The Money Makers

Explore employment types and career options available to physicians of all specialties. Each opportunity emphasizes physician autonomy, schedule flexibility, and significant earning potential.

AS FEATURED IN

Per Diem

Per-diem-contracts can be the first and most attainable step towards Doctoring Differently. Instead of being a full-time employee, it is possible to convert to a part-time or full-time contractor. It allows one to remain at their same institution or within their same community and continue to generate income in a safe and familiar environment. In such cases, the EMR system and support staff is familiar and such a physician would be immediately efficient and a profitable asset to the department. Per-diem employees are paid an hourly rate and often can accrue paid sick time. As a per-diem employee, health benefits and retirement contributions are not provided. But not to fear, you can procure those benefits on your own.

Benefits

Freedom of schedule. Most institutions do not have a minimum requirement of shifts per month that are required of their per-diem physicians. You are free to flex your schedule as you desire to meet your own personal and financial needs.
No limit on the number of per-diem contracts. For those living in medically saturated cities and communities, you can become credentialed at multiple institutions. If one institution has limited per-diem shift availability, another institution may provide the shifts at the times that fit with your schedule.
No administrative responsibilities. You are only required to perform clinical duties without attending meetings, sitting on committees, teaching, preceptorship, or researching. If you specifically desire to continue one of these responsibilities as a per-diem employee, many departments would be receptive to such a request.
Malpractice Insurance coverage provided. The Institution will provide high-quality malpractice insurance.

Salary: Highly variable between specialties. Generally, it starts between $110-150/hr for primary care practitioners and hospitalists.

Flexibility Meter: 8/10 (your flexibility will depend on the institution’s shift availability). But if you don’t want to work nights, weekends, or holidays, you are not required to.

Locum Tenens

For most of us, it started near the end of residency. The barrage of calls, texts, and emails from locums recruiters promising piles of money in exchange for practicing in a rural community in a state you’ve never even visited. Perhaps you, like me, found yourself briefly daydreaming about hopping on a flight (or a couple of flights) to arrive in that town, work for a couple of weeks, stuff your well-earned dollars into an extra suitcase and go home.

Let’s start by dispelling a common myth. Not all locums assignments require flight travel. It is very possible that there are high-paying locums assignments within driving distance of your home. Community hospitals even a few hours from major cities often experience a dearth of physician coverage and are willing to pay large sums of money for short-term or long-term staffing. Additionally, I am a proponent of exploring locums opportunities in states where you are already licensed. Given the amount of time, money, and paperwork it takes to obtain a state license, exploring states where you already hold a license will expedite the process and give valuable experience.

Private locums agencies are hired by hospitals to recruit and credential physicians for short or long-term staffing assignments. The assigned agent is not a medical professional, but an intermediary essential in the negotiation process. The agent will present an applicant’s resume to the contracting hospital and, if accepted, facilitate credentialing, negotiate schedule, provide malpractice insurance coverage, and arrange travel and lodging accommodations. The physician will be paid directly by the locums agency rather than by the hospital.

The need may be inpatient or outpatient or a combination of both. Many positions also offer a 24-hour on-call rate (just to remain within a certain radius of the hospital for emergencies) and an hourly on-call rate. As a locums contractor, health benefits and retirement contributions are not provided. But not to fear, you can procure those benefits on your own.

Benefits

Negotiation of all terms. From salary to schedule, every aspect of a locums offer is negotiable (never accept the opening salary offer). Increased pay rates on Thanksgiving, Christmas, New Year, can frequently be negotiated as well. Finally, nurses aren’t the only ones who can collect holiday pay!
Malpractice Insurance Coverage Provided. The locums agency will provide high-quality malpractice insurance.
Travel. Explore a new town or community through a short-term locums assignment! They will undoubtedly be happy to have you.
All Travel and Lodging Expenses Covered. Nothing will be at-cost to you.

Salary: $2000/day or more. Depending on number of hours worked.

Flexibility Meter: 7/10. You may be able to negotiate a working part, or all of an available block that a hospital offers.

Landing at my first Locums gig in Mammoth Lakes, California in September 2017.

Telemedicine

It’s no surprise that telemedicine platforms are developing at an exponential rate. The CDC reported a 154% increase in telehealth visits in 2020 compared with the same months in 2019 and it is no surprise why. The convenience for both doctors and patients is truly incomparable and it has become the benchmark for ultimate flexibility in clinical medicine. By limiting direct patient contact, physicians are protected from communicable disease while safely generating income and providing critical clinical services to grateful patients. I imagine that the telehealth platform will only expand to the point of most Americans having easy telehealth access to a provider within just a few years.

While many physicians already provide telephone or video appointments through their institution of employment, independent telemedicine companies are empowering physicians to break away from hospital employment to provide telehealth care entirely on their own terms. Credentialing is efficient, streamlined, and only takes a few weeks. Physicians can see patients in the states where they hold an active medical license.

