This List Keeps Growing

In today's show, John will provide an in-depth overview of some of the popular home based and remote careers.

There have been some significant developments in recent years. Multiple podcast guests have addressed remote careers and utilization management, in general, consulting, coaching, and so on.

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Benefits of a Remote or Home Based Job

Being able to work remotely or from home has several benefits:

  • flexibility
  • convenience
  • lower costs for transportation
  • availability for family members

Categories of home based and remote careers:

  1. Chart reviews

    This includes utilization management, medical legal consultant, expert witness, clinical documentation improvement, and quality improvement.

  2. Medical writing

    There are several major categories of writing, namely: technical medical writing (CROs and pharma companies), medical communication (marketing agencies), continuing medical education and continuing education for other healthcare professions, patient education, and journalistic writing for clinicians or for the general public.

  3. Telemedicine

    This includes direct primary care services, specialty consults by expert physicians to other physicians, remote patient monitoring, remote imaging, and remote medical director services.

  4. Consulting

    The options here are to develop your own freelance consulting business or work for a large national or international consulting firm, much of which can be done from home.

  5. Coaching

    You can do one-on-one coaching and progress to group coaching remotely. You can work as an employee or as a freelancer.

Summary

There are both positive and negative aspects to working remotely. There is less structure with home based and remote careers, but with increased freedom and flexibility.

NOTE: Look below for a transcript of today's episode. 

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Transcription PNC Podcast Episode 291

5 Most Popular Home Based and Remote Careers

John: These are the most popular home-based and remote careers. And this is going to be an overview. There have been some new things that have come up in the last few years, and that's why I wanted to revisit this topic. I've had several guests who have talked about remote careers and utilization management, generally, consulting, coaching, and some of the other things we're going to talk about today. But today I want to also go ahead and give a broader overview and maybe mention some types of jobs that we haven't really specifically talked about in the past.

Before I do that, I do want to talk about the benefits of a remote or a home-based job. They're pretty self-evident. I could skip this part, but just to remind you of the convenience, for example, with childcare. It doesn't mean that you can work at home and attend to an issue, or an emergency while you're working. But being at home and working from home remotely allows you if you have school-aged kids and they need a little bit of supervision, but pretty much have things to do on their own, you're available.

Especially, this is true when you have other members of your family who need care and you can't be gone for days and weeks at a time or gone 8, 9, 10, 12 hours a day when maybe your next-door neighbor happens it'd be your senior mother or father or down the street, somebody close by. And it's nice to have someone like you at home working, but available if there's an issue if there's a problem. And so, it's convenient in that sense also.

Then there are cost savings. If you don't have to pay for a car and gasoline insurance upkeep on the car and so forth, it's going to save you a significant amount of money. In fact, one of the best advice I've ever heard is for someone new starting their career, one of the things you can do to maintain balance in your finances is trying to find a job or move your home to within walking distance of that job. And you can avoid all that expense and get a little bit of exercise at the same time.

Obviously, it's more flexible. And the flexibility means, okay, in the middle of the day, maybe you can answer the door and accept the package. Maybe you can let in a contractor who has to spend an hour or two in your garage fixing something and then you go back to work. So, having someone at home, it just adds a lot more flexibility.

In one form of that flexibility is the ability to travel. We are calling it home based or remote careers, but it can be remote from anywhere. A couple of examples. Probably the most extreme example is Dr. Chelsea Turgeon, who I've interviewed here on the podcast before. And she's also a mentor for the upcoming summit that I mentioned earlier.

And basically for the last four years, she's lived in various international locations building and now serving her consulting business. She consults mostly with people in the United States, but she does live in the United States. I don't think she's lived in the United States in over four years. I believe most of her travel's been in Europe, also the Far East. She worked in Korea for a year teaching English. I think she's lived in Central and South America.

And she continues to travel. She was actually changing her location monthly and now she's settling down to a one-year position in another foreign country. But she's able to work and make a really good living remotely while she's traveling. We've heard about my colleague at NewScript who oftentimes does telemedicine while he's on the road, whether it's in the East or in the West Coast or Texas or Florida. And so, that's a really good benefit for these kinds of remote careers.

