Categories
All posts Entrepreneurship Medical Career Telemedicine

Earning A Living With A Telemedicine Career

I just finished another interview with yet another telemedicine group. It’s a publicly traded company with a fairly decent business model. I’m in the credentialing process with them for doing telemedicine. In this post I want to talk about pursuing a telemedicine career.

I thought it would be a great time to throw up a post about doing telemedicine to earn a living. I’ve done it for a while now. It has been lucrative and offers me the opportunity to work from anywhere.

This post is supposed to be a summary of how to go about replicating a similar lifestyle building a telemedicine career.

 

Real Medicine vs Telemedicine

I want to be cautious how I word my thoughts but I don’t consider telemedicine a real form of medicine, it’s more of a stopgap measure and probably more of a customer convenience option.

The skills of practicing real medicine are learned at the bedside. It comes from seeing the same diagnosis present in multiple different ways. The physical exam and the experience from consulting with your colleagues is not something that a telemedicine career will offer.

 

1. Applying For Telemedicine JobS

Seems as though I have this process down. I search the media for mention of telemedicine companies, I go on their website, scroll to the bottom, and often find a link that says “physician/provider” or something like that.

I then get contacted by a recruiter to schedule an info session, followed by an interview with a medical director.

The info session with the recruiter informs you how much you’ll make per patient. They will tell you that you’ll be an independent contractor and that you’ll need to pass a background check before being hired.

If you have telemedicine experience and if you know how to use a computer, that’ll be a big plus. Note that even though you want to create a telemedicine career, most companies will want you to still have some presence in a physical clinic to keep up your skills.

 

2. Earning Telemedicine Income

You will get paid a 1099 by most companies. There is always a chance to hop on part-time or full-time but why would you do that? You can be your own boss, set your own hours, and dictate your pace as an independent contractor.

It’s fair to say that you can earn around $30 per patient if it involves video or a telephone call. You’ll make less if it’s a text-based interaction.

As I am writing this post I have my American Well screen open on another laptop and when a patient gets put on my schedule then I walk over to my “station” and handle it. I make anywhere from $30-60/patient depending on what insurance they have.

With enough volume I can easily see 5 patients an hour without breaking a sweat. That’s $150/hour gross. If I see fewer patients that’s alright because my downtime wasn’t wasted – I am often at home getting other things done.

A Few Hours A Day

Using only JustAnswer and American Well as an example, I can spend about 1.25 hours a day and earn $3k/month gross from JA. Add another 1 hour a day for AW and I could pull in another $3k/month – gross.

2 hours a day = $6k/month. 

I work when I want.
At my own pace.
In the comfort of wherever I am.
Without a commute.
Without a supervisor on my ass.
Without having to put on gloves.
Without dealing with volcanic patients.

$6k a month seems like so little to healthcare professionals but it’s an amazing income for others. Don’t forget that you no longer would have the expenses associated with having to show up to a job. Which means you’ll save on:

  • food
  • childcare
  • transportation
  • insurance
  • commute time
  • clothing
  • health
  • housing
  • taxes
  • electricity
  • water
  • cell phone

 

Taxes

Obviously if $6k/month isn’t enough money for you then you’d work more. It looks like a full-time gig at reputable telemedicine companies will get you at the very least a $200,000 annual income.

The nice thing about 1099 income is that you can write off anything associated with work. Whatever is left over you can either deposit into a retirement account or spend on your overhead. This flexibility is unique to being an independent contractor and more healthcare professionals should consider this option.

Read this post on how to transition from full-time to per diem.

Retirement

There isn’t anything terribly special about the 401k that your employer offers. Neither is the 401k match. You can create your own Solo 401k plan through the major brokerage houses. You can even do your own matching.

If you want to get fancy then create a non-profit entity and make yourself the employee. You’ll get massive tax breaks and write-offs and you’ll still earn a healthy living doing something meaningful with the rest of the income.

