By Dr. David Beran, Guest Writer
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 earn more money on the side. I began looking for a physician 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.
How to Find Physician Side Gigs
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 side hustles 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 Club, Doximity and LinkedIn.
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!
Review 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
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.
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!
[Founder's Note: Dr. David Beran is an emergency medicine physician that has made a hobby of pursuing physician side gigs to balance his clinical workload and says he's always looking to try new ones. Another side hustle to consider is taking medical surveys. If that's of interest to you WCI has listed out some of the best options. 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. This article was submitted and approved according to our Guest Post Policy. We have no financial relationship.]
There are many clinical and non-clinical ways to boost your income. It’s good to build on the fact that you have MD or DO at the end of your name. This is a great list. My experience with my list in my book on smart career alternatives is that people see this list as the only options and then explain why they won’t work for them or their specialty. Don’t be one of those people. Use this list as examples and then start looking for ones that WILL work for you. Don’t talk about the reasons they won’t work for you. Be creative and find your side hustle if you want one.
Dr. Cory S. Fawcett
Prescription for Financial Success
Thanks for sharing this review. It really helps other doctors to hear direct experiences from peers.
Keep up the great work. Over time you will find an optimal mix of income, variety, and ongoing personal growth.
I have benefited from a dozen or more different side gigs over the years. It is hard to describe all of the benefits. Some of the benefits have been: earlier Financial Independence, better tax efficiency, expanded relationships, different models of thinking, less employer-dependence, improved technical knowledge, improved legal knowledge, and an expanded platform and influence.
Thanks also for linking to my WCI guest post. That one got several doctors interested in SEAK and medico-legal work. I found SEAK very practical and helpful and provided the legal background I needed. I have been clear with all attorneys and insurers that I will only testify to my own honest opinion. If that isn’t what they want, they can go elsewhere.
I have been pleasantly surprised to learn that there is a demand for someone who can render a clear review and opinion. Some attorneys really just want to understand a case and know whether there is merit or they want someone to be able to explain it to the jury. I do agree that keeping it to 10% or less of your income adds credibility.
I think most lawyers look at percentage of time you spend doing Med Expert work rather than percentage take home as most experts make multiple of clinical hourly wage acting as an expert.
Re: Med Expert work- SEAK conferences
Initially a skeptic and avoided going, but decided to give it a shot (I’ve been to 3 conferences now)
I will say from my experience – the SEAK conferences for Med Expert Witnessing have been paramount to my success and ramp-up in the past 3 years. They recently started a course on ‘How to make more money as an expert’
Some will say the $1.5k for the course plus travel and hotel and time not working is too much.
I looked at it another way
What could be the lifetime value after implementing their recommendations!
For me—I’ve doubled my expert work since the course 6 months ago and lifetime value of the course – probably 1000x
JustSayin’
I will second what has been said about SEAK. I have been to 3 of their courses and spent 2 years as a mentor. If you are after ways to make money with your degree without seeing patients, you should be at their annual course in October.
Dr. Cory S. Fawcett
Prescription for Financial Success
What a great post. Thanks so much for going through all these options.
I would echo your comments about administrative roles. Physician leadership is like herding cats. Smart, overall well-meaning, but occasionally devious and self- serving cats.
And your blog income beats mine so far by $0.49!
I’d agree that it’s immensely satisfying to create something like a blog, though. With each post there’s a sense of accomplishment and momentum. It’s a great compliment to the more mundane aspects of my week.
Thanks for this post.
— TDD
Great article, thank you for the information!
How long after completing residency did you start seeking out these side hustles?
Are any of these jobs better to start with as a young attending vs. delaying others until one has more practice experience?
I imagine that you are a more credible and competitive consultant/reviewer/etc if you are not fresh out of residency.
Thanks again! I’ll definitely be referencing this article in the future
Depends on your specialty for expert witnessing. Also depends on how composed and well spoken you are. I’ve seen med students with more confidence than an Attending. General rule 3+ years out for expert witnessing, but doesn’t mean you can’t try. One consideration- track record counts. Performing well on one case can get you more cases. Being well prepared is the crux so I wouldn’t sign up unless you feel like you can perform.
Find someone you know/trust that are doing the side gig you like and learn from them.
