How to hustle $30,000 without wearing pants

After years of training and hundreds of thousands of dollars in student loans, I finally figured out how to make money with my pants off.

pants around ankles
The doctor will see you now.

As you may recall from What makes a good side hustle?, one of my criteria for a good side gig is that it can be done remotely from anywhere.  That could be the beach, a family vacation or just sitting on my couch in gym shorts.

I’m glad to report I just received my first paycheck from my newest work-at-home side hustle.

What’s the job?

This is a physician advisor job like I discussed in If you can’t beat ’em, join ’em (and take their money).  I review inpatient charts and recommend inpatient vs observation status based on severity of illness, time in the hospital and the available documentation.

There are established rules about what meets inpatient vs observation status, so I’m not reinventing the wheel.  I simply look at a chart, sum up why they were admitted, what the plan of care is and write why I do or do not think they needed to be inpatient.  It’s ironic that someone who has spent a career trying to convince hospitalists to admit patients (and occasionally sneaking a dump into the hospital) is now advising hospitalists   about appropriate admissions.

What are the hours?

I work a minimum of 5 hours a week, with the ability to pick up extra time if available.  Most days of the week there is an opportunity to pick up at least an hour of work.  The rate limiting factor is my work schedule and my family.  My wife is a stay at home mom so when I’m not in the ED I’m full-time dad.  No amount of money is worth putting extra stress on my family.  If I was single or my kids were all in school I could make money from my couch every day.

These reviews occur in real-time, while the patient is still in the hospital.  This means I have to actually sit down, log on to their system, read charts and write reports in a 5 hour block.  Not just sporadically in between Monk re-runs.

Mr. Monk always wears pants.

There is also a 1 hour monthly quality control meeting where we review and discuss difficult sample cases.  We have quarterly online meetings with the CEO as well.  These are all paid for and done remotely.

What does it pay?

$112 per hour.  I also am in the process of signing with two other companies that pay $115 and $125 per hour.

This is certainly less money than I would make picking up locums shifts in another ED, but it does not involve disimpacting nursing home patients, coding heroin overdoses or telling someone they have cancer.

Did I mention I don’t have to wear pants?

5 hours per week x 52 weeks = 260 hours

1 hour monthly meeting x 12 months = 12 hours

1 hour quarterly meeting x 4 quarters = 4 hours

260 + 12 + 4 = 276 hours/year

$112/hour x 276 hours = $30,912 without wearing pants.

Just imagine all the pants I could buy!

Going the distance

I’ll let you know in future posts how the job is going, but this certainly seems like a side hustle I’d like to keep long-term.  It is guaranteed hours which means guaranteed income.  The other chart review jobs I’ve been hired for are on an as needed basis.  I don’t know what “as needed” means, but I know my mortgage company thinks “as needed” means every month like clockwork.

Hustling to the FInish line

I’m not financially independent yet, but I’m on FI autopilot.  Like I discussed in How to hide $215,000 from the IRS, I use of every form of tax advantaged savings possible.  I avoid debt like the plague, save the first $1,000 of every paycheck in a taxable account and invest the bulk of my year-end bonuses.  My plan is to be financially independent by age 53 (the day my 1 year old starts college).

These side hustles accelerate financial independence because I’m not spending any of the money.  I max out my solo 401k, pay self employment taxes and the rest goes into index funds and crowdfunded real estate.

I can foresee a time where I have enough saved that I no longer need to continue saving for retirement, and my side hustles provide enough cash flow to pay our bills.  At that point I can work anywhere that has WiFi or cell phone reception.

Non-financial benefits

This job gets my foot in the door of the “Physician Advisor” business.  Not only will it legitimize me when I apply for similar jobs at other companies, but I will actually learn a new marketable skill.

If one day I want to apply to be certified in Health Care Quality and Management the hours I train and work will contribute to the 208 hours of active involvement requirement.

If I like the work I plan to pursue that certification next year.  Sounds like the kind of fancy schmancy title that gets you more work without pants.

What do you think?  Does this sound like a side hustle you would enjoy?  Do you think I’m naive to think I can read chart after chart from the comfort of my couch?  Leave comments and suggestions below.


