Hi, I’m Jim Mangraviti from SEAK. I’m here with our President and Founder, Steve Babitsky and we’re going to talk to you today about how physicians can earn extra money supplementing their income through six different activities. Steve, let’s talk about these six different activities that physicians can earn extra money on. The first one is consulting. Can you tell us a little bit about how physicians can make extra money through consulting?
Steve Babitsky: Sure. Physicians are hired by clients to do consulting in various topics within their area of expertise. And this is an interesting and fascinating work. You get to work with very smart people. You get to set your own fees. And you really get to solve problems. And there are a lot of really important things about consulting that physicians need to know.
First of all, you don’t need a license. And many physicians have let their license lapse for various reasons, because they’re retired or not clinically active anymore. So that’s a really good thing for them to be involved in. You don’t need an office. Most physician consultants work out of their home office and you don’t need board certification. It doesn’t matter to the client whether you’re board certified or not. The only thing they’re really concerned about is whether or not you can solve their problem.
The second really important thing for physicians to know about consulting is that you’re paid to solve problems. This is not some government controlled entity that will tell you that if you do some kind of an operation, you get $129 even though you’re saving somebody’s life. Private industry is not like that. These companies have significant problems and if they could hire a physician to come in and check on due diligence or check on coding, whatever other area, they’re more than willing to pay a substantial amount of money to get that information.
This could also be an entree into changing careers. So many of the people that come to our courses, for example, are considering leaving active clinical practice but many of them have a one or two-year plan. They’re going to think about it, maybe try it out, and then go into a non-clinical practice. Consulting is the perfect way to do that. You get to pick a topic. You start working on it. You start working in the industry. You see if you enjoy it. You see if you’re good at it. You see if you can get clients. And you see if you can get paid. And many physicians use consulting as an entree into full-time and non-clinical employment.
Again, you don’t have to do it full-time. You don’t have to make that big jump from a clinical practice to a consulting practice. You can do it part-time. You can do it on nights and weekends. So you don’t have to give up our clinical practice to start a consulting practice.
Now what do you need to be a good and successful physician consultant? You need to be a self-starter. The big secret about consulting is generally speaking you have to get your own work. So you have to be able to get the word out about what you do and how you do it, do a little marketing, and pick up clients. And the physicians that do well at consulting get a lot of repeat business and then the clients start coming to you.
And the last important thing for physicians to know about consulting is maybe the most important. Nowadays physicians are being squeezed for various reasons economically, being squeezed by managed care, the Affordable Healthcare Act, insurance companies, and all kinds of other entities are trying to squeeze physicians and make the practice of medicine a commodity. Well, consulting is not a commodity. It’s a personal business and therefore physician consultants can earn a substantial amount of money. If they work by the hour, it’s not unusual for them to charge $500 an hour, $600 an hour, or more.
Sometimes they work by the day. Sometimes they work by the job. Sometimes they work on a percentage of money they can save their client. So in sum, it can be extremely lucrative for physicians to think about getting into physician consulting.
Jim Mangraviti: All right. Let’s talk about the second area, file review consulting. Can you give a brief overview of the opportunities available for physicians to supplement their income through file review consulting?
Steve Babitsky: Sure. Under the Affordable Healthcare Act there are more and more file reviews, utilization reviews, reviews by insurance companies, and by IROs. There are hundreds of thousands of these file reviews which need to be completed on a timely basis. So these companies are looking for physicians who know something about doing file reviews, to hire them, to get them to do these cases.
Again, just like consulting you can do this off hours. You can do it out of your home office. There is little liability. There is no physician patient relationship. There is no contact with the patient or the examinee, so there is no liability. You can earn anywhere from $100 an hour to sometimes $200 or $300 an hour. Again, this is net because you don’t have any overhead. It’s not like the practice of medicine where there might be a 50% overhead. So if you’re earning $200 or $300 an hour doing file reviews, you’re probably earning more than you do in your clinical practice.
And the last thing is, this is not confrontational. Many physicians don’t like to be involved in situations where they have to go testify in depositions or trials, or hearings. They’re not really up for that. And if you’re not up for that kind of confrontation, medical file reviews is a great thing to do because there is no testimony.
Jim Mangraviti: All right. How about a third area, writing? Can you talk about that a little bit?
Steve Babitsky: Sure. Many physicians are interested in writing for fun and for profit. We at SEAK have been running writing courses for many years. We’ve run 20 or 30 writing courses. So what are the advantages of writing?
First of all, obviously it can be done from your home office. You don’t need board certification or a license. Just like in the other areas, the only thing that people are interested in are in results. Can you turn out a high quality product? You can do technical freelance writing. You could do self-publishing. You could do traditional publishing. And just like consulting, writing could be an entree into other areas. So if you write about an area, you become an expert in the area. Once you become an expert in the area you can be a consultant and once you are a consultant that could lead to full-time employment if you decide to give up clinical medicine.
It can be fun and doctors are allowed to have fun. And this is one of the areas they do have a lot of fun with. It can be rewarding both personally and professionally. And lastly, it can be quite lucrative. There are physicians who are earning hundreds of thousands of dollars a year doing both technical writing, non-fiction writing, and fiction writing.
Jim Mangraviti: How about expert witnessing? Can you talk about that a bit?
Steve Babitsky: Expert witnessing, there are probably 30 or 40,000 medical experts in the United States who are doing medical expert witness work. It’s extremely high paying. The clients that we have worked with, with various specialties whether it be neurosurgeons, neurologists, orthopedic doctors, forensic psychiatrists, they earn $500 or $600 an hour. We’ve had examples of them earning up to $1,000 an hour. So for those physicians, we’ve had an experience with a doctor from Boston who came to one of our courses, opened up a forensic expert witness practice, started to do expert witnessing one day a week, and within a year he was earning more from doing that one day a week expert witness practice than he was actually earning in his clinical practice.
