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?