There are many free things in life to appreciate, but this isn’t one of those blogs. So, while I enjoy turkey time with my family, I’m going to post about a work-related issue for which am thankful (all the time remembering that health and family are what it’s really all about!)
Author: Robert A Felberg MD
Topic: Alternate sources of income, Financial Advice
Keywords: Side jobs for doctors, Physician Side Hustle, telemedicine, locum tenens
I side gig. It’s a huge part of my plan for financial independence. And, quite frankly, there are times I enjoy the side gigs more than my primary job. What I love most about my physician side jobs is that they have all of the positives of my primary job, with very few of the negatives. If I were asked to name something about my work for which I am most thankful, my side hustles would top that list.
[Editor’s note: this mostly tongue-in-cheek post is part of a series presented by physician advocates and medical success central. There’s a lot of great doctor financial advice available in the “blog-o-sphere” but much of it is highly technical. This series is more about the philosophical aspect of physician financial planning. Please be certain to sign up for our newsletter.]
I got into side gigging late in my career and through a bit of a roundabout manner. After studying financial planning for a while, I had come to the wise decision to pursue financial independence. I quickly realized that the best way to do this was to earn more money and invest it. So, I decided to really accelerate my practice. I started booking and overbooking patients. I saw every consult and stayed late every night. I would wake up early on weekends and round even when I wasn’t on call. If there were patients that needed to be seen on Easter, I’d be there. My plan was to maximize my collections, crush my bonus, and then relax in my early retirement.
Man, was that plan a disappointment! After a year of honest and sometimes exhausting effort, the results were pitiful. My bonus was only $36,000 and most of that disappeared to federal and social security taxes. Talk about depressing…
There are two big problems with most bonus plans:
- Nearly all bonus plans are poorly designed and biased against doctors. The emphasis is getting you into bonus territory, not rewarding you for the work you do afterwards. Can you blame the hospitals? When you get into bonus territory it’s like they hit a home run! You have covered your expenses and generated enough profit to make the administration happy. But, the last thing they are going to do is willingly and generously share the money with you.
This leads to the sad state where the effort of maximizing your productivity is not equal to financial rewards. You are running uphill fighting diminishing returns. Maybe your bonus plan is better, but I see quite a few through my clients, and none have been truly favorable.
- There is a physical or schedule limit in ramp-up. You are already seeing patients all day, there’s little room to add more. You can’t operate 5 more patients every day. The same is true for weekends, they just won’t pay for staff. You really are limited within your primary job as to the hours, time, call coverage, and reimbursement you can receive to at least some degree- even if you decide to commit fully to increasing volume. Especially if you are truly committed to quality care and patient experience.
After my disappointing bonus return, I was struck by a sudden realization. I could easily earn the same $36,000 doing 3 weeks of locums rather than 52 weeks of constant struggle at my primary gig. I could take 2 weeks of “true vacation” and 3 weeks of “working vacation” and then cruise the rest of the year. I wasn’t taking vacation anyway trying to maximize my bonus, so this was an actual improvement.
The experience as a locum was great, better than I ever hoped. Even though it was work, it was also a semi-vacation. It was a different locale, nice people, a novel hospital, and a new system. I really liked it. And, the money was fantastic! I could earn more in a week doing locums than I did in 2-3weeks at my main job. I learned to do the occasional weekends and earn $3600-$5000 for 3 days of work. Around this time, I also started to contract out for telemedicine which has opened even more opportunities.
Here’s the great things about side gigging and why I am so thankful for it:
- Options equal freedom. I used to stress out unimaginably about compensation issues. Now, if I need more money I just line up an extra shift. I also have no job stability concerns. I have jobs lined up throughout the country and could find more in a matter of a few phone calls. The alternative opportunities have led to an unparalleled sense of control and freedom. I may be the only doctor in history who cured his “burn-out” by working harder!
- No drama. I’m not married to any of these jobs and the local drama just isn’t a concern for me. I don’t care if Alice hates Bob or Charlie is stealing consults from David. I’m there to do my job and care for patients. When my shift is up, I go home. When the week is up, I’m on a plane home.
- SEP-IRA Plans. The SEP-IRA is the second only to HSA as the greatest gifts the IRS gives high earners. Not only can you max your 401(k)/403(b), your 457(b), and your traditional post-tax IRA, you can also put away 25% of your 1099 income to a maximum of $53,000 on top of the other plans. That comes out to $95,500 of tax deferred saving annually! Even more when you are over 50.
- The compensation is fantastic. The hourly salary varies between $40 to $250 hourly depending upon the intensity of the job. Your earnings vary depending upon specialty
- If you don’t like something about the job, you complete the contract and move on without emotional or reputational baggage. It doesn’t really matter the reason, if you don’t like something you just don’t renew at the end of the contract. There is no wringing of hands, exit interviews, or restrictive covenant. Just thank them for the opportunity, turn over the beeper, shake hands, and move on to the next gig.
- They treat you better than the permanent docs. You may think as the locum or the outside contracted provider that you would be treated poorly. But, the opposite is true. You are a highly prized and expensive commodity. They are thankful you are there, and they know that you can leave at any time. Also, they want nothing more than to have you fall in love with the hospital and sign on full-time. This is quite common, doctors frequently go from temporary to permanent jobs via locums.
Side gigging has been a blessing to my career. Although not even marginally important as family, health, or peace- my side hustles are something for which I am thankful. Hopefully, you have things about your career that you appreciate. Maybe side gigging is the secret sauce that you need to kick start your medical and career success.
Physician finance, like other professional and business skills, are a vital part of your ultimate success. Fortunately, there are a lot of great resources available to master this important aspect of your career. Be sure to up your skills, negotiate your best deal, and be thankful for your side gigs. With the proper training and some hard work, you’ll be able to reach your dreams and succeed… really succeed.
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What do you think? I am crazy to be thankful for extra work? What are you thankful for in your career? Do you side gig? How did you get started? Share your thoughts in the comment section.