A few years ago I moved down to Austin and met several people working in tech sales. They were younger than me but had no medical school debt and made as much or even more, depending on how their year went. They made money by just using their phones.
I realized that we were all employees, just in different fields. But they had leverage and I had none. Their income could scale, and mine couldn’t.
I still enjoyed being a physician but I knew that I needed to get the flexibility, leverage, and ability to make money in another way that didn’t require me to be in the hospital or clinic.
In today’s newsletter:
Compensation and side hustle news for physicians
The Two-Jaw Trap in medicine
Tracking basic recurring expenses
Locums and backing out of credentialing
What I’m Reading
Compensation satisfaction hits a 10 year low.
Medscape’s 2025 report: only 48% of physicians feel fairly compensated. Salaries are up, but so are documentation burdens, overhead, and frustration.
To me, this means the amount of administrative paperwork has led to increasing dissatisfaction
Up to 54% of physicians reportedly have a side hustle.
Sermo survey found that most docs are doing it for extra income but nearly 1 in 5 cite work-life balance as the main reason
Physicians are clearly looking for other opportunities to offset their main clinical work
The Two-Jaw Trap
Physicians are generally high earners and generally have a good reputation. So why don’t they feel wealthy or free?
This is a multifactorial issue but two major ‘jaws’ tend to happen to physicians once they finish residency. Lifestyle creep and a single income source.
Jaw 1: Lifestyle creep.
Spending more when you make more is really common, especially for docs who have their first job out of residency. You see a big paycheck and you feel the need to spend. Bigger house, nice car, etc.
Jaw 2: Single Income Source
I realized once I had my first W2 job that 100% of my income relied on me being present at work. The major issue with this is that it creates no leverage or ‘passive’ income. You are also tied to your place of work physically which can restrict you to a specific city.
The result? You end up as a ‘high earner’ but with no other options.
The Fix
First, get visibility on what you actually spend. You can’t fix what you don’t measure. We didn’t learn finance in medical school but it is a critical portion of becoming independent.
Start building income that doesn’t require you to be in the room. Yes, that could mean learning new skills but if you made it through medical training, you have what it takes. Remember, thinking of your career as a business is a way to take better control of it.
The Practical Win
Ask yourself the dependency question: If you stopped working tomorrow, how many months could you sustain your current lifestyle? That number is your runway.
I made a simple subscription tracker on Google Sheets you can download a copy of and use. Just plug in your recurring expenses and it calculates your monthly and yearly spend. This is a good starting point to see where your money is going.
I'm also working on a more comprehensive income and expense tracker. If you want early access when it's ready, just reply to this email.
The Locums Corner
🚀 If you get deep into the credentialing process with a facility, make sure you see it through. If you back out at a later stage, that can be seen as a red flag for your reputation. Remember, locums agencies and facilities talk. Getting you credentialed costs them both time and money. If you need to cancel, do it earlier in the process.
What’s Coming Next
How to stop being tied to one city
Contract red flags that limit your options
What is the #1 thing stopping you from creating a secondary income? Let me know and I’ll address it on a future newsletter!