Now, there are a few downsides. It’s not for the thin-skinned. You have to write reports. You have to deal with attorneys, personal injury attorneys, and other attorneys who can be quite aggressive. Even both the retained attorneys could be aggressive and the opposing counsel could be aggressive in cross examination, and you will often have to testify.
Now, most of the testimony nowadays is given at depositions, 97% percent of civil cases settle before trial. So that means the bulk of the testimony is at depositions, but depositions can be difficult and trying. And the doctors that do get into this should make sure they’re prepared to testify before they testify at a deposition or at a trial.
Jim Mangraviti: How about inventing? You mind talking about inventing?
Steve Babitsky: Inventing is a great area for physicians to consider. Everyday physicians run into problems, but they can’t deal with it. They run into problems at work. They have a test, people come in for a strep test. They have to wait three days to find out if the kid has strep. Well, parents don’t want to wait three days to find out if somebody has strep or that’s crucially important, or some other inventions.
We’re putting stuff on apps in the iPhone. So there are a lot of opportunities in inventing. The physicians that do well in inventing are the type of physicians who look at it instead of looking at a problem and just complaining about it, they look at each problem as an opportunity. And they think to themselves, “How can I solve that problem with some kind of an invention?” And that’s a good way of looking at it.
You also have a tremendous opportunity to help people. You help many people. So if a physician treating in clinical practice, even nowadays when they’re forced to see more and more patients a day, they may see 10 or 20 patients a day or more, but that’s all you can help. If you come up with an invention, a physician, a medical invention, you may help thousands of people, tens of thousands of people, or hundreds of thousands of people, and you may save thousands and thousands of lives.
And the last thing I would say about inventing, it can be very, very lucrative. Physicians that invent products or services can make hundreds of thousands of dollars or in extreme cases millions of dollars on a medical invention that really takes off. And if you’re doing something like that where you’re helping thousands or hundreds of thousands of people and you’re making a lot of money, it’s a lot of fun.
Jim Mangravati: Lastly Steven, would you mind addressing IMEs, independent medical examinations?
Steve Babitsky: Sure. Independent medical examinations are those exams done by physicians. Usually requested by insurance companies, defense attorneys, case managers and so forth. And they are exams of injured persons either in worker’s compensation, personal injury, or other kinds of cases. This kind of work, these independent medical exams can be quite lucrative and the reason is you’re getting paid $1,000 or $1,500, or sometimes more in complicated cases per exam.
The clients tend to bunch up the exam, so you don’t run around doing one exam here, one exam there. They usually put together five or ten exams in the day for the person. So if a person is charging $1,000 an exam and they do five or ten exams that day, they can make $5,000 to $10,000 for that day’s worth of work. And over the course of a year they can make hundreds of thousands of dollars.
There is very, very little overhead for physicians. They don’t need an office. Very often you could rent an office or sometimes the IME companies will provide you with an office, so there is very little overhead. The only overhead is possibly transcription costs or something like that. It’s low-risk. There are very, very few instances where physicians doing independent medical examinations have been sued successfully.
The only times that they potentially can get sued are number one, if they injured the patient. For example, if they’re doing an orthopedic exam and they ask the patient to bend over, and the patient doesn’t really make an attempt to bend over, and they put hands on, and push the patient forward, the patient can then allege some kind of an injury.
And the second area is potentially if they’re involved and engaged in some kind fraud. Most of the doctors that do this get an inexpensive Errors and Omissions Policy. For a few thousand dollars a year you can be covered.
Another advantage of doing IMEs is you can often do this after you retire from clinical practice. Many physicians when they hit 50 or 60, or higher want to cut back on their clinical practice. What a lot of them do that we see that come to our courses is they start doing more and more medical legal work, and particularly do more and more IME exams.
So a doctor that was working five days a week or maybe an orthopedic surgeon that has stopped surgery now sets aside one day a week and he does independent medical exams. And that physician could make hundreds of thousands of dollars a year if he does them well. And the specialists that are used most often are mostly musculoskeletal physicians, orthopedic doctors, neurosurgeons, and neurologists, PM&R doctors, occupational medicine doctors, pain doctors, physiatrists, and forensic psychiatrists. But there is an opportunity for a lot of different specialties because there are all kinds of different injuries.
You can have an ocular injury in a motor vehicle accident and in a worker’s compensation case, and they need an ophthalmologist. You can have an injury to your ear or vertigo resulting from an accident and they need an ENT doctor. You can have a dermatitis situation and need a dermatologist, so there are tremendous amounts of opportunities for physicians to earn additional money doing independent medical exams.
Jim Mangraviti: Are there any resources that you could point to that SEAK has that can give physicians further information about how to supplement their income?
Steve Babitsky: Yes, SEAK provides several things for doctors for supplemental income. The first thing I would recommend to people is they go on our website, www.supplementalincomeforphysicians.com. We have a whole series of free articles and our white papers for physicians, you can download them, you can get them for free. We also have a series of courses that we offer on all of these topics actually that we have been discussing here today from consulting, medical file reviews, writing, expert witnessing, inventing, IME exams. We have a whole series of courses. We usually run those courses once or twice a year.
And the last thing I’d mention is very often physicians can’t get away to come to the courses. They have time schedules. They can’t get coverage. They have other commitments. If you can’t get coverage and you can’t for some reason come to these courses, which are excellent courses by the way, I recommend you give us a call and we can talk to you, and we can work with you one-on-one to help you get your supplemental income practice started.
Jim Mangraviti: Thank you very much.