Nisha Mehta, MD on why physicians should consider side gigs [PODCAST]

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“At first, it may seem strange that ‘physician’ and ‘side gig’ are even used in the same sentence. After all, the average physician in the United States is already working more than a 40 hour work week and struggling with issues related to work-life balance. As someone who talks about physician burnout and as the founder of the Physician Side Gigs Facebook group, I’ve been asked many times how adding yet another thing to the physician’s plate could possibly be a good idea.

And yet, I’m a strong believer that physicians should have additional revenue streams and pursue other interests. Why?”

Nisha Mehta is a radiologist and founder, Physician Side Gigs and the Physician Side Gigs Facebook group.  She can be reached at her self-titled site, Nisha Mehta, MD, and on Twitter @nishamehtamd.

She shares her story and discusses her KevinMD article, “Why physicians need side gigs.”

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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show, we have Nisha Mehta. She’s a radiologist, and she’s the founder of Physician Side Gigs and Physician Community, two of the most popular Facebook groups. She’s a speaker on my Physician Speakers Bureau, Physician Speaking by KevinMD. And she wrote the KevinMD article “Why physicians need side gigs.” Nisha, welcome to the show.

Nisha Mehta: Kevin, always great to be with you. I’m excited to be here.

Kevin Pho: So we’ll get into your article in a little bit, but first off, can you share your story and your journey to where you are today?

Nisha Mehta: Sure. I mean, it’s kind of a long story, so I’m going to try to give you the one-minute version here, but essentially, after I had finished my first attending job, we were moving, and for a number of reasons, I had a little bit of downtime between jobs, and I started writing during that time. And when I started writing, I started becoming exposed to a lot of different opportunities as people were reading my stuff and asking me for more information or asking me to come and speak. And so when I had that, it was the first time in my life that I did anything outside of medicine in terms of my professional career, and I wanted to talk to other people who were doing the same thing. So I started a small community, less than 10 people, just to be able to talk to other people who were doing things that were similar to what I was doing.

Long story short, five years later, people have just really kind of loved the concept of exploring who we are outside of medicine, and those communities have grown to now over 117,000 physicians. So now we have two groups. One is Physician Side Gigs, which is basically based on the concept of passion projects and side gigs and building business and finance skills, which we all know we don’t really get enough training for in medical school. So that community really focuses on that aspect of things. And once we built that community, we saw that everyone just loved having a place to be together to talk about things, and they wanted to talk about things that weren’t related to those things.

And so, to kind of keep PSG on task, we created a spin-off community called Physician Community, where we could talk about anything that we wanted: a hard day, recommendations for a friend across the country for a different specialist, advice on cases, or just being able to share something funny that you saw that you thought your physician colleagues would identify with. And so a lot of that activity happens on there. And we’ve actually been able to create a significant advocacy component in Physician Community as well, which for me, personally, has been really fulfilling and has sort of expanded the scope of what I am able to do in that regard, too.

So I do all of that. And then, of course, as you know, through Kevin’s speaking bureau and on my own, I do a fair amount of speaking. And so that’s definitely something that I’ve loved doing, although, as Kevin will attest to, things have slowed down a little bit during the pandemic. So, primarily, recently, I’ve been focusing a lot more on the advocacy and the community building.

Kevin Pho: Excellent. So when it comes to side gigs, what are some specific examples of what physicians are doing outside of clinical medicine?

Nisha Mehta: Yeah, so it’s interesting. I think it’s interesting as a physician to pursue a side gig because people, number one, will always kind of be like, “Well, you’re a physician, why do you need a side gig, right?” And I think the answer to that is different for everybody. I think for me, it turned out just as a place to be able to talk about some of the other things that were going on in my head, or things that I wanted to see changed, and just being able to have an outlet to be able to discuss those things. So for me, it really started out as just a passion project. It was never supposed to be an income generator, and then it turned into something that generated income.

For other people, they’re really doing it to be able to supplement income, or to be able to cut back clinically, or to pay off their student loans faster. So a lot of what people pick as their side gigs is going to depend on what their ultimate end goal is. Is this about advancing a cause? Is this about money? Is this about generating additional revenue streams? And sometimes those things can all overlap, right? But I think you have to have a primary goal in mind when you’re choosing things.

So if you’re doing a little bit of writing or speaking, do you need something that is steady cash flow? Because things that are sort of ad hoc are going to come in waves, right? Maybe you get a speaking gig one month, and you don’t get one another month. You can’t really depend on that income for your day-to-day. But if you want something that you know is going to bring steady income, you might pursue something like real estate, or a consulting opportunity that’s a long-term consulting opportunity, or start a business that is completely unrelated to medicine. Maybe you open up a franchise in conjunction with some people that you hire, or family members, or friends, or whoever you’re going to be doing things with.