Okay, let's get into the options. Some of these are going to be reviewed I'm sure again because I've had guests in the past who have done some of these jobs and we've talked about them specifically. But again, since we're doing an overview, I want to try to include everything that might fall into this category.

Some form of chart review. That's kind of a generic term, but it does cover a lot of things. I'll get into the specifics, but let me go over the major five because I did say we're going to have five categories or five jobs today. And the reality is I'm going to be talking about a lot more than five jobs, but there are five general categories of jobs.

The first is chart reviews, and the second is some form of medical writing. Third is telemedicine and telehealth, fourth is consulting, and fifth is coaching. So, you've probably heard me talk about all those and I've addressed specifics, but there have been some new things that have come up. So I thought I would expand on each of these and tell you what kinds of jobs are in these major categories.

So let's start with chart reviews. Again, I was starting to talk about utilization management. We've talked about that a lot. There's more utilization management typically if you're working for an insurance company or a third party that's providing those benefits management. But it is reviewing records a lot of times, and then sometimes you'll actually have to pick the phone and call somebody or receive a call from someone who's appealing something.

You're in the comfort of your own home. My daughter is a social worker and she does utilization review for mental health, or she had before remotely. And so, she was at home checking these things, approving, disapproving, calling, and sometimes attending. The same thing that a physician would do in this position. Sometimes it doesn't require actually calling different types of utilization management jobs, benefits management, case management, and so forth. But sometimes it does.

Then we have disability workers comp, which is basically a subset of utilization management, but there are different rules and sometimes it's just an up or down call on whether someone qualifies for disability for a certain type of insurance or whether they qualify for workman's comp when it turns out the accident they were involved with occurred in a time when they weren't at work, or the nature of it is an illness, not so much an accident. And so, they're definitely jobs in that arena that are slightly different from the usual UM jobs.

Then we've got all the medical legal type expertise or the typical classic expert witness. That part of their job is just doing a chart review and providing an opinion. In some cases they have to do a deposition, but those are usually remote or online as well. In rare cases, they will have to testify in court. And even some of those situations were able to be done remotely, especially during the pandemic, although I think that's more 50-50 or less in terms of you might actually have to show up in court, maybe even travel if you're working on a case that's at distance from your home. But technically speaking, that is a remote job. It doesn't require an office. Usually it's part-time because most expert witnesses also continue to practice part-time.

And then there's the other version of that, another form of forensic medicine called medical legal consulting, which is also done from home. It involves usually worker's comp and personal injury. It's pre-litigation. It does not involve depositions or testifying in court. It's almost completely remote, although in some cases you'll want to interview the client of the attorney who you're serving, which will mean either a Zoom call or a possible face-to-face. And there are rare occasions when you might have to go into the attorney's office to meet with a patient.

And then if you're doing something called an IME - Independent or insurance medical exam rebuttal, you might need to actually attend the IME visit. So, it's 99% or 95 plus percent remote, but sometimes you might have to do those other types of activities for that particular type of legal witness.

Another type is clinical documentation. Couldn't do this in the past when we had all paper charts, but now that all of our charts are electronic, you can review that chart anywhere. And as a result, a lot of CDI, clinical documentation improvement, or clinical documentation integrity jobs are remote. You can work remotely for an insurance company. You can work remotely as an employee for a third-party CDI service company and you can be a solo consultant. You can work one-on-one as a freelancer doing CDI for one or two or multiple hospitals. So, that's another type of chart review.

And then there are some chart reviews that are mainly focused on quality improvement. I think some governmental agencies like Public Aid and Medicare will sometimes ask for quality improvement reviews for various reasons. A lot of state licensing boards will hire people to review charts for purposes of determining whether there is a quality issue with one of its licensed physicians in that state. And there are other opportunities like that. There are some chart reviews you can do remotely that don't involve a lot of interaction with other people. You don't have to show up. And so, keep that in mind.

