How Doctors Can Break Into Healthtech

In today's newsletter:

CMS gave independent primary care a structural win

Independent primary care practices participating in Advanced Payment Models can see meaningful reimbursement increases, and CMS added a new site-of-service differential that shifts some reimbursement dollars away from hospital-owned practices and toward independent ones. They also removed a longstanding billing barrier for behavioral health integration

The share of physicians in private practice dropped from 60% in 2012 to 42% in 2024 per the AMA. This rule is the first real pull in the opposite direction. If you’re thinking more about independent practice for primary care, the policy environment in 2026 is slowly improving.

13% of hospitalists are now working locums

Inpatient volumes are projected to keep rising through 2035, hospital medicine remains one of the most actively recruited specialties, and a recent Medscape survey found about a third of hospitalists reported worsening work-life balance compared to three years ago.

If you're still treating hospitalist locums as a fallback, the market has moved past that framing. Locum tenens is essentially mainstream now. This might mean more competition for independent contractors in the future.

Last week I went to a healthtech meetup in Austin. It was a room mostly filled with founders and some clinicians. A prominent healthcare entrepreneur was the main speaker.

His message to the docs: say yes more often.

He was talking about advisory and consulting work for healthtech startups. The kind of non-clinical income most physicians don't know exists, let alone know how to land. He said most docs he meets are too cautious, too busy, or too unsure where to start. So they never start.

If that's you, here's the landscape:

1. Consulting and advising. The most flexible entry point, and where most physicians start. The terms consulting and advising are often used interchangeably, but loosely: consulting tends to be project-based and cash-paid, while advising tends to be an ongoing relationship with equity attached which can include a seat on a clinical advisory board, regular calls with founders, and helping shape the product over time.

Physician Side Gigs reports most physicians doing consulting work make at least $250/hour, and Sarah Gebauer, MD puts the range at $150-500/hr. The bar is lower than people think and often your medical degree is the main credential required.

And notably, a lot of physicians advise for reasons that aren't money. It can be an intellectually stimulating change of pace for a lot of physicians. If you're curious and you like novel problems, that's often reason enough.

2. Fractional or full-time CMO. The chief medical officer is the clinical voice of the company which can include product decisions, external representation, and answering clinical questions in sales calls. Most early-stage startups can't afford a full-time CMO, so newer flavors have emerged: part-time CMOs, interim CMOs, and "virtual CMOs" working 2-10 hours a month across multiple companies. These are often referred to as “fractional”. If you want real influence without leaving medicine, this is a great option.

3. Venture capital and investing. Healthcare is roughly 20% of US GDP, and VC funds genuinely need clinicians to separate pitch-deck fantasy from what will actually get adopted. Most physicians who land here do so through their network or via an MBA plus internships at funds. A lighter version: becoming a physician angel investor, either solo or through a group. Be honest with yourself about business fundamentals because a great clinical idea is often not a great business idea.

4. Founder. Highest risk, highest ceiling. Some docs stop advising other people's companies and build their own because they've seen a problem in the wards or the clinic that nobody else is positioned to solve. It's the hardest lane and is the largest financial risk, but also the only one where the upside is entirely yours. Worth knowing it exists, even if it's not where you start.

Keep in mind this can take time. You might network for a while before landing a gig. But once you get the first one, the rest gets easier

The difficult part

None of these opportunities come to you. They move through networks. Founders ask investors; investors ask clinicians they already know; those clinicians refer the next clinician. You need to get visibility and real connections.

Gebauer's advice on this is blunt and I think correct: physicians often find networking distasteful or think they shouldn't have to put in the time. Her reframe is that networking is just meeting people you might be able to help. This is the mindset shift most of us need.

A few things to keep in mind in regards to networking:

The single best move I've made for my locums pipeline this year was buying an Interstate Medical Licensure Compact Letter of Qualification (LOQ) before I had a job lined up that needed one.

The LOQ is good for a year. Once you have it, you can fast-track state licenses that are in the Compact.

Pro tip: find which states you want to work in and grab those licenses through the Compact. Get licensed beforehand since in my recent experience, many facilities are now requiring you to have the license in-hand before you are even presented to them.

A few things worth knowing:

If you don't have an LOQ yet and you're doing or considering locums, it's the highest-leverage paperwork move in our job.

What would you like covered in future issues? Reply to this email and let me know!