• Margaret Curtis, MD

Side Gigs: Good, Bad and Just Plain Wrong

Updated: Jan 5, 2019

There is a lot of interest among doctors in earning auxiliary income, either through extensions of their medical career, through investing or through entirely new ventures. There are entire websites and online groups for discussion of physician "side gigs". Sometimes these enterprises are just for enrichment: after twenty years of looking into people's ears, you might want to learn a new skill or scratch an entrepreneurial itch. More often, they represent a way out of clinical medicine for frustrated physicians.

Reasons are many, and the solutions are complicated. Here I want to talk about the ways you can't increase your income, the ways you can, and the ways you shouldn't .

(These gigs fall in two categories: those that use the medical skills you got in training, and those that don't. I don't really think of selling skin products as a "doctor job", because you don't have to be a doctor to do it. I am going to assume you want to use your hard-earned skills and knowledge in your side gig.)

Nice work if you can get it....but you won't get it: The American Urological Association has an entire periodical devoted to the business of medicine and making sure urologists get paid fairly (AAP, get on your horse). They recently published an article on physicians leaving the field early, and profiled four former urologists who are now all - wait for it - physician coaches. Now, I have lots of respect for physician coaches - I have worked with one, Dr. Maiysha Clairborne - but we can't all become coaches because if we did we wouldn't have anyone to coach.

Doctor and best-selling author Siddhartha Mukherjee MD recently wrote an article in the New York Times about how he and his med school colleagues were able to avoid burnout by becoming translational researchers, highly specialized-specialists authors. I will give him a point for mentioning a family physician who has created his own niche in HIV care, but take a point away for recommending a career path that is open to almost no one else.

Instead, how about a job you already know how to do: Practice telemedicine. Do chart review or expert witness testimony. Start a private practice or concierge practice. Become an expert in some aspect of your current practice, and then open a practice focused on that (ADHD management, anyone?). Do home visits. Become the medical director of a nursing home or hospice. Become more productive or negotiate a higher salary at your current job. Do some locums. Write or teach. Invent a medical gizmo. Go to work for pharma (but if you do, please disclose it). Start a business as a nutrition or sleep or firstaid expert. Become a consultant on end-of-life planning for families. Be a team doctor [1]. You have skills and smarts that can be used in many, many pursuits.

Lastly, thanks but no thanks. I belong to several social-media groups for physicians looking for extra income. Some actual ideas proposed: Remotely supervise midlevels, who you have never met, seeing patients you have never met, at a site you have never visited. Do joint injections (that you haven't been trained to do). Do conscious sedation (that you haven't been trained to do). Get a hyperbaric chamber for your office (you can figure out what to do with it later). Any of these carry real risk of harm, medical malpractice lawsuits, and the loss of your license. You would be better off selling skincare products.


[1] OK, we can't all do this one either. But it's so cool.

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