[Editor's Note: Originally published at Passive Income, MD, this post covers a subject near and dear to my heart. While physicians certainly do NOT need a side hustle to be successful (simply seeing patients, saving 20% of gross income, and investing it in boring index funds will lead you to financial independence), my personal experience is that it can speed the whole process up and add some spice to your life.]
The idea of a side hustle seems to appeal to most people I talk to. It’s a great way to learn new skills, supplement your income, and build streams of passive income — all without quitting your day job. And as evidenced by the discussions in our Facebook group, many physicians also love the idea of a side hustle and gaining passive income. Honestly, who doesn’t?
However, despite their apparent desire to pursue a side hustle, plenty of obstacles seem to stand in the way for physicians. The same issues seem to pop up again and again, keeping many physicians from realizing their passive income potential. Here are some of the big ones, as well as some things to consider about each.
Not Enough Time
We already feel overworked as physicians. Residents are working 60-80 hours and attending physicians’ hours don’t seem to be much better. Even when we’re not seeing patients, we’re spending an extraordinary amount of time on paperwork. Many barely make it home to see their families in the evening. How can we possibly find time for a side hustle? There simply aren’t enough hours in the day.
I started with this one because it seems to be the biggest challenge in the physician life – finding time to not only be a physician but also to pursue other meaningful things. Therefore, this is an entirely valid argument. However, for many of us, if we take a hard look at our daily routines, we might just be able to create some more time.
How do we do that? Well, one thing I’ve mentioned is to perhaps find ways to outsource activities and errands that we don’t enjoy, in the form of paid help, like a virtual assistant or someone from TaskRabbit or Fiverr to perform a service.
Another way is to perhaps reprioritize how you’re spending some of your time. I’m not saying that you shouldn’t binge-watch Game of Thrones or Black Mirror, but how you spend your time reveals where your priorities lie. If it matters to you, you’ll find time for it.
Not Worth the Money
Despite steadily dropping reimbursements, physicians consistently top the lists of highest salaries in the U.S. We make a decent living. Are there really side hustles that exist that provide anywhere near the amount we’re making as physicians? Can a side hustle provide the kind of financial security that we’re looking for? Why even start a side hustle when you can just work a little more as a physician and likely get paid significantly more?
Another valid point, especially when starting a side hustle. It’s true – many of us will not be able to find side hustles that compensate us as well as our physician salaries do.
However, it’s also true that we as physicians are trading precious time for money. There is very little opportunity to scale our income, meaning that in order to make more, we have to put in more time. But with some side hustles, the opportunity to scale is there, and ideally, these side hustles will lead to truly passive income. Just check out my True Doctor Stories for examples of physicians who have found some of those profitable side ventures, like this one of Dr. Jim Dahle.
Sure, that stream might be a trickle at first, but the income potential in some of these side hustles is limitless. One day, they may even make your physician salary look small.
Not Enough Expertise
As physicians, we’re trained for one specialty. Even if we want to venture out, medical school doesn’t prepare us for the realm of business, and many of us don’t know where to start or what to do. Our path to our specialties has been pretty clear-cut – get into residency, do a fellowship, and get a job.
The truth is, many successful business owners had little to no expertise in their exact business sector. They just figured things out as they went. They googled things, they found mentors, they tried and failed. But they got back up every time. Just listen to the How I Built This podcast, and you’ll hear amazing stories of entrepreneurs who started with just an idea. Largely through trial and error, they figured it out and formed multi-million dollar companies.
Having a base of knowledge is great, but it’s not a necessity or indicator of success with a side hustle in any way.
Too Much Risk
Physicians are fairly risk-averse people. Everything we do in our daily lives involves a risk-to-benefit analysis. In fact, many of our clinical decisions are made to minimize risk, not necessarily for maximum benefit. This carries over into other parts of our lives, particularly when it comes to investing or having side hustles. Many of us fear that the risks simply outweigh the benefits and that keeps us from starting a side hustle.
