Find Opportunities Yourself or Use a Broker – 371
In this podcast episode, Dr. John Jurica dives into part-time remote collaboration for physicians seeking extra income.
He shares various ways to collaborate with mid-level providers (NPs and PAs), primarily through chart reviews and supervision, with a minimal daily workload. This episode offers practical advice for physicians looking to reduce burnout and earn income while transitioning away from full-time clinical work.
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Exploring Part-Time Remote Collaboration Opportunities
John describes how physicians can leverage remote collaboration opportunities with mid-level providers (NPs, PAs, etc.). He discusses the increasing demand for collaborative agreements. Then he shares how physicians can provide support through chart reviews and supervision, which requires minimal work while providing a steady income.
Companies Offering Remote Collaboration Services
These collaborations can easily fit into a physician’s existing schedule, allowing them to earn a monthly stipend with minimal effort. Some telemedicine providers use this strategy to earn additional income, paying between cases to collaborate or review charts.
Key platforms include:
- Collaborating Docs,
- Zivian Health,
- Moxie,
- Doctors for Providers, and,
- IBA Nurses.
Each company has unique requirements and services, making it easier for physicians to find the best fit based on their specialties and licenses.
Balancing Liability and Income
John addresses concerns about malpractice liability. Physicians must be aware of the legal implications when collaborating remotely. And it must be crystal clear which party is purchasing malpractice insurance for the physician. Some companies provide the necessary malpractice coverage as part of their arrangement, making it an appealing side income for physicians easing out of clinical work.
Summary
John shares insights into remote collaboration opportunities for physicians, collaborating with nurse practitioners, physician assistants, and nurses providing infusion services. He highlights several platforms where physicians can connect with these opportunities, such as Collaborating Docs, Zivian Health, Moxie, Doctors for Providers, and IBA Nurses. These platforms enable physicians to earn extra income through chart reviews and providing oversight, often requiring minimal time commitment.
Links for today's episode:
-
- Collaborating Docs Website
- Zivian Health Website
- Join Moxie Website
- Doctors for Providers Website
- IBA Nurses Website
- Why Part-Time Remote Medical Director Is a Great Job – 240
- Why an Infusion Lounge May Be the Best New Thing
- Dr. Armin Feldman's Pre-trial Pre-litigation Medical Legal Consulting COACHING Program
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Right click here and “Save As” to download this podcast episode to your computer.
Transcription PNC Podcast Episode 371
Update On Part-Time Remote Collaboration For Extra New Income
John: Hello, I'm John Jurica, and I'm back to do the weekly Q&A on behalf of the NonClinical Career Academy. For those of you that are not members of the NCA, it's a collection of basically about 30 different lectures. Some are multi-lecture courses, all about nonclinical jobs, non-traditional work, and that kind of thing. I want to get into today's topic real quick here. I'm trying to be more efficient on these calls. I look back and some of these calls lasted like 45 minutes.
So let's see, if I see a question here in the chat, I will definitely address that, but I came prepared to address a topic which should probably only take 10 or 15 minutes, but let me give the potential question. Is it true that I can make a significant amount of extra money by working for a company to collaborate with, I guess I'll call it mid-level providers, okay? So, or how can I do that?
And this actually came up when I was doing a presentation for Dr. Cherisa Sandrow and Alex Sandrow's course that they teach, which is a telemedicine, telehealth how to create your own telemedicine practice, and it walks you all through it. I think it's a 10 week process. And then we ended up talking a little bit about the issue of using some of that time efficiently by being a collaborator.
And there are obviously NPs and PAs in some states that require collaboration. There's many institutions and many of those, particularly the NPs, of course, who can be licensed without collaboration, but they still like to have the collaboration. And so it just varies, but bottom line is you can be available for different responsibilities related to that, and you can get paid for that.
And I first ran into this more or less, I've known about it for a long time because I employ a number of PAs and NPs and I'm their supervising or, quote, collaborating physician. In Illinois, the NPs don't necessarily have to have a collaborating physician, although again, I think most of them do because they feel like they can maybe do a little bit more in their practice if they have the background and ready availability of a physician. But let's just step back and talk about it in non-specific terms.
So what does this mean? This means that there are NPs and PAs that, and sometimes just nurses, that require physicians relationships to allow them to do either all of their job, like PAs generally can't work without that collaboration, or part of their job, or some things that normally they can do in a hospital setting sort of indirectly. So for example, infusion services.
