James J. Mangraviti, Jr., Esq.

Excellent side gig options exist for physicians looking to supplement their clinical incomes.  This post will discuss three popular and well-paying physician side gigs: file review consulting, independent medical examinations (IMEs) and expert witnessing.

File Review Consulting

File review consulting is an excellent physician side gig.  The work involves reviewing medical charts for insurance companies and responding, concisely and in writing, to a question or questions asked by the insurer.

There are two major categories of reviews.  The first is a medical necessity review requested by a health insurer. Here the physician would be asked to offer their written opinion as to whether a requested drug, procedure, or diagnostic test meets the definition of covered services under the insurance policy in question.  An example of this could be a patient with migraines requesting Botox injections.

The second major category is disability reviews.  In these reviews the physician reviewer is asked to give their written opinion as to whether or not a particular patient meets the definition of disability under the insurance policy in question.  For example, a physician could be asked to determine whether an interventional cardiologist is disabled under their insurance language if that cardiologist can no longer stand more than 3 hours at a stretch.

There are many advantages of file review consulting as a physician side gig.  The work can be done from home or anywhere convenient.  What you learn doing this work will absolutely make you a better clinician.  The skills and experience you gain from doing this work as a physician side gig will also well position you for a full-time medical director role at an insurance company (which could pay $250,000+ for a work from home 9-5 position).  Compensation for file review assignments is generally in the range of $85-$200/hr.  Physicians who do superior work can earn a large volume of business.  The key to receiving repeat business from clients is learning how to perform these reviews at a very high level and distinguishing yourself from your competition.

There are a few potential disadvantages to file review consulting as a physician side gig.  Peer to peer calls with treating physicians are required in some cases.  The work can get repetitive and this physician side gig is not a great fit for someone who thrives on human interaction.  Also, the compensation provided is going to tend to be the lowest of the three physician side gig options discussed in this post.

An excellent resource for obtaining physician file review assignments is SEAK’s National Directory of Medical File Reviewers.

Independent Medical Examinations (IMEs)

Performing IMEs is another excellent physician side gig.  IMEs are requested by attorneys (usually defense attorneys), insurers, third party administrators and IME companies. IMEs are a subset of expert witness work, where, in addition to reviewing medical records and other documentation, the physician is also asked to examine and take a history from the examinee.

Each IME assignment consists of reviewing medical records and other documentation (for example possibly surveillance video), taking a history from the examinee, conducting a physical or psychiatric examination, and then issuing a written report.  The report could be anywhere from 3 to 20 pages or more in length.

This physician side gig is well paying.  The average fee for an IME and report is more than $2,000.  Some fees in complex cases can exceed $10,000.  In some cases the IME physician will be asked to provide testimony at deposition or trial.  Time for physicians providing testimony in these circumstances is commonly compensated at $500-$1000/hour or more.  Physicians who get good at performing IMEs can earn repeat and word of mouth business and generate an income well into the six figures. The keys to building a high-earning IME practice are learning to perform at IMEs at a high level and getting the word out.

IMEs as a physician side gig has disadvantages too.  The examinees may be confrontational or less than forthcoming.  You may be required to give testimony (some physicians don’t like doing so).  You also are required to have access to someplace to do the examinations – so the work can not be done almost exclusively from home.

The demand for IMEs definitely varies by specialty.  The specialties most in demand treat musculoskeletal or mental injuries and include neurosurgery, neurology, orthopedics, pain, physiatry, psychiatry, psychology, chiropractic, etc.

Expert Witnessing

Expert witnessing is the physician side gig with the most earning potential.  Physician expert witnesses are typically compensated at a rate of $500-$1000/hour or more.  Successful physician expert witnesses have the ability to build a side gig practice well into the six figures annually and seven to eight figures over the course of a medical career.

Expert witnesses are employed to educate lawyers, jurors, and judges on technical issues in dispute in a legal case.  Areas that physician expert witnesses are commonly retained to opine on include, standard of care breaches, causation of harm, future medical care needs, medical necessity questions, patent validity, disability, competency to stand trial, etc.  Physician expert witnesses are paid for their time, not their opinions.  They never have to testify to anything they don’t believe in.

The vast majority of expert witness work for a physician consists of chart and document review, research, report writing, and speaking on the phone – all of which can be done from home.  Since most cases settle, physician experts rarely testify at trial – typically in 5% or less of the cases they work on. When trials do occur physician experts can often appear remotely via Zoom or by way of a pre-recorded deposition.  For depositions, the lawyers typically either travel to the location of the expert or are deposed via Zoom.

There are many advantages to serving as an expert witness as a physician side gig. As previously stated, expert witnessing is the highest compensated physician side gig and has the greatest earning potential.  The work is interesting.  What you learn as an expert will make you a better clinician and will help you with your documentation.

There are disadvantages to serving as an expert witness as a side gig for physicians.  The biggest is that you have to deal with trial lawyers working on high stakes cases.  There can be tight deadlines and scheduling issues will occur.  Trials and depositions can also be confrontational.

The key to building a successful and sustainable physician side gig as an expert witness is simple.  Get the word out, do a great job and earn repeat and word of mouth business.  Training is available to show physicians how to excel at expert witnessing and simple and effective resources are available to help the physician make their availability to serve as an expert witness known to lawyers.


File review consulting, independent medical examinations and expert witnessing are three great options for physicians looking for a side gig.

About the Author

James J. Mangraviti, Jr., Esq. is the President of SEAK, Inc. SEAK specializes in helping physicians succeed as expert witnesses, independent medical examiners and file review consultants. SEAK also specializes in non-clinical careers for physicians.  Since its founding in 1980 SEAK has had the pleasure of training and assisting many thousands of physicians.  Jim can be contacted at jim@seak.com or 978-276-1234.