All right, the next big category we mentioned is medical writer. I've talked a lot in the past about medical writing and medical writers. You can categorize these by either freelance or employed. In freelance, you're starting slowly. You're learning how to be a medical writer. You're contacting different editors and publishers, and you're starting to write, you're creating a portfolio and eventually, you're just writing after you develop these relationships with these companies, usually if you have four to six or seven publishers that you work with or less oftentimes. You can have a regular income, lot of stability, and you can get paid well because a lot of times you'll get paid let's say as a CME writer, the hourly rate might be less because you're creating let's say a new CME program or event. It could be an enduring material, which basically is something that's available online or on paper.

But when it comes time to renew those things, a lot of times the upgrade and the review and the editing are very minimal. And you can actually make more money per hour doing that because you were the original author, it makes it a lot easier to do that second and third time around.

You can do the same thing as an employee. And remember, there are five or six major categories of writing, everything from technical writing for a pharma company or medical device company or, for a CRO (contract research organization,) which works for the pharma companies. And you've got the technical, then you've got things like educational. You can do CME or CE for different clinicians. You can write educational for patient education, put together brochures, and other forms of education for patients that different organizations need to produce and customize over time.

Then you can do more journalistic type of writing for physicians and other clinicians. Updates on certain medical conditions. There are a lot of articles written about COVID, for example, during the pandemic and still to this day. And then there's also education for the public and journalistic writing and newspapers and magazines and health magazines and all kinds of things like that. And again, you can develop relationships as a freelancer or you can go work for those companies.

And then you can also find a job as an editor who is really oftentimes called the medical director, for lack of a better term I guess. And that means you could be doing the classic editing that you would do, overseeing someone else's writing, but you might also be part of the management process for reviewing and coordinating with the other writers at your company.

I had a guest who went from really full-time podiatrist and she happened to have some leadership positions at the podiatry association that she was a member of, and she had been hired in as an editor for one of the podiatry magazines that get sent to physicians to podiatrists. So, don't forget about those editorial-type jobs other than just the writing jobs.

All right, telemedicine. This is a big area, but I wanted to mention it because it's not nonclinical, it's obviously clinical, but it's non-traditional. We always talk about non-traditional remote jobs and home-based jobs. So you've got the classical type of telemedicine jobs. You can do those either freelance or as an employee, just like most of these jobs can be done.

And we usually push the freelance version of this because it has a lot more flexibility, and takes more upfront work. It's fairly straightforward to obtain a list of the top 10 telemedicine providers, maybe talk to your friends about the ones that seem to be the best to work for, apply, get a job, and then they just start sending you, and you agree to a certain schedule and you just start seeing patients online in various ways, which I'll talk about in the moment.

But the freelance type where you're independent, you work for multiple platforms, and you're not really constrained with other things that you can do, there's no non-compete when you're freelance, generally if you sign the right kind of contract. So, being employed is fine, it's a good way to get your foot in the door. But as colleagues and NewScript mentors like Dr. Cherisa Sandrow have taught us and actually teaches others to do, the freelance form of this is usually much more lucrative. You can often work 20 or 30 hours a week and make a full-time salary. So, that's what we usually recommend.

Now the freelance form of that is being a primary care physician and doing one-on-one short visits, much like you would do in urgent care, not actually face-to-face, but remotely. That's probably the most common and the most lucrative. But there are other things that you can do. You can be involved in remote patient monitoring. RPM - Remote patient monitoring. Usually, the actual monitoring would be done by another type of clinician, a nurse, or a technician technologist. But a lot of times with the RPM, they'll need medical directors and need physicians to supervise and to create protocols and things like that.

So, keep your eyes open for remote patient monitoring companies that are growing. There aren't a lot of them, they're not that active, but I'm sure they will be more and more active over time. If you're a radiologist, you can do remote imaging. That actually was one of the earliest forms of telemedicine.

I've had a guest that came from Doctors For Providers. Actually two guests, the two co-owners. And this is a way to provide remote supervision. So, I'm including this as a form of telemedicine. I don't know if technically it is, but there are urgent care centers that employ PAs and NPs. There are independent APNs in certain states who have their own clinics. There are some legal constraints here. And buyer beware, make sure that your malpractice is covered completely and that you're not getting into a high-risk situation.

But there are many physicians currently doing remote monitoring, and collaboration supervision. They might be doing chart reviews to help with the quality improvement for the staff at the remote site, and they never set foot on the site, and they can do this even while they're working another job. Because as long as you can break away and do some collaboration and consultation, and also if you're doing chart reviews or doing reviews protocols, those are all done on unscheduled time at your own pace.

