Transcription PNC Podcast Episode 392

Exploit Your Medical Knowledge In New Ways

- Interview with Dr. Robert Cooper - Part 2

John: Well, let's go back to another one then. I think that's one that you've been doing for the most amount of time and have spent the most cumulative hours on, and that's the disability file reviews. So how did you find that? Did someone point you to it? Were you just searching around the internet? I mean, how did you find that? What should we do if we're interested in it? Because I have looked into this a little bit myself. And I'll just say, as a family physician, they're usually looking for a specialist. I mean, there's a lot for neuro and physiatrists and that, but I know they're out there for primary care at times when they just need the general. So any tips on that? What's it like? How long does it take? We'll kind of do that first, and then we'll move on to the next one.

Dr. Robert Cooper: Sure. The first gig, I think, was through the New England Journal of Medicine. Like I said, I answered that in the New England Journal of Medicine. Small company, I went out and learned how to do it, and they trained you to some degree—not terrific. And I started doing it. I like it because it's almost like taking raw materials, right? Looking through a file like a detective and trying to figure out what's going on. What you're trying to do is determine the level of impairment of a claimant—we call them claimants. There's terminology involved, but you have to know what you're doing when you're going through this. It's a method for actually sorting out the file, figuring out where it is, where the pieces are, how to put it together, and the different components.

I have not found really good training in this, honestly speaking. I took a course in it, but it didn't help me—I had done it before. So I think really providing nuts and bolts is important. I worked for three companies, but there is another way to find it. I'm not gonna mention the specific companies, but I will say that NAIRO—N-A-I-R-O, the National Association of Independent Review Organizations—has companies on there. Now, here's the important thing. Here's the important point for viewers: don't be undersold, okay? A lot of these companies are paying rates that are ridiculous.

What's happened in the disability world, unfortunately, is that they're moving a lot of stuff in-house to do full-time physicians come on board, and they're taking it away from some of that. I found that that's happened over the last five years. I told you before, I worked 10 hours a week for a major insurance company as an independent contractor. So I was doing that in addition to the other vendor companies. It was just a lot of work—10 hours a weekend. But I learned a lot from doing it. Then they stopped that and moved it in-house. So you have to be careful.

There are companies out there who ghostwrite reports. I'll just tell you that what they do basically is—they write the whole report up, and you just sign it. And they pay you very little money to do it. They're trying to save money. That is something you want to avoid. Okay, I won't mention any specific companies except to say that you don't want to do that. You want to really be legitimate about this. This is important. If you're doing this kind of work, it's important to be fair and impartial and to look at the work and come up with a conclusion that's reasonable. And that's what they want, actually—insurance companies want. Unfortunately, they're constrained like everybody else financially, so they're looking to cut corners. Unfortunately, that doesn't work too well when it happens.

So you have to be careful what you're getting yourself into. It's very important to pick and choose who you're working for carefully—not just in terms of what they're paying but also if they're ethical and so forth.

John: So does it seem like that's one of the things that's sort of changed since you've been doing this, right? I mean, heck, you started probably doing this before the pandemic, and then the pandemic hit, and everything's going online. Any other observations about what we should look for or not look for when looking for disability evaluation file reviews?

Dr. Robert Cooper: I mean, a reasonable rate is reasonable. I mean, I don't want to go into exactly what I mean. The ranges generally are, just to give you a range, I mean, $150 to $200 an hour is reasonable or over that. Some companies—I mean, I've not settled for $50 an hour or $25—I mean, it's ridiculous. Some companies that are actually coming into play, I would just walk away from them. Again, walk away. Instead of walking away, they get in trouble with that.

I will make a comment about something you said, John. There are a lot of family physicians doing this—general physicians. It's not actually—it’s just as much general physicians as there are actually specialists doing this because you need to have a holistic point of view of some of these patients. They look for this, and they want somebody to go through everything, all the problems, and come up with a conclusion. So, it's very much driven by primary care, family medicine, and internal medicine. In fact, the whole segment of that, in the company I worked in, was for that. So, you could do that.

You could also use this, by the way, any of these things, as a segue. I mean, mine is the expert network consultant, but a segue to get into full-time work. If it is what you choose to do and say, "Listen, I just don't wanna do clinical medicine anymore. I have to determine this is not for me." I mean, unfortunately, that's what happens sometimes. It's nothing—somebody's choice.