I think there's some states where nurses can do infusions and they don't have to be an NP or an advanced practice nurse, but they do need to have a physician review things before they do the infusion. So this came up in the telemedicine course because when you're doing telemedicine, you can oftentimes have several sites open and take patients from different sites, wherever you may be licensed. And so you'll be taking, as a freelancer, you'll be taking these patients in as they sign in, and sometimes there's gaps, and so some people will do more than one cue at a time to optimize their time.
But the other thing that you can do while you're doing those things is some collaborative activities. And this doesn't mean that you're also taking calls directly from the provider, the non-medical provider, I'll call them, but that you're doing things like chart reviews because a lot of these collaborative agreements require, and again, it's state-specific, require that a certain percentage of charts be reviewed each month as a, I guess, a quality measure in a way to make sure that there's some oversight. So some might be working full-time as an NP, running her own clinic, doing whatever she does, and one way you may get a call from that person. You get paid for being available whether you get a call or not.
And so there's lots of situations where that might be a good thing. So let's say you're just starting your practice. You've only been out for six months to a year, and you don't necessarily have a full practice, and you're not super busy.
Well, you could sign up for several of these companies and be their collaborating physician. You might be doing telemedicine and telehealth, as I mentioned. Another is you might be in more of an administrative role.
Let's say that you're the owner and operator of a practice, and you happen to supervise several NPs or PAs. Maybe you have a small clinic. You can only see so many patients in a day or at a time.
Maybe you've got six exam rooms, but you employ two non-medical or mid-level providers. So sometimes you're just doing your business part of your job of managing. Maybe you're doing payroll. Maybe you're doing some research or you're doing some paperwork. You're in your office. You're available to collaborate with the other providers.
Well, you could also be available online and collaborate. And again, you get paid for just being available, and you might get an occasional call, but by no means do you get necessarily if you have one collaborative agreement more than one or two calls on any given day. At least that's my experience with if you recruit and employ very experienced medical providers.
If you think about it, this is just one way to look at it. Someone was doing some calculation, and I'm going to go through the actual names of some of the companies that do this, but it was an example from one of the companies, and they said, well, you can make easily, let's say 500 to $1,000 a month being a collaborating physician. And probably in that situation, the most of the time you're going to spend is going to be in reviewing charts, and those can be done at any time.
So you can find the slowest part of your day, and let's say you're taking a one-hour break for lunch and you only need 20 minutes to eat, you could be reviewing charts for the other 30 to 40 minutes. But anyway, you're going to make $6,000 to $12,000 per year just to be available for that person to whom you're assigned to collaborate with. Well, you could have four of those was the example I read, and you could easily make up to somewhere between $24,000 and $48,000 a year just being a supervising and collaborating physician with probably minimal work.
There's obviously if you're supervising four different medical providers, then you're going to have a number of charts to read and review. So, all right, so I want to get back into this, the rest of this by saying there's a couple of things I want to talk about here. And let me first of all say that I put the names of the companies that I'm aware of, and they're in the chat.
Now, because not everyone who will be watching this in the future has access to the chat, I'm going to go ahead and give those URLs right now. And they're in no particular order, but I'll mention some specifics about them as I go along here. So, first of all, we have collaborating docs, which is at www.collaboratingdocs.com.
And the thing that's unique about this one is it only does collaborative services for NPs. So, if you want to make some extra money supervising, collaborating with NPs, then that would be a good one. The next one, and I'll get to the questions that are coming in in a minute, Zivian Health is another one, zivianhealth.com.
And then we have joinmoxie.com. Now, that one is called Moxie, but the URL just happens to be joinmoxie.com. And then we've got doctors4providers.com. I think you can get at it by going to doctors4providers.com or doctors4providers.com. I'm pretty familiar with that because the owners have been on my podcast, and I've actually worked with them to consider getting coverage for our NPs and PAs and my urgent care centers. But we did not consummate that.
And then we've got this kind of screwy one, IBAnurses.com/joinus because there's an organization that is run by the International Business Association for Nurses, and it has a lot of APNs. And so it has put together a service for connecting these physicians to the APNs. And then the last one I have is guardianmedicaldirection.com, just the way it sounds. And I don't know too much. They do NPs and PAs. I think the only one that only does NPs would be actually collaborating docs.
And it's funny because I think even the IBA one, which is a nursing organization, does provide collaboration for NPs, PAs, and let's say BSNs or RNs who are doing infusion services on their own. So those are the links. Let me answer this question real quick.
Would it be this type of work would increase your medical liability? Well, by definition, it increases it. Anytime you're extending the scope of your practice, even if it's an indirect way, you're going to be liable.
It needs to be covered. I'm not an expert on this, but I know that some of these companies include the malpractice coverage with their contract. In others, the physician has the onus of having the coverage and in others, it might even be that the practice would have to.