 

3. Working A Telemedicine Week

So what’s it like working a telemedicine career on your own time, from your own home, with your own hardware?

The logistics aren’t that hard and you’ll get into the groove fairly quickly. At first it’s really miserable because apparently hardware and software were never meant to work together so it’s impossible for both to behave properly simultaneously.

I decided to get a dedicated laptop for my telemedicine work. I’m also a bit of a security nut so I try to be incredibly careful with installing anything on my personal laptop.

I know what times are the busiest on each platform so I turn on my laptop and log onto those websites at peak times. If it’s going well then I keep answering patients. If it seems like a drag or it’s slow then I put the laptop away and try again in a couple of hours.

I set a financial goal for myself and turn off the computer once I’ve made my projected amount. It’s hard because it seems like such easy money to say no to. But this way I leave a little more for other clinicians and don’t burn myself out.

 

4. The Best of A Telemedicine Career

Here is a list of what I enjoy the most about earning an income through a telemedicine career:

  • I can work whenever I want
  • I can work based on how much income I want
  • I don’t have to commute
  • No time commitment
  • 1099 income which saves me taxes
  • I can concoct my own retirement plan
  • I can capitalize on my time efficiency
  • Work from any location (cafe/library/strip club)
  • Work from any country
  • Work in my Pink Panther boxers

There is something very pleasant about helping someone with assistance of technology. Especially when the person has no other means of getting access.

The pay is quite reasonable since the scope of work is limited. I never see high acuity and it’s relatively easy to refer a patient back to their PCP or recommend being seen in the urgent care if an in-person visit is needed.

Patients value being reassured and are willing to pay good money to feel heard and have all their questions answered without feeling the rush of the outpatient clinic setting.

 

5. The Worst of Telemed

I’ve identified 3 major points which are the negative aspects of pursuing a telemedicine career.

Typing & Technology

It can get frustrating having to be glued to a monitor or your phone for extended periods of time. Not only is it tough on your neck and eyes but it can really exhaust your wrists.

For the most part technology is reliable but when you have a scheduled shift that you must report to then everything has to go right. There are no excuses.

I’ve had the sound on my laptop just decide to not work.
I’ve had problems starting my laptop.
I was unable to connect to the internet even though there was a connection.
I couldn’t get the VPN to work.
I couldn’t place a single call from my phone.

During each of these events that I recall, it’s been incredibly fortunate to have a backup device. When my laptop didn’t work then I hopped on my phone. If that didn’t work then I’d hop on my laptop.

Read about my telemedicine gadgetry here.

Repetition

It gets repetitive even when we’re in the office but at least there are different faces, different rooms, different staff, and different nuances. When doing telemedicine it’s the same penis pictures, the same scabies, and eczema pictures.

You will hear & see the same congested, runny nose, coughing patient on the video visit during cold and flu season. They will have same exact complaint as the other 25 patients that day. And you will have the same exact spiel to offer them.

One thing that has been really helpful is changing up the times in the day that I do my shifts. Doing a part of my work with telephone and another with video changes things up a little.

Difficult Patients

It’s tough for a patient to navigate the US healthcare system. But on video/phone visits patients are incredibly polite.

However on text visits some patients lose all inhibition and can get incredibly rude. If you are working on multiple platforms then it makes it easier to opt out of a consult with a rude patient. But if it’s a full-time gig for you, then your customer service side needs to be that much more polished.

I have found that the biggest reason is that patients are pissed that I gave them such a simple answer and they are about to be charged $x. So what I often say is that they should ask me whatever else comes to mind regarding their issue and if in the end they aren’t happy then I’ll try my best to get them a refund. This works 80% of the time – they leave happy and don’t request a refund.

Should you change jobs or remain where you are?

20 replies on “Earning A Living With A Telemedicine Career”

Dr. Mo, Thank you for your article. Are you working for American Well telemedicine from oversees? I was told that they only work domestically.