You could use this because many of these companies will ask you, "Have you had any work before? Have you done this before? Have you done disability file review? Have you done medical assessment review before?" Yes, I have. I've done, you know, X, Y, and Z, and this is what I've done. "Okay, great." And they'll interview you. This is why people have a problem getting in at the ground floor if they want to convert to full-time. If that's what they choose to do, it's because they don't have the experience. This is a way to get experience.

John: One of the things in my little research I've done on this topic is looking at Social Security disability file reviews. And that one seems to be a unique animal. Have you ever done those for Social Security? I think they have different companies specifically that only do SSDI-type reviews.

Dr. Robert Cooper: I have a friend that does that for endocrinology. But the problem is they don’t pay well. Private insurances, the vendors, the ones that deal with private insurance, pay much more. So it's not uncommon to get about a third or a half. She actually looks at me and says, "Oh my God, you're getting that kind of thing for doing it for the vendors? That's ridiculous, I'm getting nothing." And so I don’t, and I get those rates back, and they come back to me. And then, you know, people come to me and they'll approach me all the time. Today I had three of them approach me. "Would you like to do some work for us?" And I just look at it and say, "It's not worth it for me to do what I make." It’s not gonna do it. And I think once you get to the point where you're comfortable doing this, you’re gonna realize that and say, "You know, I’ve just not." It’s better to walk away.

John: Well, that’s good to know. I’ll just stop even trying because it’s been difficult to get any information on the SSDI ones, but they don’t pay well. What’s the point? Are there other types of chart reviews? This one, I get this question all the time. I know, for example, that state medical societies, you know, they have quality reviews. Those are pretty few and far between. But any other types of, you know, more or less paperwork, file review, based on your clinical knowledge that you've done or that you know of?

Dr. Robert Cooper: The medical necessity ones are good ones actually too, because they could be quick sometimes. Unfortunately, they don’t pay as much as the disability ones. But some of the private vendors will pay fairly well for a medical necessity review. The big thing about— I didn’t talk about this—but the peer-to-peer phone calls, those can be challenging. So you have to have a thick neck about you, particularly when you're doing a peer-to-peer for a medical necessity review. But I worked full-time for the insurance company. Every day was filled with these peer-to-peers. And eventually, after about two or three months, I said, "Uh-uh, no more." I went back to clinical medicine because I just didn’t want to. I was just... But doing it on a part-time basis, you know, and calling up, you can conduct these, and it's an act of doing this. You have to have a knack for doing this and calling up, but it’s a challenge sometimes. Because physicians are generally, you know, not going to be amenable. You know, they’re frustrated and upset. You’re calling them up and telling them that you're going to deny something or you don’t have the adequate information, and they're gonna come back at you. But there’s a way to handle yourself in both these things. And that includes disability file reviews too, because there’s peer-to-peer for that as well when you're calling up the attorney position. So you get that a lot too. So you have to be willing to do that. Some people are, some people aren’t. And just handle that. I mean, everything has its pros and cons. Every one of these things, okay? So you have to kind of take the good with the bad when you're doing it.

John: Well, yeah, I guess, you know, each person has to sort of assess what they’re good at, what they’re interested in. You know, I’m a meticulous person. Maybe that helps in certain situations. Maybe it doesn’t help in others. I was going to also ask your opinion, switching gears here, on some follow-up on—you've been, in the past, an expert witness, which, you know, as you mentioned earlier, in the field of endocrinology. But what advice would you have for physicians who maybe are still working, you know, part-time, thinking about entering that field?

Dr. Robert Cooper: It’s a good field. It’s very lucrative. I mean, it’s not uncommon for somebody to charge upwards of up to a thousand dollars an hour in some cases for some specialties. I mean, it sounds great, but it has its problems too. I mean, you have to have a thick neck. I mean, just sitting in the seat I'm in right now—I told you last week, I had a deposition. I was deposed actually on a case. I have another case that’s going on that I’m getting subpoenaed in. I might have to travel to a different state—it’s a criminal case that spun out of a civil case. I mean, I’ve never had that happen before in the years I’ve been doing it, but I mean, these things happen, and they can be disruptive to practice. They can be disruptive to doing it. You have to have a contract in place. I mean, all these things are important. They're not something that you just kind of throw yourself into. And you have to be able to carry yourself well to be able to do that.