However, perhaps we should be considering the risks of inaction. The real risk is doing nothing and expecting medicine to give us the lives we want, whatever that means to you. Is it possible that you could fail? Possibly. But how would your life and the lives of your family be improved if you were no longer dependent on trading time for money?
Too Tired
Being a physician can be mentally and physically draining. You give so much and at the end of the day, there just isn’t much left in the tank for anything else. The last thing you want to do is think about another venture and have it keep you up all night. Those trying to juggle family and jobs feel the exhaustion on a daily / weekly basis.
In the selection process known as “Hell Week”, Navy Seals are pushed to the point of complete exhaustion and then are pushed harder. They force people to tap out. However, those who ultimately make it into this elite force are the ones who find that extra determination when everyone else is giving up. They realize strength they didn’t know they had.
Ultimately, I think this is part of what separates those who successfully create side hustles and those that don’t. Every successful entrepreneur seems to have a story where they were pushed to the edge and perhaps thought of giving up but endured. It may not be easy to dig and find that extra motivation and energy, but for those that do, it could be worth it in the end.
Don’t Want the Distraction
Physicians have to devote a lot of time, energy, and brainpower to excel in their fields. The last thing they want is something that takes away from that. Being a physician requires constant studying and staying up to date on current literature. Have a side hustle could be a distraction from being the best physician that you can be and the desire to be as well.
It is possible that a side hustle can be a distraction. I’ll be honest, when I leave work, my thoughts immediately turn to my family first, then side hustles second. I try really hard not to let any side hustle take away from my day job.
Although when I leave work, I love the fact that I have something else to focus on. In some way, it may not be healthy to always have the day job on the mind. I’ve found that these side hustles are an amazing way to stretch and use different parts of my brain that I may not have used before. It keeps my day job fresh in a way because I’m not always fixated on it.
Then again, it’s all about priorities. If your day job demands all your focus and if that’s where your priorities are, there’s nothing wrong with admitting that perhaps a side hustle isn’t right for you.
Conflict of Interest
Physicians are bound by ethical and moral rules to do best by the patient. It’s important for these potential conflicts of interest to be recognized so that decisions for patients are made appropriately.
If a side hustle you’re considering does contain a conflict of interest, then it’s probably best that you figure out how to deal with that ASAP – by either quitting your day job or quitting your side hustle. There are many, many ways to accomplish the passive income dream without causing any undue stress and conflict.
Lack of Inspiration
Many people love the idea of having a side hustle but can’t figure out which one to pursue. Nothing seems to fit within their passions, or perhaps nothing seems to gel with their personality. All that brainstorming seems to only lead you to dead ends.
In reality, sometimes finding that first idea is the hardest part. However, there are ideas all around. Perhaps expectations are keeping you from honing in on one. Maybe you’re waiting for the perfect idea. But the “perfect idea” doesn’t exist. It’s very, very unlikely that a single idea will be one that you’re perfectly interested in, have a passion for, have expertise in, and makes a lot of money without any effort.
The best thing is to grab at an idea and make it into the perfect idea. Shape it the way you want, even if it doesn’t appear perfect at first.
Is a Side Hustle in Your Destiny?
I’ll be the first to admit that having a side hustle is not necessarily for everyone. But it’s also true that everyone can have one. It’s just a matter of having the right mindset, making it a priority, committing, and just going for it. If it fails, get back up and try again. Many successful entrepreneurs have failed miserably, and they credit that failure for making them the massive successes that they are.
If you think having a side hustle can make a positive difference in your life, you have to ask yourself: are you letting obstacles and roadblocks get in the way? If so, identify them and overcome them. You’ll be glad you did.
What do you think? What are some of the obstacles you face in having a side hustle? What side hustles have you tried? Share your successes and failures below!