I would just remind everyone that telehealth is a huge field and there's a lot more to it than just face-to-face visits. The remote consultations also include specialists consulting with primaries, so they're not actually seeing the patient, but they're communicating with you as a primary if that's what you're doing to help you address a problem. And then obviously they can do remote consultations with patients as well, but sometimes I prefer just to work with the physicians rather than the patients in some situations.

Okay, now we've used the term consulting, but this time I'm going to focus specifically on the classical form of consulting, which again is either freelance or employed. Now, I threw boutique in here too because that's a term that's thrown around. But basically, the freelance is a one-person shop. Most of the time you have an area that you're an expert in, that you're passionate about. It could be inside the bubble of a medicine, inside direct patient care or it could be outside. Maybe you are an expert at marketing your practice. And so, you develop some courses, some consultation, and you can do these things remotely to help other practices do their marketing in an efficient and effective way.

On the other end of the spectrum, you have these national and international healthcare consulting firms. Places you may have heard like IBM has a large component, $50 billion-plus per year. Accenture, Deloitte, McKenzie, Ernst & Young, Huron. I've lifted these here. There are at least 40 more that do consulting to hospitals and health systems and large groups and telemedicine companies and other consulting firms and other delivery firms in healthcare and pharma and you name it.

I put the boutique in because you could start out as free freelance and then if you're doing that, let's say that marketing, you might end up hiring a copywriter part-time. You might end up hiring a social media expert. You might end up hiring an email expert. And then you're doing the basic marketing. And so, now you've developed a small free-standing consulting firm, which from the hospital side, health system side that I was involved with. And we would decide, do we want to get one of these huge international or national firms, or we want to find a boutique firm that has a smaller crew, but they're more focused on a very specific problem. So, that's another great remote and home based career. When you're doing freelance, it's probably more remote and more home based. When you work for a large firm, sometimes you do have an office to go to from time to time, and you do travel quite a bit. So, it might only be partially home based.

And the last category that I want to talk about today is coaching. 10 years ago, I think we were not aware that there were that many physician coaches around and there were some people who have been coaches for a long time, physicians coaching other physicians that are quite iconic. I won't mention any names, but nowadays there are literally thousands of physicians who are doing coaching.

There's a fuzzy line between coaching and consulting. But when we talk about coaching, we're talking about mostly starting with one-on-one coaching. It can be life coaching, it can be career coaching. There are at least 10 types of coaching, and there are probably more that I haven't even seen or heard about in the past.

But business coaching, professional coaching, and then even what you do as a consultant in a way is a form of coaching. But I've even seen yoga coaches in our physicians, meditation coaches, and success coaches. I've interviewed many coaches, and several of the coaches, in fact, at the summit that's coming up in April about seven or eight of the people that are presenting their formal job as coaching and training other people to do things that they've done and that they're experts. So we have a telemedicine coach and we have a locums coach and we have a pharma coach and so forth.

I won't get into the names right now, but suffice it to say it's a very popular type of job and it's one where you become an expert in something and you're just going to do one-on-one and help to train them. You can be employed. There are firms that employ physician coaches and that takes away some of the risks of building a business.

Most coaches that I know are either freelance or run some kind of a coaching business, and they may actually recruit other coaches, although they may not truly employ them. They might be more of a 1099-type relationship. So, technically, they're even sort of semi-freelance, although they have that relationship and they get some of their clients from this coaching company, they both exist.

And sometimes being employed first, as long as you don't have some kind of an exclusive contract that goes beyond a year or so, then you can move from employed to freelance if you want to do that.

Most coaching starts out as one-to-one. It oftentimes moves into group coaching. I've interviewed several successful very busy coaches, whether it's Heather Fork or Katrina Ubell who coaches for weight loss, or you name it, people that coach for doing real estate and coaches for starting a practice, coaches for being a medical legal consultant or for being an expert witness. There are all kinds of coaches and there's a blurry wall between coaching and consulting.

That's really what I wanted to do today. I've probably described at least 30 or 40 jobs depending on how you want to break it down.

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