I mean, writing an expert report is very important. I mean, SEEK has some courses on this, how to do it. There's a great book on that too, but I think also being coached—like, how do I write a report? How do I put one together that's going to make sense, that's going to flow? Because the better your report is, the less chance you're going to be deposed or put to court because it's going to settle most of these cases. So you have to learn that. It's the kind of thing that you learn as you go along.

So again, you need to enact this—kind of figuring out what is the best way to put a good report together, different stages, learning a little bit about law and how it works, and the evolution of a case. How do you get deposed? When you get deposed, how do you handle yourself during a deposition? How do you handle yourself during a trial? These are all things to consider because if you screw up a couple of times, you're not going to get asked again to do any cases.

So it's all about putting your hands into one thing. You know, I always step back and say, "You know what, I want to do a good job. I really do, as an expert witness." But if, for some reason, something out of my control happens—and it does sometimes—that I get looked upon or frowned upon negatively for whatever reason, I have something else to fall back on. I can do other work. I don't have to throw myself into one particular thing. That's how I always look at it. I still want to do a good job.

John: Let me ask you this, because this comes up, I think, in others I’ve spoken with who are looking to get more and more into expert witness consulting. I guess, marketing themselves—how do they find clients or attorneys? Do they just come to you when you've done this just because of your local notoriety? Or do you have a process for trying to get visibility for some of these attorneys who are looking for help?

Dr. Robert Cooper: First off, you have to be careful with that. If you start listing yourself all over the place, that's going to come up during deposition. It came up last week. "How many directories are you in, Dr. Cooper? How many times do you do this? What are you doing?" Because they're looking for people that are hired guns and trying to nail them on that. So actually, I don’t list myself in anything except SEEK. SEEK is the only directory I list. I’ll make a little plug because they’re a good company.

I just had somebody call me right before I got on the phone with you, saying, "You know, the spam call—it wasn't a spam call—it was somebody trying to get me into a directory." I just quickly got them out of there. "How much money is it going to cost me? What is it going to do?" I really don't have a need to list myself in 16 different directories. I've never really found it to be helpful.

I think the best thing is word of mouth. When you do a good job, the next thing that happens is the next attorney tells somebody else about it. Then they call you and say, "You know, you worked with my friend on a case, and I want to work with you too as well. I've heard that you are pretty good. You're responsive, you get back to me, and you're available."

I think calling people—like if an expert, if an attorney calls you—you need to get on the phone with that attorney the same day, within an hour or two. Get on the phone and respond to that attorney, saying, "What's the deal?" And also, you're interviewing them too. You don’t want to get involved with any type of attorney who’s not doing anything ethical. Everything has got to be ethical. It’s got to be impartial. You don’t want to come across as somebody who’s biased during a case.

These are all things you learn as you do it. There’s a way to conduct yourself. It’s very, very important. You don’t just jump into these things—you have to know what to do to provide a good product.

John: I think that particular one—the expert witness—it’s a good combination because you're acting as a physician, as an expert, as a professional, but at the same time, it’s a business if you decide to continue doing it on a regular basis. So you have to know about those resources, like the SEEK list of available consultants.

And again, there are places where you can learn—SEEK included—that, you know, maybe give you a little advice on how to prepare for these things. And if you're doing your first deposition, that kind of thing. So that's always been interesting to me.

Dr. Robert Cooper: Yeah, oh, sure. It's a very interesting thing. I mean, I've done probably over 100 cases in expert witness work over the last 10 years. And I would say that I've had everything from somebody having a terrorist attack and blowing up the pituitary gland in our country and having me testify in that to, you know, hypoglycemic episodes in jail and things like that. I've had cases like that. I mean, it's so fascinating. It really is. You find yourself like a detective. Many times, I've come back to an attorney and said, "You know what, you don't have a case here." They don't want to hear that, but you don't have a case. You have to be honest, very honest with your attorneys that are coming to you. Very ethical and very honest. This is very important, any of the work you do.

John: Well, they might not like to hear that, but better that than they waste tens of thousands of dollars and find out at the end that they don't have a worthwhile case at that point.

Dr. Robert Cooper: That's right.

