Giang Le: Every physician side hustle list on the internet is the same eight things. Locums, telehealth, chart review, expert witness work, medical writing, consulting, speaking, maybe a course. And here's the thing, none of that is wrong. It's just incomplete in the one way that actually matters. Every one of those lists treats all eight items like they're interchangeable ways to make extra money. They are not. Some of these pay you for hours. Some pay you for what you know. And a small handful pay you for a position, which is the only kind that gets more valuable the longer you do it. I want to spend the next few minutes sorting the list that way, because knowing which bucket something falls into before you say yes is worth more than any individual item on it.

Giang Le: I'm Giang, founder of Studio Germina, and I talk to physicians about this constantly. Not because I'm trying to talk anyone into a side gig, honestly the opposite. Most of the conversations I have are about which opportunities to turn down. But before you can turn anything down intelligently, you have to see the pattern. So let's look at what you're actually selling in each of these arrangements, because the list stops looking like eight equal options pretty fast once you sort it that way.

Giang Le: First bucket. Locum tenens, moonlighting, telemedicine shifts, urgent care coverage, per diem work. Telemedicine is the one most physicians ask about first because you can do it from home around your existing schedule. It's the most reliable side income available to a physician and the easiest to start, because it's literally the job you already have, done somewhere else. But it's also the ceiling. You're trading time at a known rate. The rate doesn't go up because you did it well last month. And it stops the day you stop showing up. Second bucket, close cousin. Chart review, utilization management, independent medical exams, disability and peer review, medical director roles for smaller organizations, even paid physician surveys. Chart review is usually the first step physicians take away from the bedside. Surveys are the smallest and easiest to start, think of them as the lowest rung, not a strategy. The economics here are often better than shifts, no call, and it's a first taste of work that doesn't require being in a room with a patient. But it's still hourly. Still capped by your calendar. Both of these buckets are perfectly fine if what you want is reliable extra income and nothing more. There's no shame in that and no strategy required. Take the shifts.

Giang Le: Third bucket is where the economics actually change. Expert witness work, consulting for health technology and device companies, advisory roles, medical writing and editing, pharma medical affairs, speaking. Here you're paid for what you know, not for the hour, and the rate is set by how rare and how legible your specific expertise is, not by some benchmark for your specialty. Expert witness work is the clearest example. It pays well precisely because it requires someone who can explain a clinical reality clearly to non clinicians, which is rarer than it sounds. And notice, the physicians who get retained again and again aren't the ones with the most years in practice. They're the ones known for one specific thing. Fourth bucket, selling something you built once. A course, a book, a paid newsletter, a digital product, a small business. Genuinely scalable, genuinely hard, and dependent on an audience most physicians don't have yet. The passive income conversation always starts here and then quietly discovers that the passive part comes after years of very active work building the thing and the audience for it.

Giang Le: Fifth bucket, and this is the one nobody's list quite gets to. Brand partnerships, media appearances, paid speaking on a national stage, product collaborations, professional partnerships, the advisory and board roles that come to you instead of you chasing them. None of these are available on day one. All of them are available to a physician known for one specific thing. And here's the part that actually matters, they compound. Each one makes the next more likely and better paid. So here's a test I use with clients constantly. Does this opportunity make you more legible for the next one, or does it just pay for this one? Locums shifts pay for this one. Expert witness work in your specific clinical niche makes you more legible as the person who explains that niche, which leads to speaking, which leads to consulting, which leads to a brand wanting the physician known for that exact thing. A random sponsored post for a product that has nothing to do with your expertise pays for this one and slightly damages the next one. A partnership with a company solving the exact problem you're known for pays and compounds at the same time. Physicians tend to evaluate these on rate alone, and the compounding ones are frequently not the best paying option in front of you this month. That's exactly why they get passed over. And it's why five years later, the physician with the lower paying but coherent body of work has options the higher paying one simply doesn't.

Giang Le: Let me make this concrete, because it's easy to nod along to buckets and harder to see how it plays out in real life. Say you're an endocrinologist and right now you've got a little bit of everything going, some chart review on the side, a sponsored post for a wellness brand, an occasional lecture at a regional conference. Four separate paychecks, no common thread connecting them. Now imagine instead you decide your position is the doctor who explains GLP-1 therapy clearly, without hype, to primary care physicians and to patients. Suddenly the chart review might not fit that story anymore, but the lecture does, and so does a partnership with a company actually building tools in that exact space. The common mistake is chasing whichever offer pays the best this month. What to do instead is write your one sentence position down first, then hold every single offer up against it before you say yes.

Giang Le: So what do you do with all this. If you want reliable extra income and nothing more, genuinely, take the shifts, do the chart review, no strategy needed. But if you want something that becomes more than extra income, the first move isn't picking a gig at all. It's deciding what you want to be known for, writing that down, and evaluating every single opportunity against it. That decision makes the list shorter, and that's the whole point. A physician with an actual position turns down most of what's offered to them, and the things they say yes to start adding up to something. One honest caveat before I let you go. The compounding path takes longer than the shifts do. Anyone selling you a fast version of it is selling you something else. What it offers instead is a set of side gigs that eventually stop being side gigs, because the platform underneath them has quietly become the main thing.

Giang Le: This is the exact conversation I have with physicians every week, working out which of these paths their expertise should actually become and how the pieces fit together so they're not just collecting disconnected income streams. Here's the honest split. You are the medical expert. We are the marketing and business experts. You keep doing the clinical work, the teaching, the content people already trust you for. We handle the positioning, the deals, the pricing, the contracts, and we make sure the hours you're already spending online get paid for properly, on terms that actually fit your ethics and your vision, not someone else's template. If you're a physician or healthcare creator who would rather just create, book a consultation at studio germina dot com, and we'll handle the business side with you. The links are below, I'll put them in the show notes. Thanks for spending this time with me, I'll talk to you next time on Beyond the Screen.