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42 thoughts on “How to hustle $30,000 without wearing pants

  1. Awesome title. Definitely caught my eye and had to read on. Any job that lets you make that kind of money from the comfort of home is top of my list as a side Hustle. I’m very fortunate as a radiologist that when I stop my normal job (which unfortunately requires pants) if there are any rough patches I can supplement reading studies with a telerad gig from the comforts of my home (and I guess I could be pantsless then)


      1. Most companies want dedicated hours but “dedicated” might mean a few hour block once a week or every other week. As an ER doc who works shift work, my schedule is pretty flexible. The key is getting your foot in the door – these companies are often overwhelmed with cases and will email me daily asking if I can read a few. It’s like getting a daily email offering you easy cash – take it when it’s convenient, ignore it when it’s not.


  2. This seems like a pretty sweet gig. I think I might want to claw my eyes out after 5 hours of reviewing charts, but the money seems decent and the flexibility is hard to beat. Looking forward to hearing how it goes.
    – Ray


  3. Interested if anyone knows of an outpatient hustle like this. I’m a primary care doc- 10% kids 90% adult. OTOH I don’t want to be the family medicine equivalent of an AIM radiology reviewer.


    1. There are plenty of side hustles an outpatient doc is qualified for. You could do telemedicine which would require no additional training. With some CME you could start doing disability chart reviews as well. I plan on trying both of those and then creating a road map for readers in future posts. Stay tuned!


  4. Love this idea! I’m just starting my intern year in EM so obviously won’t be starting this for at least another year…but when I do what’s the best way to find these companies that offe these gigs? Also wondering if they’d hire residents.


    1. Most of these companies want physicians who are board certified, which means you couldn’t start until after you were an attending. That doesn’t mean there aren’t other side hustles you can do in residency. Moonlighting in urgent care your 3rd year is the easiest place to start. Just make sure your side gigs don’t interfere with residency. You have the rest of your life to hustle.


    1. $75 is below market price. You can always ask for more but if they can find enough desperate docs to work for less they may not budge. A few of the places I applied asked me to name my rate. I recommend applying broadly to as many IROs as you can before accepting an offer. There are enough companies paying > $100/hour that you shouldn’t have to settle. Good luck!


      1. I am a new internal medicine residency grad starting as a locum hospitalist in a few weeks.

        I have been interested in this type of work for a while (even sat on my hospital’s CDI committee as a resident).

        Do you think your 7 years work experience played a big role in getting work? Most online job postings say they want 5 yrs experience. I’ll have my 3 years of residency experience and should be board certified later this year, but obviously won’t have much attending work experience.

        Do you think I have a shot at getting some part time remote work like you have if I contact companies this year, or is it too early in my career?

        Also, do you ever have to do peer to peer discussions with the physician taking care of the patient in the hospital?

        Thank you!


      2. It wouldn’t hurt to ask and make a case that you have 3 years of internal med experience already. I don’t think 7 years experience helped me as much as a willingness to work and having a specialty that is familiar with inpatient medicine. Most of these IROs are busy with work and can use the extra help. If you get shot down, use the time to take some CME offered by the ABQAURP ( to make yourself a more appealing applicant.


  5. I just started fellowship (ophtho), and am desperately trying to find a side hustle. This sounds great. I have a full license, but am not board certified yet. Am I able to do this at all? Or do you know of any other good side hustles you can do with a license but no board certification?

    I do surveys, which usually net me at least $1k a month but that is a fair amount of work and not always steady.



    1. Most of these IROs want board certified, licensed physicians with at least 3 years of post residency experience. I suppose if they were desperate for workers you could get your foot in the door. I think the bigger question is how comfortable would you be reviewing inpatient charts commenting on inpatient management of CHF and DKA. My ophtho friends are some of the smartest people I know, but by the time they hit fellowship it had already been years since they managed any of these. Telemedicine is likely the best work from home side hustle for most surgical sub specialists. I’ve recently read about how even ophthalmologists are getting in on the action by screening patients for diabetic retinopathy remotely. That might be more up your alley.


      1. Thanks for the reply!
        I haven’t been able to find any of those gigs online, do you have any links or resources that might help?


  6. This article is great and I also enjoyed your compiled lists of all of the opportunities for a side hustle. I’m an attending and have passed my written boards but my oral boards are winter of 2020. Do you think any of these companies would take me yet? I would love to do this extra work before we have another child seeing that mg husband can’t nurse 😉.


    1. It couldn’t hurt to ask but most of them want board certified docs with at least 3 years of clinical experience. With that being said, some of the companies I’ve worked for have been desperate for warm bodies and may bend their criteria when necessary. I can attest to the chart review job being easy to do from home with small kids.


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