, whose online identity is Space Doc, hasn't made money on his side gigs but says he doesn't care. "I have several side gigs, passion projects, whatever you want to call them," he wrote. "Maybe one day they will make money, maybe never, still enjoyable all the same."

    Almost 1 in 3 Doctors Have Side Gigs

    Physician side gigs ― work performed independently of a doctor's main job ― come in many flavors, serve many tastes, and are widespread. It's estimated that 30% of physicians had a secondary income in 2017, and the number is thought to have grown during the pandemic. A Facebook group called Physician Side Gigs has more than 75,000 members.

    Traditionally, physician side gigs involved taking jobs such as speaking to colleagues on behalf of pharmaceutical companies, serving as expert witnesses in malpractice cases, and taking moonlighting assignments. Newer versions often involve the internet, such as writing online blogs or coaching through podcasts, videos, or one-on-one sessions.

    Physicians' growing interest in side gigs is a reaction to physician burnout, says Jimmy Turner, MD, a blogger and physician coach who calls himself the Physician Philosopher. "Now most physicians are employed," says Turner, an anesthesiologist employed at Wake Forest Baptist Health, in Winston-Salem, North Carolina. "They feel overwhelmed and don't feel in control of anything."

    Burnout is prompting some physicians to exit medicine entirely, says Eric Tait, MD, a Houston, Texas, internist who manages physicians' funds on the side. "Many doctors are using side gigs to explore ways to get out of clinical medicine, because they don't like the way the system works," says Tait, founder and fund manager of Vernonville Asset Management.

    Why Do Physicians Take on Side Gigs?

    Turner says side gigs are often taken on as a quest for autonomy. "As employed physicians, we work hard, but we are no longer the captains of our own ships, as doctors used to be."

    He also sees side gigs as an opportunity to pursue new goals. "At the beginning of their careers, physicians had to get through a series of hurdles ― get into medical school, get into residency, pass exams," Turner says. "But when physicians start practicing, they realize that this is what it's going to be for the next 30 or 40 years, and they start looking for a new goal outside of their work."

    Tait says many doctors see a side gig as a way to cut back on their clinical work. "Physicians would be happy if they could reduce their clinical time by 25% to 30% if they could maintain their same income," he says. "Working fewer hours can free you up mentally, which can make you a better clinician."

    With the internet, there is little financial risk in most side gigs, says Jim Dahle, MD, an employed emergency physician in Salt Lake City, Utah, better known for his financial blog for physicians, the White Coat Investor. "Having a relatively well-paid job as a physician lowers the risk of failure with a side gig," he says. "There is essentially no risk for physicians to try out a side gig. If it doesn't work, they still have medicine."

    Pandemic Spurred Interest

    Dahle says the COVID-19 pandemic has increased doctors' interest in side gigs. "Many doctors took a big hit in their income last spring and were at home a lot more, so it's no surprise that many of them decided to look into side gigs," he says. "It was a scary thing to realize that your income is not as secure as you thought it was."

    In a survey of physicians that was conducted last November, 48% said the pandemic had caused them to seriously rethink their career or their practice, and 25% said the pandemic had prompted them to find nonmedical sources of income.

    "Physicians have become proletariat," wrote a family physician in North Carolina, commenting on a Medscape article on side gigs in January. "Most are on salary, and their jobs can disappear on the whim of some unknown faceless bureaucrat."

    Downsides of Side Gigs

    Dahle, who still works as an emergency physician, has turned the White Coat Investor into a going concern, with 10 employees. But he warns that many side gigs don't pay much.

    "Most side gigs pay less than a physician's regular income," he says. "Doctors could make more money by simply taking on a few more shifts at their main job. Or they could simply manage their money better. If you can't live on the income a doctor makes, you have a spending problem, not an earning problem."

    When Dahle laid out his views on side gigs on White Coat Investor in 2020, several readers agreed with him. "I tried this for about a year, and the loss of my free time just wasn't worth it even though my hourly rate was very high," one wrote in a comment to his article.

    Other readers commenting on the article defended low-paying side gigs. "Doing extra side gigs here and there just to get rich?" one doctor wrote. "Well, you went into medicine for the wrong reasons."

    Your Employer May Have Something to Say About Your Side Gig

    Tait says more employers are clamping down on side gigs. "Employers don't want you to do anything that would reflect badly on them," he says.

    The employment contract or the employer's policies and procedures may bar outside clinical work, according to a report by Bruce D. Armon, an attorney with the law firm of Saul Ewing in Philadelphia. A noncompete clause in the contract may be in effect while you are an employee, not just after you leave, he added.

    The prohibition may apply to more than clinical work. "If you write a blog, your employer may ask to preapprove articles before they are posted," Tait says. "They also want a cut of intellectual property, such as inventions."

    The pseudonyms that many physician bloggers use can be a way to avoid scrutiny by their employers. "When I started my Physician Philosopher site," Turner says, "I was anonymous because I did not know how my employer would respond."

    But Turner says his apprehension turned out to be unfounded. When he informed his department chief about his side gig, he was supportive. Now Turner recommends that physician bloggers reach out to administration.

    You Can Do Many Side Gigs Without Any Extra Training

    Doctors' clinical experience opens up many doors to side gigs. There are plenty of roles that physicians can take on without learning any new skills. Doc G, a popular blogger, calls these "lazy side gigs," and they have been a staple for many years. Here are a few examples:

    Chart review. Reviewing medical records for insurers or other sources allows doctors to work online from their homes, without exposure to medical malpractice risk. A physician working 3 to 4 hours a week can make $1000 to $3000 a month, according to one analysis.

