[Editor's Note: This is a guest post from Wealthy Doc, a long-time physician financial blogger who prefers to remain anonymous. I often get questions about side gigs or side hustles whereby a physician can increase her income and thought this post did a great job explaining some of the specifics. We don't have any financial relationship.]
A physician friend of mine recently reached out to me for advice on “supplemental income options.” We met for lunch and talked things over. She works part time and her husband is working on his Ph.D. She wants to increase her income, not by adding two more days of clinic time to her schedule, but by doing something different – preferably something more lucrative than her current practice.
She thought my recommendations were valuable. Valuable enough that she bought my lunch! Here is some of my advice, in case others are looking for this guidance.
I openly admit my bias here. I am a strong believer in the benefits of experience, dedication, education, and certification and I never look for quick fix shortcuts to success. To be excellent you need to really know your stuff and that doesn’t come easily. There is a price to pay. You may spend weeks or months in training. You may spend thousands of dollars in education, training programs, and certification. You may not see an immediate payoff. Hang in there. Keep grinding away and building your knowledge and skills. It will eventually shine through and pay off. It has for me and everyone else I know who went down this route.
You don’t need to reinvent the wheel. There are great resources to help you succeed. A few are listed here:
Disability Insurance Evaluation Work
The website of the International Academy of Independent Medical Evaluators can be found at http://www.iaime.org/.
From their website:
“In 1986, the Founding members of the IAIME, formerly known as the American Academy of Disability Evaluating Physicians (AADEP), dreamed of creating a medical organization that would teach the unique skills and techniques required to perform special medical evaluations and assessments on certain types of patients. Today, IAIME is the premier organization that produces educational courses and products on such issues as the proper techniques to perform impairment ratings based on the AMA Guides to the Evaluation of Permanent Impairment, treatment of industrial related conditions, prevention of the disastrous disability cascade, surgical treatment of back pain, the science of bone and soft tissue healing, and the proper methods to perform return to work evaluations that place the injured person in a physical demand Category of work, based on the Dictionary of Occupational Titles (DOT).”
They offer training for and the credential of The Certification in the Evaluation of Disability and Impairment Rating (CEDIR) exam. I achieved that certification and I found the process and result helpful to my career.
The website of the American Board of Independent Medical Examiners can be found at http://www.abime.org/.
From their website:
“The foundation of mission of the American Board of Independent Medical Examiners (ABIME) is the belief that certification of independent medical examiners benefits the public good. This belief is based on the tenet that credentialed physicians have demonstrated that they possess the knowledge, skills, experience, and abilities required for the attainment of their certification as a Certified Independent Medical Examiners, (CIME)TM. Credentials, therefore, are reliable indicators of the professional's capacity to perform independent medical and impairment evaluations according to the profession's performance standards. Certification enables the public to make informed decisions regarding the selection and use of independent medical examiners.”
I am certified by ABIME and I found the training and the result extremely helpful to my knowledge and career. Several attorneys and insurers have mentioned that they referred to me specifically because of my Certification in IME – a credential bestowed on me by ABIME. Their directory is actively used by potential referral sources.
Expert Witness Work
The SEAK, Inc. website can be found at http://www.seak.com/.
From their website:
“SEAK is a continuing education, publishing and consulting company. We have trained well over 25,000 expert witnesses, physicians, lawyers, nurses, and other professionals. SEAK is the leading provider of Expert Witness Training and texts. We publish professional directories for Expert Witnesses, IME Doctors, and File Review Consultants. SEAK is proud to be the leading provider of Non-Clinical Career and Supplemental Income training for physicians.”
I have found them to be the most helpful for training and education. They publish solid, high-yield books, videos, and live training programs. Their advice is always clear, tested, and practical. I have benefited from more than a dozen of their training courses or associated materials.
Some of their excellent materials include:
Writing and Defending Your IME Report
How to Start, Build, and Run a Successful Physician Consulting Practice DVD Set
Negotiating Skills for Physicians DVD Set
Once you have a fair amount of knowledge and credentials under your belt you can grow your side business quickly. Again, I recommend building that solid foundation first. It will help your credibility at every point on your journey. Sign up on the registries and directories associated with the above-mentioned organizations. Start doing good work and the business will grow.
An experienced trial attorney told me of the three rules he follows:
- Get your money upfront.
- The client goes to jail, not you.
- Get your money upfront.
He suggested I always “get my money upfront.” I have a standard rate sheet the client signs, and I get prepaid for all work. I made a couple of exceptions and I got burned and won’t do that again.
You may choose just a small niche, e.g. non-malpractice pain management IMEs, railroad worker injuries, or file reviews for disabled Anthem employees, etc. If you will be working as an expert, it is advisable to do both plaintiff and defense cases to not lose credibility. There are plenty of insurers and lawyers who truly want a thorough, unbiased, medical opinion. You could become their go-to source.
Once your reputation, referrals, and revenue grow you can be more choosy and/or raise your rates. Although it is tempting to do this full-time, I recommend it be limited to <10% of your practice to maintain your clinical knowledge and your credibility.
There is a lot more to know about running a side business, too much to cover here. You need to make sure your employment contract allows the side income. See if you need to get an additional rider to your malpractice insurance policy to cover “errors and omissions (E&O)” for this line of work. You need to set aside a large portion of the income for taxes since you will have no employer withholding. You need to track your business expenses (including courses, textbooks, mileage, etc.) to deduct on Schedule C from your 1099 income. You may want to set up a SEP-IRA or Solo-401K to reduce your tax burden, etc.
Fortunately, there are great resources on the web now that will guide you on overcoming some of the other challenges of running a side business. Be sure to take advantage of these. For example,
- Side Business Besides Medicine WCI Post
- Non-Clinical Jobs
- Passive Income MD
- Wealthy Doc
- Supplemental Income For Physicians
What do you think? Have you generated income for clinical opportunities not directly related to your employment? Have you found medicolegal work pleasurable, challenging, and lucrative? Have you used any of the resources above? What did you think? Comment below!