So I think the side gigs that you can pursue are different for everyone. I always kind of try to group things into clinical versus non-clinical. Some people want to be able to use their clinical skills to generate some additional revenue. And so then you’ve got things like telemedicine, chart review, expert witness work, medical writing, lots of things that you can do in the clinical realm. And then outside of medicine, really, the sky’s the limit, right? You could pursue something related to art or music or another skill that you have that is unrelated to medicine. There are just so many things that people are doing. People are podcasting. People are writing books. People are creating projects like woodworking projects or arts and crafts, or people are doing a lot of things with venture capital or angel investing. I mean, there are just so many different things that you can do.

So for me, the biggest thing is, I think physicians in general are burnt out or express some elements of burnout. So I think that the thing that people pick should be something that really enhances your quality of life or allows you to use a different part of your brain that you enjoy. I mean, if it’s not enjoyable and if it’s just going to contribute to your burnout, those are the physicians where I say, I mean, side gigs aren’t everything. They’re not for everyone. But if there’s some way that there’s something that you want to pursue, and it can bring in some of these other benefits, whether it be from a monetary perspective, or a tax perspective, or just setting up a backup plan, a plan B or a plan B, C, so many of these things that we need in medicine, I think that there are a number of reasons for pursuing side gigs.

But the first one should really be to pursue a passion, because otherwise, if you don’t enjoy it, you’re not going to stick around longer. The people who are the most successful in their side gigs are the ones who truly enjoy what it is that they’re doing, because otherwise, you could always pick up an extra shift or work more flexibly and make more money. It really has to be about fulfilling something else.

Kevin Pho: So one of the things that we’re seeing during the pandemic is that physicians are being furloughed and laid off. There was an article in the Washington Post recently about how emergency physician residents really can’t find jobs, because the non-COVID cases in the ER have really gone down, and that’s affecting hospital revenues, and hospitals can’t hire these new doctors. Now, for physicians who can’t rely on clinical income anymore, or if they’re furloughed or laid off, is a non-clinical side gig a viable source of income?

Nisha Mehta: Absolutely. I mean, it was interesting for my husband and me, who are both physicians. Kevin, I know you know that, but I’m part of a dual-physician family, and my income streams clinically have changed now, because I used to be full-time employed, and now I work part-time, and it’s on a per diem basis. And so when the pandemic hit, a lot of my clinical revenue went down. And my husband is in a private practice, and when the pandemic hit, they’re in an eat-what-you-kill model, and he’s a partner, so if there’s no revenue coming in, the first thing to go is partner income. And so they shut down for a few months, or I guess a few weeks, when the pandemic first hit, and the partners made the decision not to take salaries for a little bit to make sure that they were able to pay all of their employees.

And so there were times when our clinical income this year went down. However, our income from our real estate investments and our income from some of the other things that we were pursuing were very steadily coming in and covering all of our daily living expenses, so it wasn’t something that we had to worry about. And I think that this year, it’s kind of become clear to everybody how unstable our clinical income is, even in the best-case scenario, where you’ve got a great clinical job that’s never given you cause to worry. I think this year we all, in different ways, have reasons to have some uncertainty about what our clinical income would be. And so I think people have been putting a lot more thought into what the other revenue streams could be that could be steady enough to be able to back up that clinical income to an extent that’s substantial enough.

So there are certainly non-clinical gigs that people actually fully transition into that are full-time jobs that come with benefits and come with a six-figure salary. There are chart review jobs that are like that. There are medical review and writing jobs that are like that. There are clinical research jobs that are like that. So I think a lot of us are very used to thinking about our medical degree in a very traditional way, but the fact is that we’ve got a very versatile set of skills, because health care is a very multifaceted industry, with trillions of dollars that are being dedicated towards health care on a yearly basis.

And so, really, there are a lot of different things that you could do, whether it is something that is a more administrative role, or something that is more in the pharmaceutical world or the research world. There are so many other things that you could do. We all know some examples of famous media personalities who are physicians, or famous writers who are physicians, and there are definitely other things that you could do that create sizable income streams.

Is it necessarily straightforward? Some of them are, right? Because people just have job opportunities that are written for physicians, and you just apply to them the same way that most people apply to jobs. And other things are more fortuitous, or you have to kind of land into them, or be very intentional about your pathway to them. And I think that that’s the thing that makes a lot of us uncomfortable. The path through medical training is very delineated for most of us. And so, for a lot of us, the last time we had to make a really important decision was when we checked off that pre-med box in high school or in college. And ever since then, there’s been this pathway laid out for us. And yeah, we’ve had some decisions about whether we go to this place or that place for residency, or whether we pick this specialty or that one. But we knew what the pathway was, and we kind of went down it.

