In recent years, we’ve witnessed a shift in how physicians work. Members of the older generations likely spent their careers building a single practice or working for one, maybe two, employers. Physician careers today are far more likely to involve multiple employers. Research from Jackson Physician Search and MGMA found that the youngest physicians spent, on average, two years in their first jobs. When the question was asked of all physicians, regardless of age, the answer was six years. Physicians typically hold a series of consecutive jobs over the course of their careers.
As physician careers continue to evolve, we are seeing yet another shift. Rather than, or in addition to, a single full-time clinical role, some physicians are generating income from several sources at once: locum tenens shifts, telehealth moonlighting, local on-call pools, consulting, teaching, research, or expert witness work. Some do it to earn more. Others do it to work less or simply to work differently.
This path is no longer a fringe choice. According to Medscape’s 2026 Physician Compensation Report, roughly 40% of physicians now find time for paid work outside their regular hours. Becker’s Physician Leadership recently reported on the data, highlighting the average amounts earned and the reasons why so many are choosing this path.
If you’re curious about your options, it’s worth understanding why so many of your peers are taking this route, what they’re gaining, and what they’re giving up.
Why Physicians Pursue the “Side Hustle”
Two motivations dominate, and they don’t point in the same direction. In the data cited by Becker’s, 41% of physicians with secondary income said they simply liked the extra money, while a nearly identical 39% said the work itself interested them. So, while some physicians are financially motivated, nearly as many are chasing variety, autonomy, or intellectual engagement that they aren’t getting from their primary role. In that respect, the moonlighting may be an attempt to ward off or ease burnout.
While physician burnout has improved in recent years, the numbers remain high. The American Medical Association (AMA) reported that 41.9% of physicians experienced at least one symptom of burnout in 2025, down from 43.2% in 2024 and 48.2% in 2023. The AMA points to workload, administrative burden, staffing gaps, and the day-to-day clinical environment as the persistent drivers. For physicians who feel boxed in by one employer’s schedule, EHR, and productivity targets, building work on the side can be a way to reclaim a measure of control.
Compensation perception plays a role too. Even though average physician pay rose about 3% in 2025, Medscape found that 61% of physicians still believe doctors as a whole are underpaid. That sentiment may explain why so many keep an outside income stream open even in a year of raises.
What Portfolio Careers Actually Look Like
The menu of options is wider than physicians may realize. In the breakdown reported by Becker’s, the most common sources of physician secondary income were consulting (25%), teaching (20%), clinic work and market research (14% each), expert witness work and medical administration (12% each), with hospice, hospital work, speaking, telemedicine, and others in the single digits. Interestingly, locum tenens work was named by only about 2% of physicians as a secondary source in the Medscape survey.
The income these paths generate varies enormously. In the same data, secondary earnings ranged from under $5,000 a year for some physicians to $150,000 or more for roughly one in ten. These extracurricular activities can be a modest supplement or a second salary, depending on how much someone takes on.
Where It’s Most Common
Medscape reports that 39% of primary care physicians and 40% of specialists augment their regular pay with outside work. While the report did not contain a further breakdown of specialties with the highest concentration of side gigs, Jackson Physician Search recruiters have observed radiology and psychiatry to be two areas in which contract, remote work is highly prevalent and often preferred. Both types of physicians can easily work offsite, and significant shortages in both specialties mean employers are more likely to hire them in whatever capacity they prefer.
For locum tenens specifically, some different patterns emerge. Reporting from the American Medical Association, drawing on benchmarking from AAPPR, found the specialties where organizations most often turn to locums include anesthesiology, pediatrics, urgent care, hospital medicine, and emergency medicine. So it follows that these specialists would be more likely to work locum. These are areas where a gap means closed operating rooms or unstaffed departments, so coverage is imperative.
The Upside of Physician Side Gigs
The appeal of physician side gigs goes beyond the financial. A portfolio approach can offer schedule control, the chance to step away from a single employer’s bureaucracy, and the freedom to work in different settings or regions. It can serve as a bridge, easing into retirement, testing out a relocation, or supplementing income while a physician builds something else, such as a new practice. For many, the variety itself is restorative after years of the same panel and the paperwork. And the financial boost can be compelling, since locum and per diem work often pays a higher hourly rate than equivalent salaried roles. For physicians carrying significant student loan debt, the appeal is obvious.
The Trade-offs
There are downsides too, of course. Independent and locum work typically means becoming a 1099 contractor, which brings self-employment taxes, quarterly filings, and the need to arrange your own retirement savings and health insurance (if you don’t have it through full-time employment). Also, malpractice coverage requires close attention, especially how tail coverage is handled between assignments. For physicians exclusively working contract jobs, there’s also the loss of continuity with patients and colleagues, and income can be less predictable.
Also, in a profession already at high risk of burnout, physicians supplementing or replacing full-time work with a series of side gigs may risk burning out even faster than their peers. Ironically, the very reason some physicians seek out side gigs (escaping burnout) is exactly what they will find if “flexibility” becomes “always on.”
If You’re Considering a Change
Physicians are telling the market they want more control, more variety, and compensation that reflects their value, and many are willing to build that themselves if a single role won’t provide it.
But assembling several jobs isn’t the only way to get there. Sometimes the underlying needs — flexibility, autonomy, the right schedule, fair pay — can be met by a permanent position that’s simply a better fit than the one you have now. Before you piece together a career, it’s worth getting clear on what’s actually driving the urge to change. The answer will tell you whether your next move is a portfolio of roles or one role that finally fits.
If you are exploring your physician career options, the recruitment team at Jackson Physician Search is eager to listen and share our market expertise. Reach out today or browse physician leadership jobs online now.
