Locum tenens physicians temporarily fill in for absent colleagues on a short-term basis at hospitals, clinics, or private practices. Locum tenens work offers flexibility and variety, allowing you to gain experience in different healthcare environments. The pay rate depends on your specialty, and you can be paid hourly, per day, or on a per-shift basis. You're treated as an independent contractor or 1099 physician.

•  Earning potential: Non-surgery: $90 - $130 per hour, Surgery: $1,400 - $1,800 per day; estimated $50,000 - $100,000 per year.
•  More bang for your buck: Taking on locum tenens work enables you to write off deductions, including expenses for travel, home office, lodging, and more, all of which can meaningfully reduce your taxable income.
•  Tax implications: Mostly 1099 income with flexibility to write off certain business expenses.

You can provide medical care to patients remotely with some flexibility for part-time shifts or the ability to choose your hours. States have different requirements for physicians providing telehealth services, so you may need additional licensing or certifications depending on where you practice. Pay rates vary depending on the specifics of the job. The median salary for a telemedicine physician nationwide is $117 per hour as of April 2024.

•  Earning potential: $90 - $200 per hour; estimated $10,000 - $25,000 per year.
•  Tax implications: Mostly 1099 income with flexibility to write off certain business expenses.

Providing medical expertise to a pharmaceutical company can involve many different types of roles, and it's usually lucrative. You may be asked to do histories and physical examinations of patients to help research a drug under development, for example, or help with medical safety reviews or the preparation of medical documents.

•  Earning potential: $1,500 on average per speaking engagement; estimated $10,000 per year. 
•  Tax implications: Mostly 1099 income with flexibility to write off certain business expenses.

Consulting is the most flexible option of all because you can choose how much and what type of work to take on. You're in charge of the consulting services you provide, and you can set rates according to the type of work. You can offer advice to health-related startups, provide opinions about a drug in development or a medical process, or lend your expertise on medical subjects to television or other media. The challenge here is figuring out how best to leverage your personal network to find opportunities.

•  Earning potential: $100 - $500 per hour; estimated $10,000 - $50,000 per year.
•  Tax implications: Taxable as ordinary income.

As an expert witness, you may be called upon by attorneys to offer your medical opinion on a case as needed. You don't always have to testify in a trial, but you can provide analysis regarding medical standards of care, diagnoses, treatments, or injuries in legal matters. Expert witness work is lucrative with physicians charging anywhere from $500 to $1,000 per hour, depending on how much time and effort the case requires. 

•  Earning potential: $300 per hour; estimated $5,000 per year.
•  Tax implications: Mostly 1099 income with flexibility to write off certain business expenses.

There are a variety of coaching options available to you, depending on your area of expertise. Coaches may work for a company or independently as self-employed. One popular coaching option is in the field of health and wellness. Wellness coaches may guide clients in areas such as nutrition, weight loss, and lifestyle changes to improve health. Another option is to provide coaching services in non-clinical areas, such as chronic disease management or practice management.

•  Earning potential: $250 - $500 an hour; estimated $10,000 - $50,000 per year.
•  Tax implications: Taxable as ordinary income.

You could create or contribute to a financial blog like White Coat Investor, Physician on Fire, or Physician Philosopher, where income is typically generated from advertising.

•  Earning potential: $50 - $2,000 per month for website ads; estimated $5,000 per year.
•  Tax implications: Business income (taxability depends on entity structure).

You could earn commission or royalties when you refer people to a company like Rakuten, TopCashBack, Fetch, or Ibotta and they  buy a product or service ( no extra cost to the buyer).

•  Earning potential: $2 - $10 for website visits and $20 - $200 for recommended services; estimated $1,000 per year.
•  Tax implications: Business income (taxability depends on entity structure).

Author a medical book or contribute to a medical textbook in your speciality.

•  Earning potential: 10 - 15% in royalty fees estimated $1,000 per year.
•  Tax implications: Taxable as ordinary income.