So I know for the collaborating docs, it's built in, and I haven't really done the research on the others. And then, so the next question is, what are the malpractice implications of this work? So I've kind of alluded to that.
In general, in the past, in my recollection, overall, NPs and PAs tend to be sued much less often than physicians. But having said that, I would say that I've been doing urgent care in my current setting where I'm a co-owner, a medical director, and we have had one lawsuit and it was a result of an interaction of a patient with a physician assistant. So I would say as time goes on and we are doing more and more with, in general, with non-physician providers, you're going to see more of those providers sued.
If you're concerned about doing a nonclinical or non-traditional job to earn money is to avoid liability, then you need to basically step away from all patient care, because as long as you're working as a licensed physician, at least as far as I know, whether it's directly seeing patients or supervising other people doing things with and to patients, your liability will continue and sometimes will expand in direct correlation with the number of patients you're interacting with, whether it's directly or indirectly.
When I decided to leave clinical medicine the first time, that was a big driving force for me. When I became chief medical officer, I really could put my malpractice into suspension, at least for once I stopped seeing patients, I still had to have the coverage for those that I had seen in the past. So some type of tail to cover that, but yeah, that's an issue. Let's see, now there are things you should look for and I just want to spend another two minutes here addressing this question, but there are things you should look for when you're working with one of these companies.
Think about it, if you're doing chart reviews, you have to get into an EMR. So do you already have access to that EMR? Do they have a platform that integrates the EMRs from anybody so that you can do the chart reviews easily? Obviously this is all going to be done electronically.
They're not going to be sending you copies of the charts or anything. So look at the platform they use, look at the EMR integration, how easy it is to handle that. Of course you have to be licensed in any state where you're doing this kind of work. That has to be addressed and how able, can they help you get the new license if you need it? Do you already have licenses? Can you limit? I think all these companies will limit it to whatever existing license you might have. Of course, the more licenses you have, the easier it is to get a contract or a relationship to do this service. Some of them have specialty needs. So depending on your specialty, it may or may not be as easy to pick up some work for others. And the malpractice coverage we've also talked about.
And then the responsibilities. Most of them are fairly explicit in saying they're going to have you do whatever it is that that state requires. There are states that do not require chart reviews, although at least one of the companies said they're going to always have you do a 10% chart review. It's just their policy just to maintain a healthy relationship and a good quality monitoring.
But if you were working in Illinois, for example, you wouldn't necessarily have to do that if you're contracting medical clinic or whatever, didn't feel that was necessary. They might have somebody else doing that who's live or on site. But all the different things that in the malpractice, the number, the minimums, the maximums, the platform, and the responsibilities should be considered when choosing these.
Again, let me just give you the names real quickly here. Collaborating Doctors. Zivian Health begins with a Z. Moxie, you can look up Moxie or joinmoxie.com. Doctors for Providers, ibanurses.com. You can find a link there and guardianmedicaldirection.com.
Like I said, I want to keep these short, but if you have any interest in doing that, check out those sites and maybe you'll find some others that I haven't been able to find and see if you can earn a little extra money, maybe while you're preparing to leave clinical medicine or as you go part-time, maybe one of the things people do, they get burnt out, well, may they slow down, but then they can do more leisurely chart reviews and take the occasional phone call from a mid-level provider.
All right, that's all I have for today and I'll see you next week. Send me your questions through the emails you've been getting and we'll address something new next time. Thank you.
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Transcription PNC Podcast Episode 371
Update On Part-Time Remote Collaboration For Extra New Income
John: Hello, I'm John Jurica, and I'm back to do the weekly Q&A on behalf of the NonClinical Career Academy. For those of you that are not members of the NCA, it's a collection of basically about 30 different lectures. Some are multi-lecture courses, all about nonclinical jobs, non-traditional work, and that kind of thing. I want to get into today's topic real quick here. I'm trying to be more efficient on these calls. I look back and some of these calls lasted like 45 minutes.
So let's see, if I see a question here in the chat, I will definitely address that, but I came prepared to address a topic which should probably only take 10 or 15 minutes, but let me give the potential question. Is it true that I can make a significant amount of extra money by working for a company to collaborate with, I guess I'll call it mid-level providers, okay? So, or how can I do that?
And this actually came up when I was doing a presentation for Dr. Cherisa Sandrow and Alex Sandrow's course that they teach, which is a telemedicine, telehealth how to create your own telemedicine practice, and it walks you all through it. I think it's a 10 week process. And then we ended up talking a little bit about the issue of using some of that time efficiently by being a collaborator.