Many of these platforms are revolutionizing physician happiness and quality of life by building *gasp* mental health breaks into the workday. There is an emphasis on ensuring that the individual physician feels supported on the platform and part of a larger community of providers.

Currently, there are a couple of different models:

Physicians are free to log on and off at their convenience and wait to be matched with a patient at any time of the day or night. This is perfect for days when you already plan to be home and doing other things around the house. Log on and wait for a notification that a patient has entered the “virtual waiting room”. Throw on the white coat hanging on the back of your office chair and start the visit. [pro-tip: prop a mini mirror on your desk to check your face/teeth before the video turns on and you find yourself face-to-face with a patient while trying to covertly suck the spinach from between your teeth]. Visits take no longer than 10 minutes and charting is simplified with a variety of preloaded templates. In this model, the physician is paid per patient.

Providers can sign up for 4-8 hour shifts in advance and be scheduled for patients ahead of time. The provider will be paid for those blocks of time whether patients are scheduled or not. Some companies that offer shift work also offer a 401K contribution match for part-time (min 20 hrs/wk) employees.

Benefits

Flexible: Anytime! From anywhere with Wifi!
Clinical: Keep up your clinical skills from the safety, comfort, and convenience of your home office.
Grateful patients: Despite this being a one-time encounter, these patients are so grateful to have access to an excellent physician, such as yourself, from the safety of their homes. It’s a good feeling.

Salary: Up to $200/hr with a high patient volume.

Flexibility Meter: 10/10 (log-in to see patients at noon or midnight and stay available for "walk-ins" for as long as you want.

Stay Updated

Join our newsletter to get news and special course offers.

I would like to receive future communications

I agree to the GDPR & CCPA Terms & Conditions

Medical Aesthetics

Botox, fillers, laser treatments. You’ve heard these ubiquitous words even if you have no idea what they mean or what they do. So you’re not in dermatology or plastics? Most of these cosmetic procedures can be performed by nurses, but in most states, the “Medical Spa” practice must have majority ownership by an MD/DO of any specialty. In my community, many MedSpas are owned by Family Medicine doctors, Emergency Physicians, Anesthesiologists. And as a Pediatrician, I’ve enjoyed the procedural aspect and customer service aspect of providing medical cosmetic procedures.

I started my aesthetics practice after a conversation with a retired surgeon who shared how he was approached about starting an aesthetics arm of his practice late in his career and his only regret was not starting it 10 years earlier. He described a short, but steep learning curve and recommended taking a few courses to refresh myself on facial anatomy and learn the safest procedures and most effective techniques. I found one of the many 1 and 2 day independent courses taught by expert injector doctors and nurses that will provide CME credits and give hands-on practice with guidance and supervision.

This Industry is growing at such a rapid pace and will continue to be rewarding and lucrative for practitioners who enjoy procedures, customer service, or who desire to grow a small practice into a full-fledged business.

Benefits

Procedure-based. After leaving the Pediatric Emergency Department, I missed doing procedures on a regular basis. This is a creative and artistic way to work with your hands again.
Highly lucrative. This is a cash-only business without any insurance. All profits are yours to grow your business as large as you’d like.
Instant Popularity. You will be very popular in your friends group. Guaranteed.

Salary: Unlimited earning potential!

Flexibility Meter: 10/10. It's your private business, work when you want to.

Veteran Disability Exams

Veteran Disability Exams (otherwise known as Compensation and Pension Exams) are independent medical exams for military veterans who are claiming injury or disability during their time in service. The Department of Veterans Affairs ensures that all eligible military veterans receive injury or disability compensation in addition to life-long healthcare. The VA contracts directly with civilian companies that, in turn, hire and facilitate the execution of these exams by civilian physicians.

You may be thinking “Well why can’t military hospitals and military personnel perform these exams?” There are many more Veterans than there are military clinicians and facilities to perform C&P exams. Active military physicians provide acute care and diagnostic treatment, but disability exams are non-clinical and non-treatment in nature and their only purpose is to ensure that veterans are fairly compensated for their service-related injuries or conditions. A physician performing the disability exam is NOT the treating physician. There is no diagnosing new conditions or ordering diagnostic testing. The examining physician does not prescribe medication nor do they follow up with the veteran. The note/questionnaire associated with a disability exam is purely legal in nature.

As this is considered non-clinical work, board-certification is not required to perform Veteran Disability Exams and a physician need only hold an active state medical license. Doctors of any specialty can be trained to perform disability exams. The contracting organizations who facilitate these exams provide comprehensive training and offer 24-hour support to their clinicians. During a disability exam, the civilian physician will obtain a pertinent medical history from the veteran, perform a focused physical exam based on the injury or condition, and execute a chart review of the Veteran’s medical record. They are subsequently responsible for synthesizing the history of the Veteran with his or her service treatment records and pertinent labs or imaging that were ordered by their treating physician. The physician is compensated based on the number of questionnaires submitted to the VA which directly correlates to the number of claims a Veteran reports. Mental health professionals are contracted to specifically see Veterans claiming post-traumatic stress disorder or traumatic brain injuries.

