Crossing the Streams

Side hustlers afraid to cross the streams

One of the great things about side hustles is the multiple streams of income they provide.  The extra money can buy you financial freedom just as easily as it can buy you material goods.  When you have multiple streams of income you become less dependent on any single one.  There’s just one catch:  there’s only 24 hours in a day.

The meter is running.

Passive income is great.  My stocks and bonds spit out dividends and appreciate in value whether I’m awake or asleep.  Real estate investments work the same way.  But for an active side hustler looking to generate extra cash to put into those passive investments I need to be working.

Time is Money

Whether I’m working in the ED, moonlighting at a locums job like I discussed in Have Stethoscope, Will Travel, or doing chart reviews like I discussed in How to hustle $30,000 without wearing pants, I’m getting paid by the minute.  I get paid well for my time, but there’s only one of me and only so much time I’m willing to spend away from my wife and kids.  Plus it’s almost summer and the whole reason to live at the beach is to actually spend time on the beach.

No shoes, no shirt, no hustles.

Most days in the ED I don’t have time to eat, pee or chart.  There’s no way I can do that job well if I’m distracted with other time intensive side hustles at the same time.

Not All Hustles Are Created Equal

Some side gigs are very hands on, while others are much less demanding. Here are a few side jobs that are easier to juggle:

Cardiac Rehabilitation

Cardiac rehabs are required to have a ACLS provider on site in case a patient has a cardiac arrest or arrhythmia while exercising. For an emergency physician, that’s just another day at the office. Non-emergency physicians shouldn’t fear this side gig – the patients almost always do fine, and when they don’t the job responsibilities include calling 911 and supervising ancillary staff do CPR until medics arrive.

Allergist/Rheumatologist Infusion Center

Many allergists offices or rheumatology infusion centers will pay a physician to be present in case a patient has anaphylaxis from allergy shots or an infusion. This job has 3 requirements: know how to use an Epi-pen, know how to dial 911, and have a checking account to cash your checks.

Remote supervising physician

  • Real time: mid-levels working in an urgent care or clinic need a supervising physician that can be available for consult (available can be by phone/text/email).
  • Retrospective chart reviews: there are companies that hire physicians to perform quality assurance reviews on nurse practitioner charts. I would highly suggest sticking to low liability issues like Medicare entrance physicals and home visits.

Physician advisor

Like I discussed in If you can’t beat ’em, join ’em (and take their money) and How to Hustle $30,000 Without Wearing Pants there are plenty of opportunities to do utilization chart reviews from home or anywhere else that has a WiFi signal.

Disability chart reviews

There are companies that will pay you to train to become an Independent Medical Examiner or to perform disability case reviews. Similar to utilization chart reviews, there are standardized criteria for reviewing these cases and it can be done remotely.

Expert witness case reviews

Reviewing a patient chart to give your opinion for expert witness work can be done from anywhere. There’s no way to review a chart thoroughly in a busy ED, but there are plenty of side gigs with ample downtime that would allow you to read through a case file.

Medical writing

Do you have a knack for writing? Are you good at taking a complicated idea and boiling it down so it’s easy to understand? You may be able to use your skills and medical background to write for publications targeting the general public or a business trying to capture the attention of your medical colleagues.

Cash à la Carte

Now that you’ve had some time to look over the menu, you can see how someone could mix and match side hustles to juice their income.

Today’s cash entrée is served with two side hustles.

Doing utilization chart reviews while sitting at a desk in a cardiac rehab.

Reviewing an expert witness case while twiddling your thumbs at an infusion center.

Being available to take calls from midlevels while writing a manuscript for a pharmaceutical company.

Doing QA reviews on NP charts in between telemedicine consults.

Or for the triple axel: texting midlevels you remotely supervise while you review disability charts from a desk at a cardiac rehab. Suddenly you have turned 3 average paying jobs into one great paying job.

Let’s Do the Time Warp

No one wants to work 24 hours a day, but there are plenty of people who wouldn’t mind getting paid for 10 hours of work in a 4 hour time span. It is important to note that you need to pick jobs that are not time intensive to begin with. No one is proposing that you do case reviews in between each step of a Whipple procedure in the OR.

A Stack of Dimes Turns Into a Dollar

There are some easy side jobs for physicians that just don’t pay well on their own. It makes no sense to give up an ER shift making $200/hour so you can man the Epi-pen for an allergist for $75/hour or sit at home and be available to advise mid-level providers for $50/hour.

Gotta catch ‘em all!

If you start stacking the low-lying fruit on top of each other you’ll end up with a delicious cash smoothie.

Don’t Get Greedy

That may sound like odd advice coming from a guy with a 6 figure salary who works side hustles to make money he doesn’t need so he can invest it to get wealthier.  What I really mean when I say don’t get greedy is don’t do anything that will jeopardize your career or financial security.  Don’t defraud employers by pretending to be doing something you’re not.  Don’t expose yourself to huge medico-legal liability for a few bucks.

If done properly, this can accelerate your financial independence.  I wish you luck in all your hustling ventures.

What do you think?  Have you ever combined two jobs into one?    Do you think the stress would be worth the trouble?  Have you ever known a physician who over-extended themselves?  Share thoughts and comments below.


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15 thoughts on “Crossing the Streams

  1. Good stuff SHS,
    You definitely have me interested. Reviewing disability charts in particular sounds like a relatively easy way to generate some extra cash.

    Love the idea of stacking your side hustles. It’s still trading time for money, but you’re certainly making the most of the trade.

    Two quick questions: 1. Are all these side hustles in the same state, and if not do you have to get medical licenses and pay taxes in each state? 2. Do you have a separate malpractice policy to cover your side hustles?

    Thanks for all the good info on this blog, I learn something every time I stop by. Keep up the good work.

    Liked by 1 person

    1. Thanks! Chart review of all sorts (utilization, disability, etc) are all 100% remote. You just need a valid medical license but it can be for any state. Most of these types of jobs don’t require malpractice insurance, but some have “omissions and errors” insurance provided by the employer.

      As far as state taxes go, since I do these jobs 100% in my home state, I only owe state income tax in my home state. This is different than if I was physically commuting to a neighboring state. The internet has taken side hustles to a whole new level.


  2. The best side job I had involved a pain management clinic.

    For some reason legislation was made that required a physician with one of the (I believe 5) specialties. I know it included anesthesia, radiology, surgery. The pain management clinic was run by a neurologist (a specialty surprisingly not included).

    So they paid me $1k to just sit in the back room and do whatever I wanted (I watched Netflix on my laptop) and all I had to do was sign that I was present in the building when they did pain injections under ultrasound.

    This was done on my day off. Although I would have made more working my regular job this was a relaxing Hustle and allowed me to decompress.

    After 3 yrs the Golden goose was gone as declining reimbursements made no financial sense for them to continue


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