So I think the scariest thing about relying on something else for income is sort of shifting that mindset and thinking about what it is that’s going to make you happy. What is it that you want? And then very intentionally pursuing a different pathway and learning a new set of skills to be able to adapt to an environment that’s not the one that you were trained under. But it’s certainly very possible. I’ve seen that once people have decided to make that transition, everybody is able to find something that works for them. There are very few people who truly can’t find something else. But it does require being a little bit, you know, you’ve got to be proactive about exploring those options and seeing what’s right for you.

Kevin Pho: Now, those non-clinical options, whether it’s expert witness, chart review, medical writing, how easy is it for the physician to transition to that? Is that something that requires a lot of extra training?

Nisha Mehta: I don’t think so. I mean, I think that the basic skill set that you need is being a doctor, right? And having the medical expertise that you have. The bigger thing, let’s say you were to try to develop a very active medical expert witness practice, a lot of it is going to be getting yourself out there and creating the publicity to get a steady enough source of cases. And so there are some elements of learning how to brand yourself, and getting yourself on a website that’s seen by some of these companies, and maybe putting yourself on a few databases that are going to throw cases your way, and things like that. But in terms of actual hard knowledge, you’ve got the fundamentals down. It’s really more just learning how to network appropriately to be able to get those jobs.

The non-clinical jobs in case review and things like that are actually very plentiful, and most of the companies that come to us through our groups are actually very actively recruiting on a daily basis. It’s just because the work is increasing on their end. We certainly have more and more people utilizing the system as the baby boom generation retires, and just in general, as the regulations increase, there’s just so much more on the non-clinical side of things related to medicine. So I don’t think that there’s a shortage of those jobs. Finding the right one, and finding ones that aren’t predatory, and finding ones that pay you according to your expertise, that’s where things become a little bit more difficult.

And then, in most cases, when you make a shift from clinical to non-clinical, there will be some loss of revenue associated with that. And whether or not you’re willing to take that hit, and what it means in terms of lifestyle versus whatever other goals that you have, I think those are the big things. People have a hard time finding the exact fit that makes it compatible for them to take those next steps and make a shift. It’s not that the jobs aren’t there; it’s that it might not be the right one for you.

Kevin Pho: Now, from your years of moderating side gigs and being in the space, do you have an idea of what percentage of physicians can make a viable income on a side gig such that they can decrease their clinical work?

Nisha Mehta: I mean, I think, of course, your results may vary, right? There’s such a wide range of how people have been able to do this. The people who I feel like have made a true commitment to creating revenue streams are able to generate substantial revenue streams, but I think where I see the most difficulty is really just the persistence of it. As most people who have pursued a side gig very seriously as a source of significant revenue would attest to, there are a lot of ups and downs along the road. And so it’s really a question of whether you at some point drop off and say, “This isn’t worth it,” or you remain committed to making it get there.

The fact is that, again, there are a lot of people who would love more services or advice or things from physicians, and if you are creative enough in being able to fit your niche to something that somebody needs, there’s a lot of ability and a lot of untapped markets out there for physicians, in my opinion. I think that it’s really just what kind of effort you are willing to put into branding yourself, and what kind of effort you are willing to put into really persistently setting aside time to grow it and making that work.

And I think that of the people who have set out to do it, and have really made the commitment and made the investment necessary to take those steps, I actually think the majority of those people could generate a good amount of revenue that would allow them to at least cut back clinically. In terms of replacing income, I think that that’s probably more rare than people think, unless you pursue things like real estate, or things that have a more direct correlation, like a more reliable pathway to money. So, obviously, if you set out to be an influencer, the success rate of people turning into influencers is not nearly as high, of course. But if you do something that is a tried-and-true pathway to a business, where you’re actually offering a service, then it’s just a matter of finding the right people to buy your service. And I think that most people who have put that time and energy into getting there, I think we as physicians are pretty skilled, and when we want to be determined, we can be. And so it’s really how much effort you put toward being there.

But I do think that the vast majority of people in our groups are probably bringing in a little bit of extra money, right? It’s not going to change their lives dramatically, but it’s something that allows them to splurge every once in a while, or some sort of bonus money that’s coming in, and it allows them to be able to contribute to a solo 401(k) or have some tax-advantaged things. And then you’ve got a percentage of those people who are very actively trying to develop significant additional revenue streams, and those are the people who are usually pursuing things like real estate, or who are pursuing significant consulting gigs, or trying to create a brand presence. And those are the people who are really able to start getting into those six-figure amounts that really start changing the way that they approach their primary gig.