And there are obviously NPs and PAs in some states that require collaboration. There's many institutions and many of those, particularly the NPs, of course, who can be licensed without collaboration, but they still like to have the collaboration. And so it just varies, but bottom line is you can be available for different responsibilities related to that, and you can get paid for that.
And I first ran into this more or less, I've known about it for a long time because I employ a number of PAs and NPs and I'm their supervising or, quote, collaborating physician. In Illinois, the NPs don't necessarily have to have a collaborating physician, although again, I think most of them do because they feel like they can maybe do a little bit more in their practice if they have the background and ready availability of a physician. But let's just step back and talk about it in non-specific terms.
So what does this mean? This means that there are NPs and PAs that, and sometimes just nurses, that require physicians relationships to allow them to do either all of their job, like PAs generally can't work without that collaboration, or part of their job, or some things that normally they can do in a hospital setting sort of indirectly. So for example, infusion services.
I think there's some states where nurses can do infusions and they don't have to be an NP or an advanced practice nurse, but they do need to have a physician review things before they do the infusion. So this came up in the telemedicine course because when you're doing telemedicine, you can oftentimes have several sites open and take patients from different sites, wherever you may be licensed. And so you'll be taking, as a freelancer, you'll be taking these patients in as they sign in, and sometimes there's gaps, and so some people will do more than one cue at a time to optimize their time.
But the other thing that you can do while you're doing those things is some collaborative activities. And this doesn't mean that you're also taking calls directly from the provider, the non-medical provider, I'll call them, but that you're doing things like chart reviews because a lot of these collaborative agreements require, and again, it's state-specific, require that a certain percentage of charts be reviewed each month as a, I guess, a quality measure in a way to make sure that there's some oversight. So some might be working full-time as an NP, running her own clinic, doing whatever she does, and one way you may get a call from that person. You get paid for being available whether you get a call or not.
And so there's lots of situations where that might be a good thing. So let's say you're just starting your practice. You've only been out for six months to a year, and you don't necessarily have a full practice, and you're not super busy.
Well, you could sign up for several of these companies and be their collaborating physician. You might be doing telemedicine and telehealth, as I mentioned. Another is you might be in more of an administrative role.
Let's say that you're the owner and operator of a practice, and you happen to supervise several NPs or PAs. Maybe you have a small clinic. You can only see so many patients in a day or at a time.
Maybe you've got six exam rooms, but you employ two non-medical or mid-level providers. So sometimes you're just doing your business part of your job of managing. Maybe you're doing payroll. Maybe you're doing some research or you're doing some paperwork. You're in your office. You're available to collaborate with the other providers.
Well, you could also be available online and collaborate. And again, you get paid for just being available, and you might get an occasional call, but by no means do you get necessarily if you have one collaborative agreement more than one or two calls on any given day. At least that's my experience with if you recruit and employ very experienced medical providers.
If you think about it, this is just one way to look at it. Someone was doing some calculation, and I'm going to go through the actual names of some of the companies that do this, but it was an example from one of the companies, and they said, well, you can make easily, let's say 500 to $1,000 a month being a collaborating physician. And probably in that situation, the most of the time you're going to spend is going to be in reviewing charts, and those can be done at any time.
So you can find the slowest part of your day, and let's say you're taking a one-hour break for lunch and you only need 20 minutes to eat, you could be reviewing charts for the other 30 to 40 minutes. But anyway, you're going to make $6,000 to $12,000 per year just to be available for that person to whom you're assigned to collaborate with. Well, you could have four of those was the example I read, and you could easily make up to somewhere between $24,000 and $48,000 a year just being a supervising and collaborating physician with probably minimal work.
There's obviously if you're supervising four different medical providers, then you're going to have a number of charts to read and review. So, all right, so I want to get back into this, the rest of this by saying there's a couple of things I want to talk about here. And let me first of all say that I put the names of the companies that I'm aware of, and they're in the chat.
Now, because not everyone who will be watching this in the future has access to the chat, I'm going to go ahead and give those URLs right now. And they're in no particular order, but I'll mention some specifics about them as I go along here. So, first of all, we have collaborating docs, which is at www.collaboratingdocs.com.
And the thing that's unique about this one is it only does collaborative services for NPs. So, if you want to make some extra money supervising, collaborating with NPs, then that would be a good one. The next one, and I'll get to the questions that are coming in in a minute, Zivian Health is another one, zivianhealth.com.