To directly answer your question, yes, I am logging on to American Well while physically residing in Spain. The more detailed answer is that I have reviewed all the hiring documents and their employee handouts and it only states that I have to be a US resident which means that I cannot spend more than 180 days outside of the US in a calendar year.
I am currently dealing with a similar issue with another medical group that I work for. It appears that they aren’t okay with me working from another country but they actually don’t have a policy since it has never come up.

I’m a bit of stickler for this stuff so if a company hires me and then decides to change the terms on me, I’m going to respectfully retaliate. If your physical location is the issue then I’d advise you to not reveal to your employer where you’re working – they have no right to that information. They only have the right to your mailing address.
If your virtual location is of concern then use a VPN such as TunnelBear and for a very low price you can have you IP address show US or Uganda.

As to the point that you were told you have to be domestic, who told you that, HR? My HR at Kaiser said the same thing so I asked for documentation. They couldn’t provide it and of course now it’s escalated (in a very civil manner) to the legal department who wants to discuss the situation with me.

Hope this long-winded answer helped.

Hello Dr Mo,
I was wandering what do you use as a phone service for the phone only telemedicine patients while you are overseas. Are you able to use any voip works on wifi? ( free) Thanks

I use Google Voice. I have a Telemedicine Gadgetry on the topic you can review. It’s quite easy making free VoIP calls through various entities.

Dr. Mo,
What are the reputable telemedicine companies that employ a board certified neurologist? I am one and I live near Portland OR. By the way I stumbled onto your blogs and very much enjoy reading them. Thank you!

I agree with Dr. Mo about the flexibility of virtual medicine. I love it as I do some at my work. I would not mind doing that 100% on my own schedule, sort of.
Not only does it save the doctor’s commute, virtual care is very much appreciated by most patients who don’t have to travel to the clinics. People who can not drive love it more. Younger generations think this is the most natural way of seeing a doctor if they have to unless they are super sick.

I would love to do a 15-20 minute consultation with you please as soon as possible. I’m a LCSW of 24 years wanting to transition into Telehealth and live in Florida. I need your advice please. Please text or call me at 630-886-6851.
What would your fee be for a 15-20 min consult ? I need your help
Please

Hello Dr. Mo,

Great blog and I appreciate the information. I am an urgent care physician who would desperately like to transition to Telemedicine.

1) Who are the best Telemedicine companies to work for?
2) Can you refuse a patient visit or must you see anyone assigned to you?
3) You have mentioned about $30 per patient but I have heard that if you set up your own EHR and billing system (ie cut out your employer), you can bring in 5x more. Any thoughts on that?

1)I’m not sure what you mean by best, I think that’s subjective. My favorite are Oscar, Teladoc, Doctor on Demand, American Well, and Roman. The last one isn’t exactly legal but they seem to be getting away with it and so it’s a gray zone I suppose.
2)You can always refuse a patient as long as you have a good reason. I have written numerous posts on the topic.
3)I have written a recent post on using VSee to setup your own telemedicine platform. I don’t understand your question in regards to setting up your own EHR – not sure how that relates to telemedicine reimbursement.

Thanks for responding. Very informative website you have here. You mentioned VSee for setting up my own telemedicine platform. So if I had VSee installed on my computer.

I would be my own boss. Correct? Meaning the entire proceeds from the visit is comes to me/my company. If that is the case, can VSee handle the billing of insurance companies for people who want to pay with insurance.

Secondly, but unrelated to above, you have mentioned targeting niche markets for telemedicine. Do you think remote management of patients with chronic conditions like diabetes or hypertension could be one of them?

Ah, okay, now I see what you’re saying.
Yes. If you see the patient and you either bill the insurance or charge the patient cash you get every last nickel and dime. You set your prices on VSee. For example, I have a 15-minute initial consult which I do for free and I have a 1-hour session for $300. That’s just me – you can do it any way you like, of course.
VSee won’t handle the billing for you, you’d have to hire a biller but if you’re doing telemedicine you really don’t need a biller because the telemedicine rates are often fixed so that will simplify things quite a bit. If you’re a specialist things might be a little different – even then, don’t see the need for a biller. You’d get a contract with the insurance company and you’d fill out the proper codes and documents they request when you see one of their patients and you request reimbursement.