Like many physicians who went into private practice, the first 5-7 years I HAD to have a “side gig” to pay the bills…..back in the day [mid-80’s] it was fairly easy to “moonlight” in ER’s or even in level 2 NICU’s [I am a pediatrician] and not only were those posts fun and more clinically ‘intense’ than primary care, they re-enforced more acute care skills and helped me to feel confident that I could indeed function well without all the layers of supervision that were present during residency. Certainly if I assumed that I could have a full schedule [4-5 patients per hour] in the practice, these jobs paid about half of what I would earn in the practice….but you cannot just magically fill that schedule, so the side income was very fair remuneration for what I did. I always had interests outside of primary care pediatrics and I did my MPH right after residency but that “public health green card” never really translated into a viable “side gig” for me….Public Health posts pay notoriously badly and there are few part-time posts available, even in a big city.
My story is a bit atypical in that I went back to graduate education after having the private practice for about 16 years….and went ‘whole hog’ doing an ID fellowship and a basic science PhD simultaneously. [my kids were done with college by then]…….and here is the essential point that I want to make….in spite of the University [un-named but highly prestigious and no different from others as best I can tell] trying to tell me and others that we “could NOT” do anything that earned us money outside of our commitment to them, I decided that they were wrong and probably violating about ten state and federal employment laws…. so I kept the private practice going, putting in perhaps ten or so hours per week during those 7 years of continued education….I loved the clinical continuity and thought it was ridiculous that I should abandon in total my practice just because I also loved research and was pursuing something that I would have liked to have done earlier but for the fact that I had to at some time point, stop going to school and begin earning. Upon completing my graduate degree and fellowship I took a full time post with a fed govt agency….and they tried to tell me that I owed them more than the 40-50 hours per week that I devoted to them and could not work outside that post either….again, challenged them that they were probably wrong and what I did one or two late afternoon or early evenings per week or on Saturday mornings was none of their damn business. So my comments are primarily directed at any physician who is working for any entity that defines a full time post as being more than 40 or so hours per week. Yes, one can, legally sign away one’s employee rights…..interestingly no entity ever put their expectation of exclusive employment in writing, so I was never violating a contract that I had signed…it was all “institutional pressure”…..”one just doesn’t do those things if one is associated with “X”…fill in the blank….a university or some other entity.
I have not sought a formal legal opinion on this matter, but I did read state and federal employee law….it is pretty clear! If you work for an entity and they deduct Soc Sec and Medicare from your wages, you are an EMPLOYEE, not an Independent Contractor….and employees have all sorts of rights! [again, you can sign those rights away if you want to but an employer cannot expect working hours beyond 40 per week unless you do agree]…..
Bottom line: I have very much enjoyed my “side gigs”…..they keep my interests and enthusiasm up…..and in my case my practice became my “side gig” after I completed further education and training……it has been tremendously helpful in financial ways, but equally important it has given me a base that I was more “in control of” and allowed me to enjoy decades of seeing patients and then seeing their kids, and I am now anticipating some sort of “semi-retirement” and I do not feel burned out at all….still love pediatrics…..
All in favor of side gigs…../REL
What an interesting and varied career! Thanks for sharing!
Ralph,
I enjoyed reading about your willingness to challenge the accepted norms of the institution. That is awesome! I too went back to school in mid-career, starting an MBA at age 45, then co-founding a medical startup several years ago. The former Vice Provost for Entrepreneurship at Duke, Eric Toone, has said that conflicts of interest always can be managed. He also had a great slide that stated the following:
Who Chases the Dream and How:
100% Have an idea
60% Discuss the idea with an acquaintance
40% Research existing products/businesses
25% Consult with a friend in target market
21% Write a business plan
20% Make a sale
19% Build a business website
18% Seek independent market expert
13% Explore financing options
10% Test demand
9% Design a prototype
I don’t think these percentages refer to an MD cohort, but as Passive MD has stated, there are lots of reasons why we don’t get a side gig, but a conflict of interest shouldn’t be one of them.
My side hustle was equity sharing single family dwellings. I had three. I did them w/ nurses from the hospital who I knew had good jobs and character. It was hassle free. It ended when they bought me out, at a profit. (one married the real estate agent who I’d recommended she work with) I live in an area w/ ever-rising real estate values and my contracts were written so I was well protected. And I had no real estate experience. The important pieces are to find good partners and have a good contract. I let the partners find the properties in which they wanted to live. I had many more nurses who wanted to partner w/ me but this was only a side-hustle so I held it to three.