John: All right, well, have there been any of these other side gigs, consulting types of things, and reviews that we haven't learned yet from you, any others, examples, or have we kind of covered the majority today?

Dr. Robert Cooper: Well, there is another thing I do—I love actually too. I teach actually, I teach at a, there's a company called MCE—I'll just be specific I guess about that. Cause I teach that once a year or twice a year, they have me fly out somewhere and teach primary care and I love it actually. I really enjoy it. We have about 150 people there sometimes and it's on it, usually it's on endocrinology review for primary care. And I've enjoyed that. I've had two stints in Disney world already.

John: Oh yeah?

Dr. Robert Cooper: Where I've gone out there and done that. And I love having people respond back and ask questions.

John: So that's just like a continuing education for physicians?

Dr. Robert Cooper: Yeah, that's right. That's right.

John: Okay.

Dr. Robert Cooper: Another part of this that we didn't talk about actually, too. Maybe we should at some point. Maybe we've done now. Locums. Locums are a way to freedom, actually, too. And I think I've done that. I've done a lot of locums work in the past. I don't now. I'm permanent. But it's some of the best freedom you can get. And if you're like in this position right now where you're kind of considering, like, I think I would just say to your viewers, if you're in a position where you say, "Oh my God, I can't go back to work," and you have that feeling in your stomach on Sunday night, like I've had a couple of times, think back for a second and say to yourself, "Hey, why do I feel that way?" That's the first thing—introspection. Why do I feel that way? Is it something that I could change in the environment I'm in first that could actually make things better? Or, if it's not, is it a different environment clinically that I could be in? Or do I need to figure out a way to integrate this other stuff maybe into place that I could do it so I could cut back on that? Because I don't think it's all or nothing.

I see people at SEEK when I taught this year. They come up to me at lunch and say to me, they sit down—we have like a group of, like, I have 50 people sitting next to me—and they say, "How do you kind of get away from this?" One physician came to me and said to me, "When I was pregnant, I was sitting on my bed. They were giving me an epidural, and the administrators were coming over to me, saying, 'Look at the computer at the CMR, at the letter on medical records, and go back to the records.'" And I said, "I can't believe that." She said to me, "How do you function in that environment? This is what I'm going through," she said. "I have to find some relief," she said, "because I don't have a break ever." I find that so difficult to deal with. I mean, you have to be able to practice. Medicine is a great field to be in. It's a great thing to be a physician, regardless of what specialty you're in. But I think you have to do it on your own terms. You can't have that plugging and deal dread and stuff. So that's the important point, actually, too.

John: Yeah, absolutely. And... You shouldn't put up with being burnt out and frustrated and unfulfilled for too long. You can do it for a little while, but you don't need to put up with that. Because really, as you said earlier, physicians, they have a lot of information, a lot of knowledge, skills, and it's all very valuable if you can leverage it to your advantage.

Dr. Robert Cooper: I think the thing about locums, I was going to say before, just to get back to that for a second, we used to think of locums as being outsiders. But the truth of the matter is that locums are actually becoming sort of the norm, almost.

John: Right.

Dr. Robert Cooper: That's not a great... I mean, it's getting competitive, actually, to get a locum position or something like that. Because there's a shortage of positions, people are looking. But there are some great companies out there that do locums kinds of activity, a call, and they can really provide you with some great experiences to do it, too. I mean, it may not be for everybody, but it's a way to sort of break away.

John: Yeah, I think if you're feeling desperate, you might as well consider everything and narrow it down, maybe, to what fits best. But locums and part-time work and consulting and telemedicine, you know, is another option.

Dr. Robert Cooper: Yeah, right.

John: So, let's see. So, you told me that you like to help other physicians learn this stuff. You're teaching at SEEK and other places. So, let's see if someone would want to get a hold of you, learn more about what you've been doing, and get some help. I think you are on LinkedIn, is that correct?

Dr. Robert Cooper: That's right. I have a website. You have it there. RJCmedicalconsulting.com.

John: Okay. RJCmedicalconsulting.com. Okay, go ahead.

Dr. Robert Cooper: Correct, correct. I'm looking at some point maybe in... I actually developed a course already for leveraging medical. I haven't done it yet. I'm looking to see if there's any traction, if people want to take it. And when I get a critical volume of people together, I might do that, actually, too—online or in person at some point. And I, you know, all these topics, I think, as I mentioned before, preparation and learning how to do it is very important. So, you know, you could direct them there to that website, and certainly, they can.

