Pediatrician Jennifer Shu spends most of her week treating coughs and colds at Children's Medical Group in Atlanta. But she performs an even greater public service on her days off. The consultant, author, and parenting guru dedicates at least one day a week to media gigs — conducting interviews, editing content for publications, and working with companies she supports to help promote their message. "I've been practicing for 16 years and I love that too, but you can reach so many more patients through the media when you're trying to get a public health message out," she says.
You can also make a lot of money. While news outlets don't pay for interviews, Shu notes, they do help promote her practice and her latest book, "Heading Home with Your Newborn," which she coauthored with colleague Laura Jana. And the editing jobs, which consume "a few hours" of her time, pay enough to compensate her for seeing patients just three days a week. (She takes one day off for personal time.) But the biggest checks, by far, come from private companies — such as juvenile product manufacturers and health food outfits — that hire her as a medical expert. Shu occasionally earns between $10,000 and $20,000 for half-day events in which she conducts a series of satellite television or radio interviews about such topics as healthy eating habits and dealing with the common cold. "Done the right way, if it's something you believe in, you can be compensated well," she says.
Like Shu, many physicians are looking for ways to boost their bottom line — and redefine their careers — amid declining reimbursement. Some simply squeeze in more patients, but not all practices are scalable. After all, you can only eke out so much efficiency without impacting quality of care. For those with an entrepreneurial mindset, however, there are a number of ways to create supplemental income without putting your practice on hold. A few options, like becoming an expert witness or hosting patient education seminars, can easily be done in your down time, while others, such as serving as a medical director or becoming a part-time consultant, require a bigger time commitment. Here are 10 options worth considering:
In-house dispensing
You could make $50,000 or more per year by opening an in-house pharmacy. Thanks to changes in the Medicare Part D program, physicians are now able to dispense prescription drugs to patients directly at the point of care — and get reimbursed for it. Because it requires special billing and contracting with private insurers, however, most practices use third-party vendors like QuiqMeds, Dr. Dispense, PrimaryRx, MedX Sales, or Physician Partner, which stock their offices with the most commonly prescribed drugs and handle the administrative hassles for them. For its part, MedX Sales claims practices profit approximately $8 to $10 per medication dispensed. Dr. Dispense, which offers an integrated software solution that adjudicates claims through existing electronic health records, says the typical small practice generates $4,000 to $5,000 per month (or $60,000 a year) using its program after the cost of medication. Physicians' Pharmaceutical Corp., meanwhile, which enables doctors to fill the actual prescriptions they write using an in-house certified prescription technician — rather than using prepackaged quantities and dosages — says some of its clients are just breaking even while other high prescribing offices are making "hundreds of thousands of dollars."
Become a medical director
The aging population presents opportunity for those with a medical degree. Long term care facilities, including hospice, home health agencies, and nursing homes, are required by federal law to retain a medical director who can coordinate patient care, establish procedures for quality assurance, and provide administrative oversight. They often look to family physicians and internists, particularly those with a geriatrics subspecialty, who perform their duties in addition to maintaining their full-time practices. Karyn Leible, president of the American Medical Directors Association, says such positions pay an average of $150 an hour. And the time commitment varies. As chief clinical officer of Pinon Management in Lakewood, Co., a consulting firm for nursing homes and assisted living facilities, Leible says her group expects at least four hours a month from each of the medical directors in the 13 homes they manage. Other facilities, though, require up to 10 hours of work each month, paying anywhere from $1,000 to $3,000 monthly.
Embrace the Web
For the computer savvy, the Web is a channel worth pursuing. Many of the larger health plans now offer in-network doctors an opportunity to conduct online medical consultations with patients through real-time videoconferencing or secure chat. Most plans reimburse less for online encounters, normally between $30 and $40 per 10-minute visit, but the advantage is that you can hold them when and where you like — after hours, over the weekends and from the convenience of your own home.
If you're looking for greater flexibility you can also sign on with an online care service company like American Well in Boston through any of its participating health plans. The company has created a Web portal that allows physicians to hold online visits, review clinical information, prescribe medication, and suggest follow-up care. Even if your physical waiting room is full, you can indicate via software that you're willing to accept "Web walk-ins" from just your own patient base. Or you can switch to accepting online visits from other health plan members for the next, say, 20 minutes, to fill in for a no-show. The system also supports a fee-for-service model, allowing specialists who have established a reputation to set their own rate. The head of oncology for a major metro hospital, for example, might be able to charge $300 for a 10-minute online visit.