I have 3 side hustles. They are all clinical jobs but they are different settings and different patient populations than my primary job. It’s a great way to switch things up and break up the monotony of my main full time job. It still isn’t scalable, but it pays well and keeps up my other skills which is a great thing.
Side hustles don’t always have to have a monetary return to be beneficial to the practitioner (although it does help and one would be foolish to turn away money if the opportunity so arises).
For me my side hustle of blogging has renewed a spark in my life. Has my creative juices flowing and stimulates my mind (I always had a passion for finance but now I find myself reading about it even more so that I can come up with ideas for posts/discussions).
The income I make from blogging is laughable compared to my W2 gig but along with passive income, the money I make from blogging I talk about far more and am proud of than the money I get from my primary gig.
There are a lot of obstacles that prevent someone from starting a side Hustle and they were wonderfully addressed above. For me it was complacency (I did not want to step out of my comfort zone and break the bonds of inertia) as well as talking myself out of it for so many years (what more could I add? There are already so many great physician blogs out there. Will I run out of ideas after the first month).
In the end I decided I would have more regret wondering “what if” if I had never pursued blogging rather than the scenario of starting a blog and flaming out in a month or two. Plus there is little sunk cost to start a blog so if that happened it was not like I took a huge financial hit, just an emotional one.
What is often missed in this conversation is something the first poster touched on—those of us in academics are very rarely allowed to moonlight outside of our own institution. Needless to say, the moonlighting rates and shift availability at my own institution is dismal. Working locums or per diem using skills we already have is a great way to substantially scale up our physician salary as long as you’re willing to travel and give up your time off. The problem comes with the clause in my academic contract that doesn’t allow me to do clinical work outside of my W2 hospital.
Just Sayin’
I hear ya about the ‘not allowed to’ but I find it hard to believe that you’re boxed in so much so that you cannot do anything
In the end it sounds more like an excuse. Shame that grown individuals cede wants, desires, dreams to another person because of some ‘rule’ (not a personal attack just my feeling on the academic strangle hold you describe)
Antiquated – non-compete mindset in a global economy
Something tells me most dont want to do something else. And if they were so good at their job then those in charge would look the other way if a side hustle was entertained
Quit asking for permission
Just Sayin
Thanks, Che. But the truth is that in my move from private back to academics I almost lost my offer fighting to remove the moonlighting clause. The way medicine is now structured gives the individual physician very little control unless he/she is in a solo practice or private group. It’d be redundant to wring our hands over that again here. I could have given up and stayed at the private hospital where I was or found a different academic job, but there are unique reasons why those were not viable options for me personally.
You’re right though—if you’re the only neurosurgeon in a small community or have developed a procedure that only you can do correctly then you probably have more negotiating power. Realistically, that is very very few of us, especially those of us early in our careers. If you have FU money, by all means exercise your freedom, but those of us still trying to pick up side hustles to pay down loans don’t have the same freedom to “quit asking for permission”.
I mean – lets look at it another way – what percent of physicians are asked to leave / fired from AMC’s – for all causes? I’d say its low …as in <1% low.
I would have recommended that you just moonlight somewhere else and if they call you on it then stop. Problem is you brought it up on being hired so the 'ask for forgiveness' approach probably wouldn't work.
Its not about 'FU money' – and freedom?
Furthermore – I'd bet dollars to donuts that several of your colleagues are moonlighting and breaking the 'rule'
…and while we're on that topic of 'FU Money'
WCI–small request….do a side poll on the website of what docs think is FU $..how much?
I'd be curious…how bout you?
JustSayin'
Everyone uses the “I don’t have enough time” card, even retired and unemployed people. Everyone has enough time to do the things they want to do. I remember when I was coaching the kids U-8 soccer team. Another surgeon asked me how I could possibly have time to do that. I told him “I’m the boss. I just tell the office staff to put soccer on the schedule from 3-5 on Tuesdays and Thursdays and it happens.” You have more control of your schedule than you think, even if you are employed by a hospital.
