Tips for physicians to earn secondary incomes

The Medical Economics Physicians Report published earlier this year took an exclusive look at the financial state of primary care practices in the United States, including asking physicians if they received a secondary income outside their practice or employer. But how does a physician, with a full-time practice, for example, become an expert witness, staff extra shifts in urgent care or work in telemedicine?

Jordan Grumet, MD, manages his internal medicine practice in Northbrook, Illinois, but he also works as a medical director for a nursing home, practices hospice and palliative care and even serves as an expert witness. He’s also taught, written a book (I Am Your Doctor: And This Is My Humble Opinion,) and has managed nonmedical businesses.

“I realized a long time ago, from a purely financial standpoint, that as a physician, how little control you have of your business,” Grumet says. “Patients come or don’t come, and if you do a really good job as a physician, hopefully, your patients don’t need to see you.”

For Grumet, the ideal way to balance his income’s natural highs and lows was to take on second and even third jobs.

“It’s nice to have a constant revenue stream that’s not so patient-dependent,” he says.

Grumet is only one of the thousands of primary care physicians who balance their practice with secondary jobs.

The Medical Economics Physicians Report published earlier this year took an exclusive look at the financial state of primary care practices in the United States, including asking physicians if they received a secondary income outside their practice or employer.

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But how does a physician, with a full-time practice, for example, become an expert witness, staff extra shifts in urgent care or work in telemedicine? Michael McLaughlin, MD, founder of Physicians Renaissance Network-a resource for doctors for exploring non-clinical careers and hobbies, and co-owner of Peloton Advantage, a medical communications company-recommends physicians do their homework.

“Spend some time looking at what you’re doing, what you want (in a second job), whether you want to earn more money, reduce your hours in the clinic or step toward retirement.” says McLaughlin, who is also author of Do You Feel Like You Wasted All That Training? “That’s really important, instead of jumping ahead quickly and applying for jobs.”

Next: Follow your natural inclinations

Grumet suggests that physicians follow their natural inclinations.

“I’m the kind of person who’s interested in a lot of things,” Grumet says. “If you are passionate and excited about what you are doing and are open-minded, people will naturally come to you, and you will find natural opportunities.”

For Grumet, about half of his endeavors came to him, but the other half he had to pursue-sometimes knowing nothing about the industry or opportunities.

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While he was initially approached to become a medical director for a nursing home-and then later expanded his personal practice into caring for those patients-he simply sent out his resume and emailed several law firms to get into the work of being an expert witness. Now, he works as an expert witness about five to 10 times each year.

“Recently, I was on the phone all day with insurers for nursing homes, and I thought, ‘boy, I’d like to learn more so I could do more for my patients,’ and then the other day, I saw a part-time job posting for insurance company review of nursing home stays,” Grumet says. “Maybe I’ll apply to that. There are opportunities everywhere.”

To target specific jobs, do an online search of national organizations and associations related to those jobs.

“Find the organization that matches what you’d like to do, and use that organization to help you,” says Sean M. McNeeley, MD, a family physician and board member of the Urgent Care Association of America. “When someone says, ‘I’ve been on your (association’s) website,” I’m a lot more interested in that they’re interested in us and not just interested in earning a few extra bucks.”

With certain side jobs, physicians might need to improve techniques not often used in their regular practice. With Urgent Care, for example, casting and splinting are important proficiencies.

“If you haven’t sutured or drained or splinted in a long time, I’m not going to be jumping to put you on my list,” McNeeley says, adding that the Urgent Care Association of America website has online lectures and accreditation on those topics.

National medical organizations sponsor national and regional meetings, and often put a call out on their websites for speakers. Sessions before and after meetings often are sponsored by pharmaceutical and technical companies that recruit physicians as speakers, and speaking is one of those side jobs that can also develop from secondary jobs like writing and consulting.

Next: Networking and finding a mentor

Other side jobs like expert witness work and telemedicine do not always require previous experience.

“We offer some training and preparation, and it’s pretty simple to do,” says Peter Antall, MD, chief medical officer for American Well. “There’s a section of our website devoted to physicians and allows them to understand the onboarding process. They can apply right online.”

Networking and getting a mentor can be helpful in setting up secondary jobs, as well.

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“Having someone who can be a mentor can be extremely important, and LinkedIn is an amazing tool for networking and connecting with people in a particular company or position,” McLaughlin says. “If you can’t find a mentor, the other option is to get a career coach.”

For example, a coach could help determine what kind of consulting would be best for you.

“When someone says, ‘I want to do consulting,’ the next question is what do you mean by that?” McLaughin says. “There are so many ways a physician can consult, but even though there are many opportunities, sometimes it can be challenging to get that first paid consulting job. You might need to do some pro bono work first.”

McNeeley says it’s important to be persistent and be willing to participate at lower levels.

“With some jobs, like teaching or speaking, you might have to put in some volunteer time and volunteer efforts first,” McNeeley says.

Getting secondary jobs also sometimes requires a different kind of networking.

“You’ve got to get over that initial fear of doing something new, and instead tackle it as a learning experience,” Grumet says. “Some physicians stop themselves before they get started. Not only can you earn money, but you can learn a lot about the world and even your own profession.”

Some physicians who work a second job end up moving into a new area of medicine, and many end up enriching their own practices with their new experiences.

“We have several full-time physicians who started doing telemedicine as a side job,” Antall says. “Others have discovered opportunities within their own systems. These moonlighting opportunities can be a segue into, ‘My gosh, why am I not using this in my day job?’ Many physicians use telehealth to see their own patients.”