Six Ways to Earn Extra Income From Medical Activities

Dennis G. Murray


April 27, 2010

In This Article

See Nursing Home Patients

Rounding at nursing homes used to be more lucrative in years past. Like medicine in general, the threat of reduced reimbursements and increased liability risks have made it less appealing to many doctors. However, some MDs and DOs still see patients regularly in long-term care facilities and believe that it's worth the effort. It's not uncommon for physicians to earn in the range of $15,000-$30,000 a year for this extra work.

Pros: The pros include very low overhead, flexible hours, and the gratitude of patients who are often forgotten or neglected by their families and caregivers.

"Most of my nursing home patients only want reassurance that I won't forget them and let them suffer in pain," says Gregory P. Zydiak, MD, who practices internal medicine and geriatric medicine in Webster Groves, Missouri. "Their trust in me is quite gratifying."

Cons: The cons include malpractice risks (including potential charges of elder abuse) and unreasonable demands from family members who may visit sporadically and not communicate with each other. The watchful eyes of insurance companies as well as state and federal regulators can be draining, too.

Malpractice insurance is generally not an issue because you'd be covered under your regular policy. However, some companies may make a distinction and charge you more for seeing nursing home patients.

How to find out more: Talk to your colleagues who work in nursing homes, or call the medical directors at facilities in your area. A good resource for basic information is Dr. Zydiak's aptly named Website,

Serve as a Medical Director

By law, all long-term care facilities need to have a medical director who oversees the quality of care, presides over monthly staff meetings, and is available to help craft policies and procedures. It's not a full-time job. This is a good opportunity for a board-certified family physician or internist who has an interest in geriatric medicine, with compensation averaging about $1000-$2500 a month for about 5-10 hours of work each month.

Pros: Overall, there are fewer messy reimbursement issues with long-term care work because you'd be paid directly by the facility on a contract basis. However, not all of the perks are monetary: "Medical directorship offers a welcome change of pace from regular practice," Zydiak says. "It's also taught me administrative problem-solving skills that were totally foreign to me."

Cons: Despite how much patients may love them, medical directors are often undervalued and underutilized, in terms of establishing policies and procedures to help assure patients' rights and head off ethical issues before they happen

Of note, it's important to make sure that the facility has business liability coverage, which covers the administrative functions of a medical director. Some places have dropped this coverage and gone bare, so be sure to ask about it.

How to find out more: The Website of the American Medical Directors Association ( has a link to career opportunities on its homepage. The site also details the steps required to become a "Certified Medical Director in Long Term Care," and is an excellent source of education and management tools for directors.


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