    Advising pharma. Participating in pharmaceutical advisory boards can be lucrative. One physician reported in 2020 that she earned $200 to $500 an hour working 3 to 4 hours a week on this side gig. But this an invited role and requires some networking to get noticed, she wrote.

    Telemedicine. Again, you can do the work online at home. The large telemedicine firms will pay for malpractice coverage. A primary care physician can earn $23 to $28 per consult, and each consult lasts between 4 and 15 minutes.

    Expert witness. You need to do some networking to find these jobs, but they pay well. Serving as an expert witness in malpractice cases pays an average of $356 per hour for the initial review, $448 per hour for the deposition, and $478 per hour for trial testimony, according to one analysis.

    Locum tenens. You can work these temporary jobs for as little as one shift over the weekend or fill your whole vacation time on an assignment. You can earn up to 50% above your average pay, and your travel and lodging expenses are usually covered. If you work through an agency, the agency provides malpractice coverage. However, you need to be credentialed at the host facility, which can take months.

    Although all of these gigs pay good money, you are still working as an employee for someone else, and the work may not be what you really want to do. Many physicians want to be their own bosses, which can be addressed by entrepreneurial side gigs.

    Entrepreneurial Side Gigs

    In a new form of side gigs, physicians start their own companies, and in a few cases have ended up making more money on their side gig than on their clinical job.

    Dahle says that when he founded White Coat Investor 10 years ago, there was only one other physician blog about personal finances, and then the topic became a hit side gig. He says that more than 100 financial blogs have been started by physicians since then, and most of them have folded.

    "It took 6 or 7 years before I made as much with White Coat Investor as I made as an emergency physician," Dahle says. Now his booming business provides a variety of services, including a blog, a podcast, online forums, books, online courses, and an annual conference.

    Turner started Physician Philosopher in 2017 as a personal finance blog, but he has shifted emphasis to physician coaching, which has become a hot side gig in recent years. Turner says he helps doctors find freedom and autonomy, which includes building online businesses.

    He says revenue from the Physician Philosopher surpassed his physician income for the first time in 2020. To meet commitments to his family and the side gig, Turner reduced the amount of work at his main job to 95% of a full-time equivalent (FTE) in 2020 and is reducing it to 65% of an FTE this year.

    Tait runs Vernonville Asset Management, which invests clients' money in private equity funds, mostly in real estate. He has about 250 clients now, 80% of whom are doctors. Each has invested $25,000 to $400,000 through him.

    He went to business school and medical school at the same time. He bought his first rental property, a condominium, while a medical student. He was an employed physician during the first 10 years of his career, and now he has a private medical practice.

    Tips on Running a Successful Entrepreneurial Side Gig

    Turner says doctors can take steps to help ensure that their entrepreneurial side gigs don't fail. Here is some advice from him.

    Pick the right side gig for you. Turner says physicians often don't know what they want to do. "Pick something you're already gifted in," he advises. "What do people ask you for your advice on? It could be personal finance, working with EHR systems, or investing in real estate, weight loss, interior design, or marriage counseling, to name a few that have been done."

    Be passionate about it. "Unless you are passionate about your side gig, you won't be able to meet the challenges that will come your way," Turner says. "But also make sure that you are providing value."

    Decide whether it's a job or a hobby. "A common reason why physicians fail with their side gigs is that they haven't decided if it's a hobby or a job, so it becomes a 'jobby,' " he says. "It's something they do in their spare time, but it's not consistent."

    Don't give up. "Small businesses in general tend to go out of business after a few years, but "I've noticed that when physicians fail at one side gig, they just come back with another kind of side gig," Turner says. "Their entrepreneurial spirit has been activated."

    The Dream of Passive Income

    Many physicians are not looking for more work during their off hours, but they still want a new stream of income in addition to their paycheck. So they turn to real estate or financial instruments that produce income. This is called passive income.

    "The idea with passive income is that you can make money while you are sleeping," says Turner, "but you may have put in some sweat equity." For example, a doctor may turn a vacation home into a rental property, which may involve improvements such as painting.

    Tait says his clients are truly passive investors who don't put any work into their investments. Even new doctors who have significant student debt have money to invest, because they are moving from a resident's modest stipend to a full-fledged doctor's salary, he says.

    "Many doctors want to continue working, but they would be happy if they could reduce their clinical time by 25% to 30% and maintain their same income," Tait says. This can be done through investment income. "Working fewer hours can free you up mentally, which can make you a better clinician," he adds.

    Side Gigs as Hobbies

    Nonclinical work that makes little or no money and even hobbies are also considered side gigs, in that they can help reduce burnout and restore balance in one's life.

    "I enjoy medicine, but I also enjoy learning new things and experiencing other things," wrote a physician dubbed "Napoleon Dynamite" on the White Coat Investor site. "I don't feel like I am developing my full potential as a human if I just keep practicing medicine."

    Some doctors perform a variety of nonmedical tasks outside of their clinical jobs. "I joke that I'm a doctor-blacksmith-beekeeper-diesel mechanic," a pediatrician wrote in response to the Medscape article in January. "My side gigs aren't really money makers, but they mostly pay for themselves and they give me the opportunity to do nice things for others."

    Hobbies sometimes turn into moneymaking ventures. In February, Medscape reported on an obstetrician in Pennsylvania who transformed an interest in decorating dollhouses into an Instagram page and then became an expert on the TV show, Sell This House.


    More physicians are turning to side gigs as a way to balance their lives and perhaps make some money on the side. In some cases, physicians derive more income from their side gigs than their clinical work, but this is rare.


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