Teaching includes different types of work, which may include tutoring medical students for the MCAT or other medical exams, helping students with medical college admissions, creating online content for educational platforms or your own website/podcast/social media, or serving on the faculty of a medical school or residency program. While this may not be as lucrative as other side gigs, you may derive satisfaction from passing on your knowledge to the next generation of physicians. 

•  Earning potential: $75,000 - $100,000 per year for part-time work.
•  Tax implications: Taxable as ordinary income.

Many companies are willing to pay for a doctor’s expertise to help review medications, pre-authorization requests submitted by other doctors, and insurance claims.

•  Earning potential: $105 - $136 per hour; estimated $25,000 per year.
•  Tax implications: Mostly 1099 income with flexibility to write off certain business expenses.

As a physician, paid market research surveys let you share your expertise on medications, medical devices, and related topics. These flexible side gigs are largely one-offs or can be done periodically; it often requires no commitments, new skills, or equipment, just your thoughts and feedback. Compensation for participation is highly varied, anywhere from $25 to $50 per hour for an online survey that takes less than 15 minutes.

•  Earning potential: $25 - $50 for short surveys and , as high as $200 for larger surveys; estimated $10,000 per year.
•  Tax implications: Mostly 1099 income with flexibility to write off certain business expenses.

•  Earning potential: While rental property returns can widely vary depending on an individual’s investment strategy, location, and market conditions, generally, an annualized return between 6% and 8% is considered decent, while a return of 10% or more is often considered good. However, these ranges can fluctuate significantly depending on market conditions, interest rates, property location, and other factors.
•  Direct ownership of properties and the management of them.
•  Firsthand involvement in  the buying, maintaining, and selling of the property. This often has greater tax advantages but requires more of the physician’s time overseeing the property.
•  Tax implications: Greater tax advantages than passive real estate investing.
•  Term: Variable but should be considered long term.

Private equity investments, in the form of a registered fund or structured as a partnership, often have limited liquidity and should be considered long-term investments. Additionally, certain qualifications must be met, such as being an accredited investor or qualified purchaser depending on the type of fund. Private investments, such as private equity, can play an important role in an overall diversified client portfolio for qualified investors. This type of investment involves considerable risk, and it’s important to note that past performance is no guarantee of future returns.

•  Tax implications: Generally taxed at the lower capital gains rate of 20%.
•  Historical returns: 16.28% annually over the 10-year period ending September 30, 2023 (Index: Cambridge Associates LLC US Private Equity Index)
•  Minimum investment required: $100,000 or more depending on the fund 
•  Liquidity: Highly illiquid with lockup periods that may be 10 years or more. 

Private real estate funds may require less upfront capital than active real estate investing and can be easier to diversify holdings; however, they usually have more management fees than active real estate and miss out on some of the tax benefits. Private investments, such as private real estate, can play an important role in an overall diversified client portfolio for qualified investors. Like private equity, private real estate investing involves a higher degree of risk, and typically there are restrictions on liquidity.

•  Tax implications: May only deduct normal costs (not business costs) associated with the property; may deduct passive losses against passive gains.
•  Historical returns: 10.34% annually over the 10-year period ending June 30, 2023 (Index: Cambridge and Associates Private Real Estate Index)
•  Minimum investment required: $25,000 or more depending on the fund
•  Liquidity: Availability of capital depends on the fund structure, but generally liquidity is limited.

Investing in a moderately aggressive portfolio or fund consisting of 80% stocks and 20% bonds offers more liquidity than private investments and requires relatively low or no minimum investment but still comes with market risk. 

•  Tax implications: Generally taxed at the lower capital gains rate of 20%. (could generate both ordinary and capital gains -DG 4/19)
•  Historical returns: 9.55% over the 10-year period ending December 31, 2023 (Blended Index: 80% Russell 3000 TR USD and 20% Bloomberg US Agg Bond TR USD)
•  Minimum investment required:  Generally, very low minimums to start investing in public markets.
•  Liquidity: Typically highly liquid with easy access to capital.

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