10 Ways to Earn Extra Income With Medical Activities

Leigh Page


December 17, 2012

In This Article

Consider This Growing Field

2. Provide Telehealth Consults

Sitting at your own home office, you can provide telehealth consults to distant patients. This work -- done by phone or over the Internet -- generally uses part-time physicians. You can arrange to take the calls in your off hours.

Telehealth doctors, who advise patients whom they will never meet in person, deal with a variety of simple complaints. Because procedures are not involved, the work is a good fit for primary care physicians. They can even write short-term prescriptions. If the telehealth physician decides that the complaint cannot be handled over the phone, the patient is directed to a local doctor or the emergency department.

On its Website, San Francisco-based Ringadoc says that physicians are paid $20 per telehealth encounter. Each encounter takes 8-12 minutes, but the physician also needs to review the patient's medical history, write a brief summary of the encounter, and provide patient instructions. Dr. Kennealy says that rate could be worthwhile if you could see a lot of patients quickly.

Some states, such as Texas, prohibit telehealth consults, on the grounds that physicians need to have a face-to-face encounter to understand a complaint. But resistance has been eroding. Telehealth consults are legal in at least 21 states, including California, Illinois, New York, Ohio, and Pennsylvania.

Many patients pay out-of-pocket for telehealth consults. Medicare won't cover this kind of telehealth service, but some major private insurers -- such as United Healthcare, Aetna, and Cigna -- have begun to cover the charges. At least a dozen states had passed laws requiring private insurers to pay for telehealth.

Providing telehealth services across state borders, however, raises issues of state licensure. Twenty states have licensure laws specifically addressing telehealth, usually requiring licensure for physicians who practice telehealth frequently with patients in that state, according to a state-by-state review in Telemedicine Today.[3] However, Alabama and Tennessee instituted a special-purpose license based on licensure in another state.

Caring for a patient whom you cannot see or touch might seem risky, but so far the work has run into little malpractice activity. To reduce risks, physicians starting telehealth consults have to undergo training in telephone best practices and use protocols, such as those devised by David A. Thompson, MD.[3]

In addition to Ringadoc, you can check out American Well, Teledoc, and iSelectMD. Another company, NowClinic, hires physicians to provide telehealth consults for United Healthcare members in 22 states. And Soliant Health, an online recruiting organization, has been looking for doctors to make telehealth consults for hospitals.

Pros: You can work in your home and set your own hours. It's a growing field, and there are many outlets to choose from.

Cons: Payments seem somewhat low, and you may be barred from doing this work in your state.

3. Work as an Expert Witness

Serving as an expert witness for attorneys is almost always part-time rather than full-time work. Full-time expert witnesses would be viewed by jurors as "hired guns" who have lost touch with clinical practice. Physicians' clinical experience is the value they bring to legal cases.

Karen Josephson, MD, a solo geriatrician in Long Beach, California, has been moonlighting as a geriatrics expert at law firms for many years. "I really enjoy the work," she says. "It makes me a better doctor because I have a chance to see what other physicians have done and think about how I could have done it better." Also, "the payment will always be better than in my medical practice," she says. She makes an average of $2000-$5000 per case.

To avoid the "hired gun" accusation, lawyers prefer that physicians restrict their legal work to no more than 3%-5% of their overall income, according to American Medical Forensic Specialists (AMFS), a recruitment firm for medical expert witnesses based in Emeryville, California.

Expert witnesses can work directly for law firms or work for services that supply expert witnesses; these include AMFS or the TASA Group. SEAK Inc., an expert witness training company in Falmouth, Massachusetts, offers seminars and other resources for physicians interested in this line of work.

Steve Babitsky, President of SEAK, advises fledgling expert witnesses to start a Webpage and establish their expertise. "Develop a niche -- a small area of expertise where you can dominate your market," he advises.

Dr. Kennealy, the career coach, warns that medical experts who go to court have to be prepared for tough cross-examinations. "You have to have the stomach for this kind of work," she says. If not, you can always review cases out of court, which she says pays $200-$300 an hour or more. You can evaluate claims to determine whether they have merit or write reports that are used to settle or adjust cases.

Pros: This work is geared toward part-timers, and payments are quite generous.

Cons: If you go to court, you may face rough treatment by opposing attorneys.