Depending on your specialty the first few years out should be used to solidify all of your training by seeing tons of patients.
One physicians opinion
JustSayin’
VMIGDAL: I started file review about two-three years after residency. But I wouldn’t focus on the time course – apply for what you want and let them say no!
Perhaps because I never signed up with AMFS I have never had a lawyer try to tilt my opinion or put words in my mouth. Sometimes they are happy with what I say, sometimes not. You can figure out what side they are on by their reaction.
On the rare occasions of depositions it is useful to practice and get an idea of what the opposing attorneys will try to do. That practice does not affect my opinions. I have found that the lawyers need an honest opinion. If you feed them what they want to hear they risk unpleasant surprises when someone shows up with an unbiased opinion. Disappointing if they are defending. Can be very expensive plaintiff’s counsel if they have spent a lot of money building a theory that falls through when confronted by the truth. Some plaintiff’s lawyers do seem to shop for someone who will say what they want. I don’t know how that works for them as the cases move forward.
I don’t do expert witness work much and I don’t have time to do more. So I am not looking to expand that part of my business. Most of the times I get contacted I tell the lawyers that they should get someone else.
For someone who wanted to make this a reliable source of significant income I can see a lot of issues.
One would be the conflict between keeping the business coming vs playing it straight on opinions.
Another would be getting known as a hired gun.
Then there are depositions and trial testimony. They are annoying. You have a lawyer, who knows nothing about medicine, who has been primed to pound on a few ideas. These may not make any medical sense but they don’t care. They are trying to make a point that will resonate with the jury. The only entertaining part is when they want to play word games. I live word games, so they eventually get discouraged when that does not work.
Agree that this is not work for people early in their careers. The lawyers need experts who can convey authority. It is hard to do that when you have only been at it for a short time. The jury of course is completely unqualified to have an informed opinion about whether you are a high level expert. So they use proxies- how much of your practice concerns this kind of case? How long have you been at it? How many times have you done this procedure? Do other physicians indicate that they believe you are an expert by, for example, asking you to lecture on the topic or sending you their difficult cases? It is hard to have the right answera to those questions with only a few years of experience.
The exception would be when it is a new microspecialty, nearly everyone who does it is young and you are among the leaders.
Hourly rate varies by field just as does clinical income. It can get awkward if the opposing attorney can suggest that you make more money being a witness than practicing medicine. It implies you will say whatever they want for the right price. Neurosurgeons can charge higher rates than family practice docs.
Take AFAN’s opinion/remarks with a grain of salt. They clearly say they don’t do much expert work then make absolute remarks like – depositions and trials are ‘annoying’. At several hundred per hour its far from annoying – Neurosurgeons make upwards of $1000/hour doubt they’d agree with you. Maybe your ‘n’ is too small to comment or maybe its just not for you. I like depositions and trials – odds are low that it will happen, but when it does its time to shine – clearly not for faint of heart. I’ve been retained by some quite sharp attorneys. Screen and vet them before taking a case.
Like any practice there are bad actors, but they are easy to spot if you know what to watch out for.
JustSayin’
The amount I am being paid has nothing to do with whether it is annoying. Getting a million dollars an hour would make it well worth doing but it would be no less annoying.
You get hired by one side. You can decide whether you want to work with them. You don’t meet the lawyers for the opposing side until the deposition. So you don’t get to choose whether you want to work with them. You can rely on the opposing attorneys to be on their worst behavior, since they cannot actually argue with you on the medicine. I suppose if you enjoy debating people who have no idea what they are talking about it could be fun. For me, it is irritating.
Testimony takes place during regular business hours, usually for depositions and always for trials. That contributes to the annoyance.
The neurosurgeons I know make a lot more than family practice people in their day jobs and charge more for their expert witness work. They would be crazy not to. The dics I know who do expert witness work are busy with their clinical practices. Depending on their fields they make not earn a higher hourly rate doing this than delivering clinical care. But it is low stress. Their is only so much time one can log in the OR before safety starts to decline.
It is not a time to “shine.” That is not the goal. It is not an ego boost for me. Again, not the goal. The goal is to convey accurate information, even when someone is determined to obfuscate.
But I am neither out drumming up business from lawyers nor trying to make it a significant source of income.
