Non-clinical for EM

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NYEMMED

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Hello everyone,

As a EM physician dealing with burnout from clinical work. Anybody have ideas for a non-clinical job for a EM doc?

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This is not answering your question exactly, but have you considered working for a slower, rural ER? Some small place where you see a few patients a night?
 
This is not answering your question exactly, but have you considered working for a slower, rural ER? Some small place where you see a few patients a night?


It would not be a bad idea but, I can’t uproot my family now, I live in the northeast, nothing is rural here
 
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Definitely not a doc yet, but when I was working as a medic my captain had a lucrative side gig doing medical review stuff for a local attorney. He was basically screening cases that may potentially put an EMS service at risk, working for the county attorney or something. Sounds like he was on the good side, but who knows what he was really doing. So that may be something to consider.

Also, when I was working in clinical research, our PI was always looking for docs to be on call for some of the "adverse events" the subjects had. When I say adverse event, I mean stupid stuff that probably wasn't related to the meds 99% of the time. Constipation, diarrhea, headache, etc. Stuff that requires no more effort than "give them prune juice and an ice pack and we'll note it for the sponsor". And this was in pharma, so of course the money was good. Anesthesia contractors were getting 2k for 4 hours of work essentially making sure no one quit breathing when we gave them experimental benzos.

If those don't tickle your fancy, there's always money in the banana stand.
 
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I was curious about the legal review stuff as well? I know someone who does this in a completely different field and I've seen 200-500 an hour thrown around on the internet. Seems like could be a good side gig, especially for those times when you are awake and others aren't. Plus legal stuff kinda interests me.
 
I was curious about the legal review stuff as well? I know someone who does this in a completely different field and I've seen 200-500 an hour thrown around on the internet. Seems like could be a good side gig, especially for those times when you are awake and others aren't. Plus legal stuff kinda interests me.

I have no idea what the job would entail or what the money would be like for a physician. I just know that the guy I worked with was making $50/review with each one taking about 20-40 minutes. I guess the downside is that he had to go to court once a year or so, but he was still being paid as an "expert witness" without even being an expert at anything. I'm also interested in the law and how it applies to medicine in a lot of cases, but not 100% sure I'll ever be willing to sell another doc down the river. And I'm sure that's where most of the money is. I can't back this up with numbers, but I would assume med/mal attorneys have much deeper pockets for witnesses than defense attorneys.
 
Legal review is a multi-step process. Most large firms have their own physicians on staff or contracted. If they think there is enough evidence to proceed with a claim, they will then turf it out to an expert witness. You can get on the list for expert witnesses by contacting a legal nurse, who often own the companies.

Reviews typically pay $3-500/hr for plaintiffs and less for defense. Government reviews are usually $100-150/hr. Depositions are usually $3-750/hr with testimony being around $1500/hr plus travel expenses (I charge a 6-hour minimum since I have to take the entire day off work). Most plaintiffs will want to videotape you if you're an expert witness for an insurance claim and not a medical malpractice case. This prevents them from needing you to be present at trial.

If you review defense work, you will need to also do some plaintiff work. An expert witness who only reviews defense work will eventually be viewed as one sided and only there to protect the medical establishment. Doesn't mean you have to agree there is evidence to proceed with a case, but be reasonable and honest when reviewing any side (defense or plaintiff). If somebody sent a patient home with a positive troponin (3) and a good story (smoker, obese, chest pain x4 hours that's worse with exertion), then it's hard to say that the doc was correct in sending that patient home.

One final word of caution: if you do legal review work and give your opinion, be prepared to defend it multiple times. First the written review, then a deposition, then likely testimony. If you have a shady past, be careful because lawyers will use that against you. Been convicted of a DUI? They will use it to discredit you and call you a drunk. If they find out you are in debt, they'll accuse you of farming yourself out for extra money.
 
I have no idea what the job would entail or what the money would be like for a physician. I just know that the guy I worked with was making $50/review with each one taking about 20-40 minutes. I guess the downside is that he had to go to court once a year or so, but he was still being paid as an "expert witness" without even being an expert at anything. I'm also interested in the law and how it applies to medicine in a lot of cases, but not 100% sure I'll ever be willing to sell another doc down the river. And I'm sure that's where most of the money is. I can't back this up with numbers, but I would assume med/mal attorneys have much deeper pockets for witnesses than defense attorneys.
Ah hellz naw! At the best, thats $150/h. I do a few online industry surveys a month (I get 5 or 6 offers a day) and I won't even read beyond the point where they tell me the expected time to complete and the compensation. If it's <$4/minute ($240/h), I delete the email and move on. The bare minimum that I'd do for any legal work (that I believed in, could do on the couch, in my pajamas, with a beer in my hand) is $250/h. Every variable that changed from that baseline has to be worth $100/h or I'm just deleting the email.
 
Ah hellz naw! At the best, thats $150/h. I do a few online industry surveys a month (I get 5 or 6 offers a day) and I won't even read beyond the point where they tell me the expected time to complete and the compensation. If it's <$4/minute ($240/h), I delete the email and move on. The bare minimum that I'd do for any legal work (that I believed in, could do on the couch, in my pajamas, with a beer in my hand) is $250/h. Every variable that changed from that baseline has to be worth $100/h or I'm just deleting the email.

Seems like a solid philosophy to me, although for me being able to drink beer while I "work" would be added dollar value in itself. It sounds like you're probably considering offers to make approximately your hourly rate, just paid per minute, correct? For context, this guy was probably making ~$25/hr at his (our) full-time job, so it was a good deal to be able to make about 6x that for a couple hours a week. It was an even better deal for him because he wasn't out building decks and getting stung by bees like the rest of us idiots.

Although another guy I worked with bred championship retrieving dogs at 2k a piece. Probably the dumbest man I ever knew, but he had a sweet house.
 
Ah hellz naw! At the best, thats $150/h. I do a few online industry surveys a month (I get 5 or 6 offers a day) and I won't even read beyond the point where they tell me the expected time to complete and the compensation. If it's <$4/minute ($240/h), I delete the email and move on.

Sermo?
 
It would not be a bad idea but, I can’t uproot my family now, I live in the northeast, nothing is rural here

You'd be surprised. There are definitely plenty of rural ER's in the Northeast, if you are willing to drive an hour or so in any direction. However, this may not be possible in NYC, if that's where you live--in which case, your whole problem is living in NYC.
 
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