6. Review Insurance Claims
There's a growing demand for physicians to help payers with utilization review (UR). "The health insurance industry is just booming right now," said Steve Babitsky, citing the mandate under the Affordable Care Act requiring all Americans to have coverage.
Although some physicians may view this as working for the wrong side, it's "actually a chance to do good," Dr. Fork said. "Your role has to do with stopping overuse of services within the healthcare system and helping to provide quality care for value."
The advantages are that you can use your diagnostic skills as a physician; you're often able to work out of your home; and, if you work full-time, it may be possible to make as much money as you did seeing patients, although many UR physicians work part-time.
Heidi Moawad, MD, a neurologist in Cleveland, served for several years as a UR physician, working part-time out of her home while raising her young children. Working with a radiology review company that contracted with several health insurers, she dealt with preauthorization requests for radiology from fellow neurologists.
Contrary to her trepidations going into the job, she felt under no pressure to deny payments and felt little resistance from the physicians whose requests she was reviewing. In fact, many of them would even ask for her guidance. "They would tell me, 'This is the story; what do you think?'" she recalled. "When I said the test was unnecessary, they were actually relieved." The job helped her get on the Practice Guidelines Committee of the American Academy of Neurology.
When her kids got older, Dr. Moawad switched to a teaching job, but she looks back fondly on her UR career. However, she thinks UR physicians are now under increasing pressure to closely follow practice guidelines rather than follow their own reasoning.
Amy E. Odgers, MD, an internist in Chicago, also switched from clinical practice to UR work. Initially she worked in a call center, handling physicians whose charges were being challenged. "At times, the work can be contentious," she said. "Doctors don't like to be questioned about why they're ordering tests."
After 9 years of reviewing claims, she now has a new position at the same company, studying ways to improve workflow. Working just 20 hours a week, she said she doesn't make as much money as clinical care physicians, but she isn't in debt either. Plus, she has time to pursue gardening and ceramics. "I love the balance I have between work and other things," she said from a cell phone while in her garden.
Pluses: Reviewing claims pays relatively well, and in many cases, you can work part-time from your home.
Minuses: The work is becoming more and more regimented.
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