I have written a ton on this topic. Yes, the more niche you go the cheaper your marketing cost and the more money you can charge – generally speaking. If you are a physician who handles only prostate enlargement for patients who don’t want surgery or you manage hair loss for those who don’t want to do laser or have plugs place …. as you can imagine, you’d be niche as fuck. You can then be the expert person in that field and your website can be very informative and rather unique. You can offer group classes for a set price (online) and then you can offer individual counseling. You can even sell some snake oil – why not, tons of doctors do it and it seems legit. Not my cup of tea but people swear by it so if you find a product or can mix several products together to make something unique then that’s the perfect thing to market to your niche patient population.
Get creative, really think about the various different patients you see. Teenage type 1 diabetic. Elderly with rheumatoid arthritis. Dry mouth patient. Dry eye patient. COPD. Hypertension. Paresthesia. MS.

Thanks immensely.

Just curious on your pricing model. Are you actually able to charge $300 for a 1hr. urgent care telemedicine visit?

And are you seeing success offering a free 15 minute initial consults. Right off the top, I would be worried that it will be abused by someone showing up under different names or my whole week could be filled with free consults.

I’m still experimenting with my pricing model and I have all sorts of other factors such as the medical boards which are limiting my ability to do what I want. I’ll share my price structures once I have more solid information. I charge $10/minute consulting on clarity.fm so I don’t think money is a limiting factor for those who value the information. The key is to finding those individuals and proving to them that you know what you’re talking about. I’ve found that the majority of my audience is very respectful of my time and doesn’t intend to abuse it. Because the information flowing out is one-directional during that initial 15-minute free consult, it’s not a matter of if someone will abuse it but if you let someone abuse your time.
Information these days is free and abundant so it’s important for medical professionals to understand that. Nothing stops a patient from finding out everything you’ve ever learned in your 4 years of medical school through an online search. It’s the added value you bring in how you deliver that information or any particular insight you might have which is overlooked by others. The 15-minute consult is often necessary when you’re planning on charging someone $300 or even $1,500 for a 1-hour session. It should be a way for you to screen out the crazies and for them to make sure that you are the right fit for them.

Got it. Makes sense. I am eager to get started. Will let you know how it goes. Enjoy your weekend.

Can you choose if you are accepting video or voice-only visits? I have kids at home that I need to keep an eye on during a phone call so having undivided video time is difficult. Also I have not really been able to find companies that are hiring that will do just texting. Any insight? Thanks!

Some states require that video be done – most telemedicine platforms have a mix of both phone and video and some have text based interactions with patients. I have listed several telemedicine companies on the website which allow for texting only – Roman and Oscar come to mind. And if you want to just offer medical expert opinions and not really do any diagnosing or treating then JustAnswer fits the ticket as well.

Hi Dr Mo,
I am a professinal holistic health care provider.
I was wondering if any of these companies hire doctors who are alternative or who do not have an M.D.
I have several degrees the highest being a D.C. (Chiropractic Medicine).
Thank you and many blessings!
Dr Ari

Hi Dr Mo,
I am a professinal holistic health care provider.
I was wondering if any of these companies hire doctors who are alternative or who do not have an M.D.
I have several degrees the highest being a D.C. (Chiropractic Medicine).
Thank you and many blessings!
Dr Ari

So far I haven’t see that be the case because there are some insurance restrictions and the time needed per patient would often be higher. But I can certainly see a huge niche for such a DTC telemedicine company.

Leave a Reply

Your email address will not be published.

This site uses Akismet to reduce spam. Learn how your comment data is processed.

× How can I help you?