I’ve been trying to ramp up my Telemedicine moonlighting for the last six months. It’s seems things are finally looking up. I’ve been credentialed at 6 different companies. Three were scam companies writing DME and genetic testing. Two companies had a total of one consult in 6 months. Finally, I’ve landed on Teladoc as my primary company. I still only get average 2 consults per day. I’m only licensed in WV which I believe is the worst state for telemedicine for lots of different reasons, namely low population and socioeconomic issues. However, I’ve just made a $2700 investment to get additional state licenses in CO, WA, KS, AZ, UT, WI, and AL. That should take my possible patients from 1.8M to about 36M! My goal is to at least turn a profit by the end of the year.
My goal is to get enough volume to be able to just login, do a few consult and sign off, maybe a couple times a day. Has anyone out there achieved a volume like this? How many state licenses did it take? Thanks!LithiumParticipantStatus: PhysicianPosts: 986Joined: 02/15/2016
Sorry I don’t have anything helpful. How did you pick those six states?October 13, 2018 at 6:50 pm MST #156955
WV is a member of the Interstate Medical Licensure Compact. All those states are also members, making licensing very easy. I chose the states with highest population, cheapest fee (Wi and UT were $75 a piece!), and emailed the companies asking them which states they needed docs.ChesskntParticipantStatus: Resident, PhysicianPosts: 1Joined: 04/16/2018October 14, 2018 at 4:37 am MST #156962gadocParticipantStatus: PhysicianPosts: 26Joined: 02/17/2016
I’m intrigued by the concept of telemedicine. What has your experience with Teladoc been? Do you think the patient population is difficult and any tips to handle over the phone encounters? How long does the total encounter take including the note you have to write? I believe the pay is something like 30 dollars an enounter, do you think this is enough to justify the amount of work you have to do?
It seems to be a way to make an extra 20-30k without doing too much extra work but I could be mistaken.October 14, 2018 at 9:48 am MST #157067
My specialty in internal medicine. I practice full time as a hospitalist. After working quite a few extra shifts on my weeks off and paying off my student loans, I’m ready to be at home more often for my kids. Telemedicine seemed to help me achieve that goal but it has been a challenge. Online visits have helped me improve my outpatient skills which I haven’t used in two years since residency!
I like the Teladoc platform and they have excellent support with 24 hour nursing support and tech support. They pay $23 for phone consults and $28 for video. Patients so far have been super grateful. Even when I’ve had to tell patients why they don’t need an antibiotic they’ve seemed satisfied. My average time from call to finishing the note is so,etching like 8-9 minutes.
I also use WellVia, I like how that platform actually records the phone call.
Im also credentialed at AmWell which seems to be the most robust platform. However, I’ve left my status available for three months nonstop and haven’t had a single visit! I believe they only do video visits and I think they pay $35/visit. They pay seems fair. Some visits are just for a refill, that’s pretty easy money. Vague symptoms may take longer to figure out. However, you can always recommend they see a physician in person.
I had to update some of my own technology and get better internet but all in all it’s been positive.
How many teladoc visits are you getting sent to you in an average day? (Not how many you do personally, but if you wanted to accept them all how much could you potentially be doing?)October 15, 2018 at 6:03 am MST #157243
Three in a day has been my max. That has been on my week off and being fairly vigilant to check the platform regularly through the day. Again, my only current license is WV which is low volume. I’ll be sure to update the forum after my additional state licenses become active. It will be interesting to see how the volume picks up. As I mentioned, those new licenses will bring the available population from 1.8M to about 36M.October 15, 2018 at 11:19 am MST #157320EMscoutParticipantStatus: PhysicianPosts: 87Joined: 01/13/2016
Sounds like a lot of hassle for little return. The medmal risk alone should pay more than $28 per patient not to mention the actual consult. You can do better with less risk doing other side gigs. I get the comfort value, but what are you making on this after taxes?
The visits are very low risk but certainly there is a med-mal consideration. Different companies pay different rates as well. At a steady clip, it should pay $125/hr. Being 1099 income, this allows to use the home office deduction, deduct my work computer, and make additional contributions to solo-401k. It’s also super flexible. I’ve looked into several side gigs, most of which required me to be somewhere else than home. The only better one I can think of is EHR chart review. I already do surveys, Expert Connect, etc. There have been some snags but if all works out, I should be able to just log-on and see a few patients. With licensed states in three time zones, that also extends the available hours. I’m treating this just as I would any other business. It will take some time to optimize and streamline but when it is fully up and running it will be very profitable.gadocParticipantStatus: PhysicianPosts: 26Joined: 02/17/2016
It sounds like a good idea. the compensation may seem low but I feel like the last 2 hours of the day i’m just sitting around waiting for an admission. if i can do 8 consults for 2 hours that would be 200 dollars a day. If I did that 14 days a month that would be 2800. Its not alot but the key is that this isnt taking away from family time or requiring extra time at the hospital. I just wonder if there is enough volume on the site to make this work.
Can you elaborate on the tax benefits you get from getting a 1099? You can deduct your phone, home computer? How do you go about using this as a home office deduction?
I’m very interested in the idea of this so please do keep updated.
are you saying that you have to be sitting there logged in waiting for a consult to come in in order to get one? They don’t like text you or something?October 15, 2018 at 2:54 pm MST #157379
They will text or call you to take a consult only if they are very busy and have consults waiting in the queue. WellVia texts every time a consult is available. Just got my CO and WI state license today! Should be credentialed to take consults for those states by my next week off work. I’ll update the thread about any changes in volume.October 16, 2018 at 8:08 pm MST #157701Wings3496ParticipantStatus: PhysicianPosts: 25Joined: 11/05/2016
I’ve been doing telemed for the last few months as a side gig. I login typically in the evenings or on weekends when I’m doing other work on my computer. Or I’ll leave it logged on my laptop in my peripheral vision while watching netflix. If a consult pops up I stop working and take the call, they typically last 5-8 minutes. It’s basic urgent care stuff for the most part. The company has specific tele-medicine clinical guidelines which I read over and for the most part agree with (Cannot dx and treat vaginitis or AOM over the phone, other things such as this).
I’m only licensed in my own state so the volume varies. I typically get 2-3 calls a night if I login from 6-9pm. Some weekend mornings can get busy and I’ll get more. The company gave me a heads up that Nov-Feb are much higher volume. I’ve thought about getting licensed in other states but I also do actual urgent care moonlighting and board question writing as side gigs, so this volume is enough for me.
It’s a good side gig – minimal work, get about $1000/month in 1099. Just have to be very aware of what you’re treating, always advise patients on the limitations of telemed, and advised and document follow up if not improving/worsening and that you educated on warning signs/symptoms.