When I was a resident, a time we don’t think we control our time, my brother was getting married. I told the high ups that I would be gone that weekend, 6 months in advance. When the call schedule came out, I was on call that weekend. I went into the office to tell them of their mistake. My boss said he would see what he could do. I told him, “I don’t think you understand the situation. I’m not asking for the weekend off. I’m telling you I will not be here that weekend. And I told you this 6 months in advance.” He found a way to get the shift covered.
Dr. Cory S. Fawcett
Prescription for Financial Success
Echoing what Xrayvsn, I spend 12 hours per week making videos for my YouTube channel. It’s stimulating, engrossing, satisfying, creative, and with little prospect of making money. I often encounter people who see this as a dubious project because it lacks a path to real business success, or who offer the opinion that I ought to be regarding it as more of a business, and forming a marketing plan. For now, it’s something creative that requires discipline . If it turns into something more, that would be an unexpected bonus.
I mean – lets look at it another way – what percent of physicians are asked to leave / fired from AMC’s – for all causes? I’d say its low …as in <1% low.
I would have recommended that you just moonlight somewhere else and if they call you on it then stop. Problem is you brought it up on being hired so the 'ask for forgiveness' approach probably wouldn't work.
Its not about 'FU money' – and freedom?
Furthermore – I'd bet dollars to donuts that several of your colleagues are moonlighting and breaking the 'rule'
…and while we're on that topic of 'FU Money'
WCI–small request….do a side poll on the website of what docs think is FU $..how much?
I'd be curious…how bout you?
JustSayin'
It’s less than enough for sure. Maybe a 3 month emergency fund qualifies.
at age 61 my surgical career is winding down, however there was time for side income activities despite carting four children around to multiple functions. Some things where part of new sevice lines like allergy testing and immunotherapy, office CAT scaner, reatail Hearing Aids, yet others included outside Laser Spa director , office real estate LLC. with much of the ancillary income to pay college tuition. The kids are older now and I think appreciated no college debt as they pursue grad school. One side hustle regret is that I did not stay in the Navy reserve.
Dave
There are also people who do the side hustles for the dream that they could find an “out” of their primary profession. I hope that the number of doctors who do that are few and far between!
When the recession hit in 2008, the hospital where I was Medical Director for an inpatient geriatric psychiatry unit stopped paying the psychiatrists for doing weekend rounding and consults. I had gotten quite used to the monies for working >40 hours a weeks and the income drop presented a problem.
I took a “side hustle” job doing weekends at a hospital in another community 25-30 miles away. I have kept this “side hustle” ever since. For Psychiatry, the most lucrative arrangement is to be a full time employee (with benefits and pension) and sell weekends to another entity. At one point for a few years, I was going to two different inpatient units an hour apart: up at 0600, start at 0730 at unit one (teaching residents) and then by 2PM, having driven an hour, I was at unit 2 from then to about 7-8 PM, then back home after 12 hours work. This was a bit too much…
I’ve since kept to the unit that pays a premium for doing a second weekend in a month, pricing the other unit (farther away) out of the equation. This side hustle comes with malpractice insurance (and a tail) and pays a further premium for holidays.
I have informed all of my employers of the weekend side work since 2008. No conflicts with a 40 hour per week, no call, no weekend job and the unit is 30 miles away from my primary location. This arrangement allows a solid wage/benefits/pension/good hours and vacation time from the primary employer, and the side work increases my overall wage by 50%. It also allows me to max out a 401A (with 5% match) and a 457 at the primary employer, then max out a solo 401K or SEP-IRA on the 1099 work. It will also allow me to use the new 20% pass through deduction to the extent I don’t exceed the deduction income limits. By taking monies off the top for the 401A/457, and solo 401K (or SEP), I can take >$70,000 of the top to reduce my taxable income (I know WCI prefers a Solo 401K).
Anyway, the side gig will allow me to bring my plans to retire from full time work at age 57 to fruition.