John: Yep, I will put those links in the show notes, along with a transcript of our whole conversation. And yeah, maybe they should reach out and at least maybe follow you or connect with you on LinkedIn and then look at the website for more information.

Dr. Robert Cooper: The other thing I haven't done, but if anybody is interested, if they want me to come out and give a lecture at one of the meetings, either a keynote or something else on this particular topic, I'm happy to come out there too. So I'll just ask you that.

John: Yeah, absolutely. In fact, I'll mention this. I haven't talked about this in the podcast much, but when you talk about these opportunities and sort of the non-clinical side of things, most of the time, it still qualifies as CME. So, some of these organizations can actually give you CME credit for it because it's something that supplements your practice. And, as I think you have said in the past, you know, like when you're doing expert witness work, you actually become a better physician. To prepare for that, you have to. So, that's all good stuff for CME.

Dr. Robert Cooper: Absolutely right, absolutely right. And even expert network consulting stuff—you learn things. And things that you wouldn’t know are coming—ARE coming and are the wave of the future. And it really keeps you up to date on what’s happening. It makes it diversified. So it gives a different meaning to going in every day and seeing patients.

John: Exactly.

Dr. Robert Cooper: When you're doing it.

John: Exactly. All right, well, I think we're pretty much at our time now. So I want to say thank you very much for joining me today, Robert. This has been great. And I think the listeners will really appreciate all the wisdom you've shared with us today.

Dr. Robert Cooper: Thank you for having me on. I hope that reaches people and hopefully, we can help them.

John: I'm sure it will. All right. Bye now.

Dr. Robert Cooper: Thanks, John.

Transcription PNC Podcast Episode 391

How To Be A Stunning Success Doing Part-Time Consulting

- Interview with Dr. Robert Cooper - Part 1

John: Today's guest is a specialist as a practicing physician, but I bring that up because in the world of physician non-clinical careers, I consider him sort of a generalist because he's done different side gigs and actually some things that are clinical and unconventional clinical. And so he's worked so many numerous side jobs that they're very interesting. And I thought, well, this is going to be really good because doing this kind of helps you avoid burnout. It's interesting, keeps things interesting. You make a little extra income and there's lots of opportunities for physicians. With that, welcome to the podcast, Dr. Robert Cooper.

Dr. Robert Cooper: Thank you very much for having me. It's a pleasure being here, both an honor and a pleasure. I can tell you, I listen to your podcast all the time and it's my favorite thing to do on the treadmill when I'm listening. I've got some great segments there that I've listened to and learned from too as well. So I'm happy to be here contributing. Thank you so much for having me.

John: I love that. I love that. But I think you have a ton to share and maybe some of the things I don't know if you found all these things yourself, or maybe there was something mentioned by one of my guests. It doesn't really matter. This is all going to be helpful. And I'm really happy to have you here to tell us about some of these things. So let's start by just introduce yourself in terms of who you are, what you do, mainly your clinical background, maybe, and clinical work that you've done through your career.

Dr. Robert Cooper: I'm a regular doc. I'm an endocrinologist. I started my training in New York. I trained at Albert Einstein in the Bronx, went on to do a residency at Long Island Jewish, then went on to do a fellowship at Long Island. And I have an entrepreneur spirit about me. So when I finished my training, I was the first endocrinologist out in the Hamptons.

And I enjoyed that, but having your own practice is very difficult these days, even then. When I first started medical school, I had no idea of managed care. I came in because I wanted to be, I actually wanted to be a family doc and I wanted to have people come to my house and set up a shingle.

I went to a very expensive medical school as I said, and I am still paying back my loans, but anyway, but I enjoyed, I enjoyed medicine to this day. I know my son is a medical student. He's a fourth year medical student now, finishing up his rotations and actually going for the match. And he's asked me many times would you go into medicine again? I said, absolutely. I think this is a great time to be in medicine. I actually despite what people say and the naysayers, I love what I do. I love practicing. I love seeing patients, but I like doing it on my terms.

That's the key thing here, John. When I was out in practice, I then got recruited to Western Massachusetts to a place over in Western Massachusetts to run the fellowship there. And I did it the traditional way. And I was in academic medicine and so forth. And there was issues and things like that. And I've been in different places in Western Massachusetts. About 10 or 15 years ago, I looked at, well, I'm not going to go any further. I want you to ask some questions.