Kevin Pho: We’re talking to Nisha Mehta. She is a radiologist, and she’s the founder of Physician Side Gigs and Physician Community, two vibrant physician-only Facebook groups. And she wrote the KevinMD article “Why physicians need side gigs.” Nisha, there’s a perception among some that physicians shouldn’t have side gigs, that physicians should only be focused on medicine, and side gigs are just a distraction. What do you say to those who think that way?

Nisha Mehta: I think to each their own. You know, the title of that article, I don’t think that everyone needs a side gig. I think that there are reasons why everyone should consider having side gigs. But I don’t think you need it for the money necessarily, right? For me, I think the side gigs have really given me the opportunity to actually enhance my career longevity within medicine, because it’s just given me a different way to approach my career in medicine. It’s given me a different way to relieve stress from my career in medicine, and it’s given me an outlet to do something that brings me fulfillment, that really overall enhances my happiness and decreases my burnout. So I think there are many, many reasons to pursue side gigs.

The reasons that physicians should consider side gigs: I think a lot of us are W-2 employed. I know my husband and I are both W-2 employed. And the tax code doesn’t necessarily favor W-2 income. And so if you are looking for a reason to be able to contribute to some extra retirement accounts or have some more deductions, the side gigs and the 1099 income can give you that opportunity to diversify your income a little bit, which I think a lot of physicians need in today’s environment. I think that for people who are trying to pay off loans faster, obviously a little bit more money earlier in your career can lead to a long-term difference in your financial success. So there are those sorts of reasons why I think physicians need side gigs.

And then, I think, as you said earlier, this year has shown a lot of us that our clinical income may not be as stable as we think. And so having some backup plans or some buffers can always be really nice. You know, one of the things that I know a lot of the people in the community know that I say a lot is, I always talk about knowing your worth and the power of negotiation, right? And I think your best place at the negotiation table is always going to be the one where you have the power to walk away. And so, for me, having the additional revenue streams has given me the ability to say, “You know what? This is actually really something I don’t want to do. And in a worst-case scenario, if you’re going to fire me over it, that’s OK. I’m fine.” And having that ability to say that has actually allowed me to stay in the job that I have and that I love, in a way that is much more conducive to long-term career longevity for me.

So I think that having options is always good. I think side gigs give a lot of people those options. And in today’s health care landscape, which is becoming increasingly complex and increasingly administrative, having some sort of leverage to be able to have more force in your negotiations can be really good. So, again, there are a lot of different reasons why I think that side gigs are beneficial to people.

There’s also just, I think these days a lot of us feel so isolated in our physician jobs, because there’s just so much work to be done, and the amount of time we’re spending on paperwork and things like that. We don’t really get that same interaction with our patients. We don’t get that same interaction with other people. And for me and my side gigs, it’s been such a great way to connect with people like yourself and other people whose relationships I really value, and it has given me a sense that I’m part of something different and bigger, and given me community. And so, on a personal level, I feel as though that might be a reason why somebody wants to do a side gig.

Even if your side gig is something related to a yoga class that you’re doing, there are so many different ways to enhance your well-being that are reasons that physicians might need side gigs that are not just money. I think it is easy to tie side gigs with money, but for a lot of people, the reasons that they’re pursuing their side gigs have nothing to do with monetary reasons. So do I think that most physicians can have financial success without a side gig? Absolutely. Do I still think they might want to consider having a side gig? Yes, absolutely, but maybe not for the financial reason. That might just be a perk.

Kevin Pho: And my final question, what’s the take-home message you want to leave with the KevinMD audience?

Nisha Mehta: The one that I really stick with to tell everyone is, I believe very strongly in creating the life in medicine that you want. And I think that we all have this picture of a pathway through medicine that has been dictated by portraits on our medical school hallways and what their careers look like. And my big message to everyone is that you figure out the career that works for you, and that, in this era of burnout, there isn’t this prerequisite that you are going to become burnt out. I think you just have to be more proactive about knowing what the things are that bring you joy, and finding ways to maximize those things, and trying to take away the things that are contributing to your burnout, and really creating that life that you want. So whether that’s working part-time, whether that’s having a side gig, whether that’s shifting to something non-clinical, or whether that’s working full-time every day as a physician, whatever that pathway is for you, figure out what that is, be a little bit more proactive, and then take the steps necessary to get there.

Kevin Pho: And how can people reach you?

Nisha Mehta: You can find me on Facebook at either the Physician Side Gigs or the Physician Community page. You can also just find me on my website, which is just my first name, last name, MD dot com, nishamehtamd.com. And that will link you to all of the different things I do, whether it’s appearances that I’ve had, or things that I’ve written, or the Facebook communities.

Kevin Pho: Nisha, thank you so much for sharing your time and insight. Thank you again for being on the show.

Nisha Mehta: Thanks, Kevin. Bye, everyone.

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