Freudian slip? 🙂
I regularly do expert witness work. 90% of the time I am not called to testify or be deposed. I am a fellowship-trained forensic psychiatrist and have training in ex witness work. When starting out, I would not charge less than double your clinical rate. I would recommend taking cases from AMFS. Each attorney is different. I will always let an attorney know in advance if my opinion is not helpful. It is clearly stated in my retainer contract that I have with attorneys.
What sort of insurance does/should a physician carry to do case review for attorneys?
I have done a bit of this type of work, and it can be interesting. In some cases I’ve encouraged the attorney’s decision to not pursue a claim, while in others there were subtle findings that could help the client’s case.
I’ve put this work on hold because I’m busy enough with my “day job” and I don’t have insurance for this “side hustle.” There is plenty of work available. Maybe I don’t need to worry so much, but I also don’t really need a side hustle.
E & O insurance covers for this type of work. Malpractice may if you in injure an evaluee during an exam.
How do I get more involved as a medical “insider” consultant? I have participated in many innovative practices such as medical hackathons and shark tanks at my home institution and surrounding cities. The most satisfiying and rewarding experience was being a mentor to guide the participants. I want to develop a future career as a intrapreneur at my hospital system, so this would be an experience that would really augment my skill set. Thank you again for the enlighting post!
Thank you for this post…It could not have come at a better time. As a 47 yo internist, I find myself looking for a side gig that suits me and have considered various options for the last 1+ year. Outpatient primary care is sucking the life out of me. I just cant find the right way to take that next step. I did a mini SEAK conference with S.Babitsky in 2018 and that was helpful. I’m looking for work from home and think file review could be a good first step with hopes of cutting back on my clinic time. Any advice or encouragement to help take that leap aside from what you posted would be much appreciated. Thanks.
If you’re 47, how far away from financial independence are you? I mean, if you look at ALL of the careers available to you out there, is file review really the most attractive one? Why not leave medicine and do something you really love?
Thank you for your reply WCI…Getting closer to FI(re) everyday, thanks to you and your mission. Just not sure I am ready to give up medicine just yet. I feel like I have a lot to offer but feel like a change of pace would be helpful. I do love coaching my kids youth basketball teams but I’m not sure the Jazz or the Sixers have any openings.
Wondering if the activities involving pharma would end up with payments reported on https://openpaymentsdata.cms.gov/ A quick search on your name didn’t yield much, so I am curious if the payments coming from a third party are not reported by pharma?
Did you form an LLC or PLLC to do all of this separate side gig work? I’m emergency medicine also and interested in delving into these areas separate from my full time clinical work and wondering what sort of company to set up.
Did you form an LLC or PLLC to do all of this separate side gig work? I’m emergency medicine also and interested in delving into these areas separate from my full time clinical work and wondering what sort of company to set up.
If there is significant liability then an LLC is a good idea. If not a sole proprietorship is fine.
That is an impressive list. I appreciate the ideas. In my experience, one key to maximizing income is to take side jobs that can be done concurrently with other work eg attend on a low acuity ward, take call for low acuity patients, medical advising for insurers such as workers compensation. I have found these side hustles to be lucrative and very efficient from a dollars per hour perspective.
Thanks for sharing this post. Does anyone do side gigs as a resident? I am kinda interested in AMFS. However, other things sound good to me too. Just want to know as a resident, what is the most suitable for you when it comes to side gigs? TIA
I’d guess the most common is moonlighting!
Thanks for your reply. That’s my former priority. Unfortunately, I am an IMG so it’s hard for me to get moonlighting due to license issue. I only can do it during 3rd year of residency. Still interested doing surveys, and AMFS.
Hello
I would like to know where you found work for peer review and chart utilization, any companies you would recommend any why?
What about pharma research, will companies would you recommend?
Thank you
I’d like to share a post I wrote about pharma consultant work. There are links to some companies that hire physicians for consultancy work with pharma companies.
https://womeninpharmacareers.com/how-to-become-a-physician-consultant-with-the-pharmaceutical-industry/
Don’t know enough about either to come up with a recommended list. The companies are large though, so it shouldn’t be hard to come up with a list and then start calling and seeing who is hiring.