John: No, tell me what happened then. Something changed at that point. Practice was okay. It was good. It was fun, but what happened?

Dr. Robert Cooper: It's always been good. But I think I answered an ad actually to do disability file reviews in the New England Journal of Medicine for a company, a small company at that point, so small that my son actually went out to Maine actually. And we went to dinner with the CEO of the company actually. And he still remembers that this day he's 24 years old now. And I started doing disability file reviews at that point. I learned how to do it. You have to learn how to do this stuff. It's very important to learn and to produce a good product. You can't just get thrown in there.

I think there's something I had to learn on my own over years. And that was my first real stint towards nonclinical medicine. And then I learned other companies and I learned how to do it well. And at points in time, I've taken other nonclinical responsibilities as well. That was my first break in to nonclinical. But what I like about it is that I could do things, as you said, in combination. The key to this whole thing, I think, and this is a little words of wisdom if you're going for practicing 30 years, is not to put your hand into one thing. I always say, I taught at SEAK as you mentioned before at SEAK. And when I put my hand, you put your hand into one thing, I tell the audience, it gets chopped off your hand.

And that's true of clinical medicine. That's true of being all in full time sometimes. That's true of being an all in employed as an insurance person. That's true as being all in you do it in little bits of pieces of each thing, actually, too. It makes the best thing because nobody has complete control of you. You have control of yourself. It's on your own terms. We as physicians are very independent people. That's why we went into medicine to begin with. And then now what happens is that all of a sudden we're being controlled. And we don't like that. I don't blame anybody for doing that.

And the problem is as you pointed out, I said before about burnout. And I hate to see physicians burn out. We have a shortage of physicians right now, a shortage of primary care, a shortage of specialists. I would like to see people remain in medicine, quite frankly, but to a certain degree. it's not for everybody.

But I think at some point also in time, if somebody could combine the nonclinical and leverage that as well and stay in clinical medicine, we'd be all better off as well as the person, maybe if they wanted to be and the population at large.

John: Absolutely. That's actually one of the reasons why I wanted you to come on, because I've seen this before where still being in clinical, but maybe cutting back a little bit, doing other things to give you that feeling of autonomy, give you that sense that, okay, you're not if this company goes out of business, if this hospital closes, I'm not going to have a job. And it also helps prevent burnout because it's just the variety and the interest. And I think there's a lot of advantages to it. I'm interested in hearing more. Why don't you run down a list, maybe without going into any depth, just in some of the things you've done over the years, even some of those things, maybe that you're not doing any longer.

Dr. Robert Cooper: Yeah. I'll outline the four things I think I do the most of, and some of it fades in and out. It depends. The thing I do, I mentioned before, disability-followed consulting. I've done that both with the vendors, part-time basis. I've also worked as an independent contracting physician for a major insurance company, 10 hours a week. And that required a little stress. You have to understand something else. I just want to step back for a stressful situations because it can be just as stressful as clinical medicine.

You want to step back and look at this and how much you could take on and so forth. And so I did that, that medical necessity reviews is also part of file review. And that's also something that I've enjoyed doing through vendors. I also worked full-time for a short period of time for an insurance company doing that as well. I didn't care for it too much. I can tell you, it's my own personal thing, but I just say, it's not peaches and cream that people would say, come on sometimes.

That's another end of it, the whole thing. I've done all, the thing I really like doing, and I've done more recently is expert network consulting. That is a wonderful way to do it. People don't know about this. I've gotten into in terms of providing expertise to nonclinical people, Wall Street people, in a way that provides just public information to platforms, but not getting specific about the platforms, but I it is something that is very lucrative. It pays almost as much or as much as expert witness consulting, which I've done also, another one of my things.

I find it to be very fascinating and I love teaching. To me, teaching is teaching fellows and residents in the past. Here, I'm actually teaching people that are brokers or people that are actually doing, or they're sometimes scientific people trying to develop a drug and diabetes or something. I'm an endocrinologist, so I'm doing that. And you could teach people how to, but basically any specialty can do this really, as long as you're doing a little bit of practice most of the time, I think, and you could combine this.