States that have a large number of military bases like California, Texas, and Florida have significant needs for independent physicians to perform these exams. At the beginning of the Covid-19 pandemic, these exams were put on hold, but they have now been mandated as essential services and the VA is working hard to schedule Veterans veterans, so the need for civilian physicians to participate in this effort is significant.

Benefits

Multidisciplinary: This is an opportunity that blends chart review, physical exam, and history, taking about a multitude of injuries, ailments, and exposures.
Enriching: This was a distant divergence from my career as a pediatrician, but I truly enjoyed hearing the stories about decades of international and domestic service from older veterans.
American History: After increasing my knowledge of the Korean, Vietnam, and Gulf Wars and the associated exposures and dangers that these brave Veterans encountered, I was even more grateful for our active and retired service members and their personal sacrifices for our country.

Salary: This job has very high-earning potential. A physician performing disability exams will be paid by the number of disability claims per veteran. Physicians who have made this work a full-time career, can generate $40,000 PER MONTH in income.

Flexibility Meter: 8/10. If you live in a city or state with a military presence, there are likely organizations that are looking for physicians to perform these exams. Many are open 7 days a week and will schedule veterans according to your availability.

Contributing Question Bank Author

Trigger warning!

You may remember spending hundreds of hours pouring over practice Qbank questions and explanations for Step and Shelf exams. Surprise! Someone has to write those. There are private companies that have made an entire industry out of hiring physicians of all specialties to write questions for their test banks. Questions about ethics and medical jurisprudence are also important contributions to Qbank.

Original content on any topic within one’s specialty is accepted and efficiency and ingenuity are rewarded with higher pay rates and bonuses for high question and explanation production. Of course, it’s not only the question itself that is important, but the explanation that details why each option is or is not the correct answer. Physicians who have spent time in academic medicine teaching residents will know this.

This is an excellent non-clinical option for physicians who enjoy creativity and critical thinking that does not require board-certification or state licensure. Obviously, question writing can be done entirely independently and entirely on one’s own schedule from vacation or other remote destination. It could also qualify as supplemental income for any physician, regardless of employment status.

Benefits

Teaching: Those coming from academic environments will excel at question writing.
Time for research: Take your time reading textbooks and crafting your perfect question.
Reflection: That complicated case that baffled you and your team for weeks? Turn it into a question and teach the masses.

Salary: Depends on productivity, but $50-$60 per question is average.

Flexibility Meter: 10/10. Scribble down that renal question anytime creativity strikes!

Medical Expert Witness

Physicians often cringe when I mention that I routinely participate in Medical Expert Witness work. They imagine sitting on a stand while a grumpy trial attorney attempts to discredit their knowledge and credentials. Understandably, we Physicians are instilled with some inherent fear and avoidance of the entire legal profession, but we are missing out on very exciting and lucrative work by shying away from it.

There are levels to medical expert witness work—it is not all juries, judges, and trials. A defense or prosecution team may simply need a physician expert to effectively translate medical records as it involves a specific case.

For example: Why was this child’s lead level tested? Is that standard for all children? Can high lead levels harm children? What is the treatment for high lead levels?

Physicians also imagine they will automatically be asked to testify in a case of medical malpractice. That is rarely the purpose of a medical expert witness.

Benefits

This work can be fully remote. You may never even see a lawyer or any other involved party in person. You may be asked to compose an Expert Report of your findings in support of the facts, the science, and your conclusion expert opinion. Notice that I didn’t say “in support of the defense or prosecution.” Integrity matters always and in all ways.

Salary: You will be asked for a “rate sheet” where you are free to set your own hourly rates and fees. Depending on the region of the country and whether you are contracted in a federal case or by a private firm, the range is generally $300-$700 per hour for Medical Expert Witnesses. Retainer fees may be negotiated upfront. Every email response, every phone call, and every minute of your time spent researching the subject matter, taking notes, or drafting a report is compensated at the rate you determined. How refreshing!

Flexibility Meter:

9/10. Very flexible in the expert report writing phase. Deadlines are usually weeks apart and, in my experience, attorneys are very accommodating of their expert witness’ time. Depositions and court dates may be scheduled according to your availability if your attendance is required.

7 Tips for Medical Students

Completing medical school, residency training, and becoming a board-certified physician in any specialty will give you the widest range of options to live a flexible and balanced life both in and outside of full-time clinical medicine.

Here are 7 tips I wish I had known during my own time as a med student.

Download the PDF with the button link below!

Download PDF