And then we have joinmoxie.com. Now, that one is called Moxie, but the URL just happens to be joinmoxie.com. And then we've got doctors4providers.com. I think you can get at it by going to doctors4providers.com or doctors4providers.com. I'm pretty familiar with that because the owners have been on my podcast, and I've actually worked with them to consider getting coverage for our NPs and PAs and my urgent care centers. But we did not consummate that.
And then we've got this kind of screwy one, IBAnurses.com/joinus because there's an organization that is run by the International Business Association for Nurses, and it has a lot of APNs. And so it has put together a service for connecting these physicians to the APNs. And then the last one I have is guardianmedicaldirection.com, just the way it sounds. And I don't know too much. They do NPs and PAs. I think the only one that only does NPs would be actually collaborating docs.
And it's funny because I think even the IBA one, which is a nursing organization, does provide collaboration for NPs, PAs, and let's say BSNs or RNs who are doing infusion services on their own. So those are the links. Let me answer this question real quick.
Would it be this type of work would increase your medical liability? Well, by definition, it increases it. Anytime you're extending the scope of your practice, even if it's an indirect way, you're going to be liable.
It needs to be covered. I'm not an expert on this, but I know that some of these companies include the malpractice coverage with their contract. In others, the physician has the onus of having the coverage and in others, it might even be that the practice would have to.
So I know for the collaborating docs, it's built in, and I haven't really done the research on the others. And then, so the next question is, what are the malpractice implications of this work? So I've kind of alluded to that.
In general, in the past, in my recollection, overall, NPs and PAs tend to be sued much less often than physicians. But having said that, I would say that I've been doing urgent care in my current setting where I'm a co-owner, a medical director, and we have had one lawsuit and it was a result of an interaction of a patient with a physician assistant. So I would say as time goes on and we are doing more and more with, in general, with non-physician providers, you're going to see more of those providers sued.
If you're concerned about doing a nonclinical or non-traditional job to earn money is to avoid liability, then you need to basically step away from all patient care, because as long as you're working as a licensed physician, at least as far as I know, whether it's directly seeing patients or supervising other people doing things with and to patients, your liability will continue and sometimes will expand in direct correlation with the number of patients you're interacting with, whether it's directly or indirectly.
When I decided to leave clinical medicine the first time, that was a big driving force for me. When I became chief medical officer, I really could put my malpractice into suspension, at least for once I stopped seeing patients, I still had to have the coverage for those that I had seen in the past. So some type of tail to cover that, but yeah, that's an issue. Let's see, now there are things you should look for and I just want to spend another two minutes here addressing this question, but there are things you should look for when you're working with one of these companies.
Think about it, if you're doing chart reviews, you have to get into an EMR. So do you already have access to that EMR? Do they have a platform that integrates the EMRs from anybody so that you can do the chart reviews easily? Obviously this is all going to be done electronically.
They're not going to be sending you copies of the charts or anything. So look at the platform they use, look at the EMR integration, how easy it is to handle that. Of course you have to be licensed in any state where you're doing this kind of work. That has to be addressed and how able, can they help you get the new license if you need it? Do you already have licenses? Can you limit? I think all these companies will limit it to whatever existing license you might have. Of course, the more licenses you have, the easier it is to get a contract or a relationship to do this service. Some of them have specialty needs. So depending on your specialty, it may or may not be as easy to pick up some work for others. And the malpractice coverage we've also talked about.
And then the responsibilities. Most of them are fairly explicit in saying they're going to have you do whatever it is that that state requires. There are states that do not require chart reviews, although at least one of the companies said they're going to always have you do a 10% chart review. It's just their policy just to maintain a healthy relationship and a good quality monitoring.
But if you were working in Illinois, for example, you wouldn't necessarily have to do that if you're contracting medical clinic or whatever, didn't feel that was necessary. They might have somebody else doing that who's live or on site. But all the different things that in the malpractice, the number, the minimums, the maximums, the platform, and the responsibilities should be considered when choosing these.
Again, let me just give you the names real quickly here. Collaborating Doctors. Zivian Health begins with a Z. Moxie, you can look up Moxie or joinmoxie.com. Doctors for Providers, ibanurses.com. You can find a link there and guardianmedicaldirection.com.
Like I said, I want to keep these short, but if you have any interest in doing that, check out those sites and maybe you'll find some others that I haven't been able to find and see if you can earn a little extra money, maybe while you're preparing to leave clinical medicine or as you go part-time, maybe one of the things people do, they get burnt out, well, may they slow down, but then they can do more leisurely chart reviews and take the occasional phone call from a mid-level provider.
All right, that's all I have for today and I'll see you next week. Send me your questions through the emails you've been getting and we'll address something new next time. Thank you.
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