And I can tell you, I will say to you this, that with the nonclinical stuff I did, I told you before, I have a son in medical school who has a huge tuition in Boston and a very good school. I doubled my salary clinically as an endocrinologist last year, last two years doing this, working four days a week, full time. And one day a week doing the nonclinical stuff. If that's your avenue is to get in and make more money and you don't necessarily want to cut back your clinical stuff, that's okay too so you can do that. And it's been really great that way too.

You have to know how to do these things. It doesn't come just with sitting down. We didn't go, we didn't just get put into an exam room and have to examine patients. We went through years of training and residency and so forth, the same thing here. You'd have to know how to do it. You have to know how to be coached, what to do, and kind of how to come up with a good product.

People want a good product like anything else. And when you have to produce that good product, they keep coming back over and over and over again, and they'll pay you what you want, quite frankly.

I think having that, I tell my son who's graduating. I said he's going to go on and do a residency. And I said even if you didn't have that residency, you should have, I'll finish it and do it. But just having that degree, the fact that we went through what we did is, you mentioned this many times on the podcast I've listened to before, being a physician and having that amount of knowledge and be able to pick up on things, we're in a perfect position to do all this type of consulting.

And so, the thing is that doctors don't realize is they're in demand, not just clinically, but nonclinically. They're in huge demand, but they undervalue themselves. This is an important point. And this is another Cooper point.

Number two, I'll just say, it's this, walk away from an opportunity that doesn't pay, that undervalues you. People gravitate to these opportunities that I find disgraceful, actually, in terms of what they do. And that can be any breadth of thing, of the things I'm talking about. Walk away. It's more important to walk away, actually, and not get the opportunity, but to take the opportunity and undersell yourself. Very important point that I've learned.

John: Yeah, I think there's nothing wrong with trying different things. But as you said, if it's not really going to be worth the time, because our time is probably our most valuable asset other than our medical knowledge, then you just should move on or take the time back and spend it with your family.

Dr. Robert Cooper: Exactly right.

John: So let's see, why don't you pick one of those? I'm interested in everything you've said so far, but the expert network consulting, how did you personally find this? Is there any ideas you can give us in terms of how to locate some of those? And then what is it you need to know to be able to do? What are they actually looking for based on what you've done so far with that?

Dr. Robert Cooper: They're looking for people who practice, who have some sort of basis, but actually could even do it without practicing. They had knowledge of the scientific basis behind it, some consults. You get these surveys sometimes that come to you through, I guess, a company called Sago or Schlesinger or other companies like that.

I don't want to go into specific companies, as I said before, but I could certainly talk about that individually with the guests that want to do that. But I think that you get these companies that will approach you sometimes and ask you for your expertise, spend an hour or so. In fact, before I got on the line with you today, I spent three hours downstairs working on three different consultations, three different ones today, because I'm "off" on Fridays.

I was working on that, but really, it's just phenomenal in terms of that. So how did I come into this? All of this is really, things just come to me, I think, somehow. When you put yourself out there, that's the key. I have a LinkedIn page and I'd like myself open to opportunities. People will come to you and they see your profile, but the most important thing is when they come to you is being receptive, A. B, providing a good product. When you're on the phone with an hour with somebody coming on that's asking you about a diabetic product or something, or asking you about the sensors or something for how you feel about this different sensors, you want to provide insight into what you do.

We all know this already. I don't have anything non-public. The key thing you have to worry about with this is that you don't want to provide anything that's non-public. That could be construed as you get arrested for doing something like that or have really a problem. So you want to provide all public information that you're not from clinical trials or anything, but I don't know anything non-public. Most of us don't. We're not involved in clinical trials. We just do what we do each day, but that's what they want to know about.

These platforms, expert network platforms are looking for people. They keep asking me, can you refer somebody an endocrinologist, another endocrinologist? I get things that sometimes are outside my field of expertise. I never take anything that's outside my field of expertise. I will not feel uncomfortable with that. I will not do it. I will pass up on it. That's important actually not to do that, but I will go on and I will refer people sometimes to it. I've never actually gotten a commission for doing it.

If you refer people and they actually do consults, you can actually get a commission for it, but I've never actually seen anything like that, but that's okay. But anyway, I think you could get, there's multiple different platforms that are out there that you could look up and research, expert network platforms and do it. It's not perfect.

