Goddamn I love writing about income – I might be addicted to money. This is my monthly post about my physician income. I earned $6,418 of income from 3 different sources in April 2018. 

April 2018 Physician Income

Most of my income came from one telemedicine company, Teladoc. I am focusing on this physician income stream because it’s the most lucrative at this time. Though I keep my foot in the door with the other income sources, I try to focus on what’s most lucrative. 

Approximately $5,700 of my income is pre-tax which I earn as an independent contractor and the other $400 is W2 income which means I already got taxed on that. 

Diversified Income

I am less focused on maximizing my income and more on making sure I diversify my income streams so that I don’t end up in another fucked up situation as I did with Kaiser Permanente last year. 

More income streams means less risk exposure. More importantly, I can pick between the various employers in order to maximize my income and minimize the amount of work I put in. 

This month I had income from:

1. Telemedicine
2. JustAnswer
3. University teaching

1. Telemedicine – $5,465

My physician income from this particular telemedicine company was $5,465 which was paid every 2 weeks in April. The patient volume is going down as we are nearing summer leaving me staring at the computer screen longer waiting for a patient to pop up. 

The ease of working on the Teladoc platform and not having to sign up for a shift in advance is well worth the wait and so I will keep it as one of my income arsenals. 

I maintain my efficiency by logging on through my phone app and if the volume seems low then I don’t bother logging on with my laptop. If it’s busy then I put on my headphones and see as many patients as I can. 

To prevent burning out I don’t see more than 10 patients a day and if I encounter a particularly difficult patient then I log off and call it a day. 

2. JustAnswer – $198

I try to answer a few JA questions to keep that foot in the door. At around $15/question I’m guessing I answered somewhere around 13 questions the whole month which gave me a $198 income. 

Just like Teladoc this is also pre-tax which allows me to write off more against this income and maximize my solo 401k if I choose to do so. Read more about tax strategizing below. 

I have made myself available to management to help with their chatbot development. I haven’t made any money from doing this directly but I have contributed a fair amount. I anticipate that I can land a decent consulting position if I prove valuable to them. 

3. University Teaching – $433

I got my first paycheck from the university which was exciting – $433. Professor Mo!

I was under the impression that I would be paid for office hours as well but after checking with HR I realized this was incorrect. The hourly rate is $60/hour for the 4 hours I lecture weakly. 

I have access to various employment benefits including health insurance and a few other perks. 

Taxes

I made my first estimated tax payment in April and will continue to send in quarterly estimated taxes. 

Towards the end of the year I’ll do a preliminary tax return to see if it will be worthwhile to contribute to my solo 401k. Last year it didn’t make sense to do it so I skipped it. 

What I love about earning income as an independent contractor is that I can optimize my taxes instead of relying on the shitty employee tax system. I can shuffle money around strategically to keep more money in my pockets – that’s a sort of income, isn’t it?

Optimizing Income

As an employee for Kaiser Permanente I had a limited opportunity to pick up extra shifts strategically when the volumes were low or it was cold and flu season and the cases were easier. 

As an independent contractor who contracts with multiple medical groups I don’t view myself as an employee and don’t owe them shit (-said with love). I can work for whoever pays more, is more accommodating, and where I can earn more for doing less. 

The working less isn’t about being lazy – it’s a simple risk equation. More patients equals a higher risk of a potentially adverse event.

Telemedicine Work

This month I realized that Teladoc’s volume is getting low enough that it’s not an effective use of my time. During the cold and flu season they had massive volumes and would pay premium-pay during peak volumes. 

This month I have increased my work with Doctor on Demand because I get paid for being on a shift even if I don’t see any patients which happened just last night. I saw 3 patients in 2 hours from 9pm-11pm and I still got nearly $200 for this shift while I was reading my book. 

Strategizing

Getting enough shifts as a per diem is not a simple game and all parties involved have their own agenda. The Doctor on Demand scheduler gets way too many requests for shifts but has very few shifts to give out so she sends out mass emails telling per diem doctors that there are no shifts available. 

My strategy is to send her an email every few days with my updated availabilities. Sure enough, after 2 weeks of this she has been texting me regularly as soon as a shift becomes available. And … surprisingly… there are plenty of shifts available. $$$. 

I’m her go-to doctor because I always help her out any way I can. If she has an opening from 7am-9pm then I tell her that I’ll do any 2-hour block that’s most convenient for her. 

Today I did a 2-hour block in the morning and I am going to do another 2-hour block later in the day because she needed that help – scratching her back. 

Future Income

For the month of May I’ll continue to do some telemedicine. I still have my medical license until the medical board revokes it. My lawyer and I are preparing for a hearing. If nothing else I’m delaying losing my license until I am ready to exit. 

I’ll be moving back to Spain in the next few months, still not sure for how long but I am going to want to have some income coming in during this time. 

Investment Income

My private brokerage account is getting sexier and sexier day by day. Perhaps I’ll start spending from that account’s investment returns.

The dividends alone will be a great income source but because I have separate investments in my retirement accounts I am not worried about selling some appreciated assets to live off of. 

Rental Income

I have the option of renting out my Portland condo for some income while I am away in Spain. 

The AirBnb demand here is strong and lucrative but requires a lot of email communication with clients and someone on the ground to manage the property.

My friend V. is willing to do it and I’m happy to pay for it. But after AirBnb’s fees and the multiple back and forth emails and last-minute cancellations I am not sure it’s the right option for me.

A traditional lease would let me rent the condo out for around $1,200/month with only around $400/month of expenses that I would have to cover. For my pauper ass this is a pretty good income.

Consulting

Consulting seems like a good way for me to sell my knowledge and time to whoever is willing to pay for it. Over the past few years I have made a lot of progress but I still have some work to do.

If I keep my medical license then there is a company who might hire me for a project. We’re still negotiating the terms. It might be something I enjoy.

Regional Medical Director

My regional medical director role with Spring Health is coming along better than I expected. As this medical startup is expanding to the west-coast with a new contract I will have a bigger role to play.

I won’t have to practice clinical medicine for this role, it will be a supervisory role which I can do remotely.

Teaching

I can do remote work for this university and teach online but I’m not jonesing to do that even for $60/hour. I’m really enjoying teaching the course in person.

A friend is willing to bring me on to teach her dental emergency courses if she decides to pursue that. I am not terribly excited about this but neither is she – we’ll play it by ear.

I’ve been doing research and coincidentally bumped into a woman at a local bar who teaches medical terminology in English to students in Italy. She works for a company which charges $200/hour for this service – damn.

After I looked into it some more I realized that some private tutors are pulling in $300/hour. So that’s another avenue that I’ll explore further.

Net Worth Update

My net worth is still climbing even though I haven’t invested much recently.

My focus is to keep as much cash aside as possible until the storm passes. My emergency fund is somewhere around $37,000 which makes me feel all warm and fuzzy.