There are downsides to it. I taught a course at SEAK last year on this, and I think they're making that, they're a good organization, SEAK, and they're making it available too. I think they recorded me part of it, but I think they're making it available as well. But I also have my own course that I've taught already at SEAK.

John: Well, let me ask you this thing just to dig into it a little bit. When I'm online, I've had a LinkedIn profile for a while. And then again, the email addresses get out there, but are you saying that of the expert network consulting platforms, most of those coming through LinkedIn? Do you ever get just blind emails coming in?

Dr. Robert Cooper: Yeah, I do get blind emails coming in from different companies I even heard about before asking me, I've heard that you do this kind of work. Are you interested in joining our platform? Are you interested in doing a one-off consult? The nice things about these one-off is that you don't have to really, but I do prepare for it. There is a way to prepare for it. I wouldn't say I didn't prepare for it. And I could certainly go into elaboration about that in terms of looking at investor conferences. I find myself sometimes looking at that more than I do scientific conferences on different drugs and things like that. So I do prepare for it.

I want to provide a good product when I get online for an hour. Because if you spend an hour and you don't provide anything, I don't think anybody's going to want to come back to you again. It's like anything else. Even the expert witness work, you want to provide a good product when you're going through that. Disability file reviews, anything.

I think that it's important to prepare and to be ready for it. You also have to have a certain mindset when you do these consults. You have to be relaxed. I think the best investment you can make is to buy a headphone, a head jack, just to put it on because it frees you up and you can look at the computer at the same time. You want to get information. That sounds like a simple thing. I think it was a few dollars to buy the headphone investment for me.

But that was a very important thing. I'm not fumbling with the phone when I'm doing it. These are little tricks that you learn as you go along that you wouldn't know about. How do you conduct yourself? How do you continue to keep the conversation flowing? That's an important asset to have that. If you just stay still and don't elaborate or know something and don't talk about it, you're not going to get that across and you're not going to get the best outcome. So I think that there's a way to train people how to do this, I think, to some extent, to make them more effective.

John: Let me ask one more question about this and then we'll move on. I've never participated in that kind of thing, but I always kind of get the sense that from the invitation, sometimes it sounds like it's a one-on-one conversation. Other times it sounds like it's kind of a panel. For the ones that you've experienced, what is it like? Is it just getting on a Zoom call with somebody? Is it more of a multi-person call?

Dr. Robert Cooper: It's all the above. The ones that are multiple ones. Sometimes I'm actually listed as, I do a lecture actually, where I'm lecturing to a group of investors actually. For that, I charge more money for that. I actually have rates that I charge. And that's another thing. I'm not going to go into that now, but I would tell you that I do that and I charge more and I charge a minimum of 60 minutes. That's another important point. I don't prorate it because I don't want to be on a line for 15 minutes and waste my time when it's an hour I could be getting from somebody.

There's a whole series of things I've learned, how to maximize your time and your profitability when you're doing this. But it can be, I actually had times when I've actually had to travel New York City or Boston, I live in Western Massachusetts, to do something.

I always tell the story at SEAK when I'm there, that they had me, it's a funny story actually. They had me actually go to Boston to do, I think it was Sago or one of those companies, to go to Boston to insert into a dummy, a device for diabetes. They had me come there and they were actually paying $1,500 to do this plus travel for an hour's worth of work. Think about that for a second. That's not uncommon, by the way, to have that happen. I got this thing and I went and traveled into Boston. I'm sitting there, there's a one-way mirror actually on this place that I'm working on. I'm trying to put this thing and I was a cardiology fellow before I became an endocrine fellow for a couple of months. A little bit manual, not that disastrous. I'm trying to put this device into the dummy and I can't do it. I'm putting it in the wrong place. They must've been laughing at me behind the mirror. I can guarantee you.

And then they came out and I said, oh my God, they're not going to pay me because I didn't do anything right. They came back and they handed me a check and they said to me, that's exactly what we wanted to know, Dr. Cooper. We wanted to know how to put it in. We wanted to figure out whether endocrinologists were capable of doing this. That was the whole point of this. Thank you so much for your help. And they handed me a check.

John: Interesting. They learned they have to change it if they're going to involve an endocrinologists I guess.

Dr. Robert Cooper: That's right. But they're looking to learn. Exactly.