Physician Side Gigs: 12 Ranked Against Your Clinical Hour

Four in ten physicians already do outside paid work. Medscape's 2026 compensation reporting puts it at close to 40%, and it holds across primary care, specialists and every age group.

Almost none of those physicians price the gig against the thing it actually costs: the clinical hour they gave up to do it.

That is the whole problem with lists of physician side gigs. They rank by activity, they quote a headline rate, and they never once compare it to what your own hour already earns. A radiologist averaged $571,000 in Medscape's 2026 report. Across a 2,080-hour year that is about $275 an hour, and closer to $240 if you work 2,400. A survey panel paying an effective $60 an hour is not extra income against that number. It is a choice, and it should be a deliberate one.

This guide sorts twelve physician side gigs by what the buyer is actually paying for, because that determines the rate far more than the activity does. Four categories: your hours, your opinion on a record, your market knowledge, and your judgment as training data. Rates, the real friction on each, and where the honest trade-offs are.

Disclosure up front. Skillora runs a verified radiology bench and the last section of this page recruits for it. That is a direct commercial interest and it is a stronger one than the referral fees most pages on this topic run on, so it belongs in the first hundred words rather than a footer. The rates below are reported as published, including where they are higher than what we pay.

Category one: buying your hours

The most money in absolute terms, because you are still selling clinical work. Also still clinical liability, still a schedule, still the thing you may be trying to do less of.

1. Locum tenens

Contract clinical coverage, usually with travel and housing covered. Rates are specialty-driven and among the highest available to a physician per hour. Locum diagnostic radiology runs to roughly $330 an hour, with interventional radiology commonly $350 to $450.

The friction. Credentialing and state licensure per assignment, travel, and 1099 income with nothing withheld.

2. Telemedicine moonlighting

Asynchronous or scheduled virtual visits for a telehealth platform. Rates vary widely by platform and whether you are paid per consult or per hour, and multi-state licensure is what actually determines your volume.

The friction. Licensure in the patient's state, not yours. That is the constraint that decides your ceiling.

3. Teleradiology per diem reads

For radiologists, the default side gig and a good one. National platforms pay roughly $100 to $180 an hour for per diem reads. Some high-volume platforms advertise $450 to $500 an hour contingent on hitting wRVU thresholds, commonly around $45 per wRVU, which is a productivity target rather than a rate. Per-study pricing at one US vendor starts near $40 for CT, $60 for MRI, $32 for mammography and $12 for MSK.

The friction. It is a worklist. You are trading your evening for the same work you did all day, with the same liability attached.

Category two: buying your opinion on a record

No patients, no shifts, and the highest hourly rates available to a physician outside of procedures.

4. Expert witness work

The rate leader. The 2026 ExpertPages survey of more than 400 expert witnesses puts the average hourly fee at $465, up from $451 in 2024, with reported rates from under $200 to over $1,500. Physicians are commonly quoted between $400 and $1,000. Broken out by activity: case review averages $356 an hour, depositions $448, trial testimony $478. Reported specialty averages include internal medicine near $385 and general paediatrics near $365, with surgical and procedural specialties higher.

The friction, and it is real. The work is adversarial by design and your reasoning will be attacked on the record. 74% of experts require a minimum engagement fee and 40% of those set it between $2,500 and $4,999, which tells you this is a business relationship rather than a gig you dip into. Attorneys find you through referral and directories, so the first case is the hard one.

5. Independent medical exams and chart review

Insurers, disability programmes, workers' compensation carriers and IME companies pay for structured record review and opinion. Lower rate than litigation work, far lower friction, and volume can be steady.

The friction. Per-file pricing varies enormously by vendor. Get the fee per file and the expected record length in writing before you accept anything.

6. Physician advisor and peer review for payers

Medical necessity review, peer-to-peer calls and appeals for a health plan or a hospital's utilization management team. Predictable, remote, and it uses judgment you already exercise daily.

The friction. Insurers are cutting prior authorization volume on a published timetable, having committed with CMS and HHS to process 80% of electronic prior authorization approvals in real time by 1 January 2027. Physician review of denials is explicitly preserved in that commitment, so the clinical review work survives. The routine volume around it does not.

Category three: buying your market knowledge

Pharma, device companies, investors and consultancies pay for what you know about how medicine is actually practised and purchased. Rates here have the widest spread on this page, from excellent to insulting.

7. Expert network consulting

GLG, AlphaSights and their competitors book one-to-one calls between physicians and investors or consultants. Reported rates for specialist physicians commonly run $400 to $600 an hour, higher for recognised authorities, and calls are typically 30 to 60 minutes.

The friction. Compliance is genuine, not theatre. You cannot discuss your employer's confidential information, ongoing trials under embargo, or anything covered by an NDA, and the screening questions exist to establish that. Call volume is lumpy and follows whatever the market is currently interested in.

8. Advisory boards and pharma or device consulting

Structured advisory panels, speaker programmes and product consulting. Day rates are strong and the work is intellectually closer to your specialty than anything else in this category.

The friction. Payments are reportable under the Open Payments programme and become public. That is not a reason to avoid it, but you should know it before you accept.

9. Paid survey panels

The most heavily promoted physician side gig and the weakest one, which is not a coincidence. Individual payouts commonly run $8 to $25 on panels like InCrowd and $25 to $200 on Sermo, with oncology, immunology and rare disease commanding the top of the range.

Read the promoted hourly figures carefully. They assume you qualify for every survey you open. In practice you are screened out partway through a meaningful share of them, unpaid, and the effective rate falls accordingly. Note also that most pages recommending specific panels earn a referral fee when you register through their link, which is why the promoted numbers are the ones you see.

The honest use case. Filler for time you genuinely cannot convert into anything else. Not an income strategy.

Category four: buying your judgment as training data

The newest category and the only one priced purely on scarcity of expertise rather than on hours or seniority. There is no patient, so no malpractice exposure attaches. The work is asynchronous and the volume is elastic.

10. Clinical model evaluation

You read a clinical scenario and a model's answer, find what is wrong, explain why, and write what a competent physician would have said. Other projects are generative or adversarial: authoring board-style questions with rationales, or constructing cases where a confident wrong answer would kill someone.

What it pays. Physician listings across the marketplaces commonly publish $60 to $150 an hour. Mercor's healthcare page publishes $110 to $250 an hour for physician roles and $130 to $180 for internal medicine, emergency medicine and cardiology specialists, with nurse practitioners at $70 to $110 and pharmacists at $75 to $120.

The friction. Independent contractor work with no benefits or guaranteed hours, and project volume follows the lab's client contracts. Screening is normally a recorded or live AI interview rather than a CV review.

11. Medical education and question authoring

Board review questions with rationales, CME modules, and clinical content review for publishers and test prep companies. Reliable, per-item or per-project, and it compounds because the same writing sample opens the next contract.

The friction. Rates per question are modest until you are known. It pays in optionality more than in hourly.

12. Imaging ground truth and reader studies

Radiology only, and it is the one place in this entire market where a single specialty sets the price.

Study-level labels, lesion segmentation and structured findings. Sitting as a reader in comparison studies. Grading model output and documenting exactly where it fails. Writing the reports, impressions and reasoning chains that report-generation models learn from.

Why radiologists are the scarcest input in medical AI

Every imaging model needs ground truth. Ground truth means a licensed reader looked at the study and said what is there. There is no substitute, no crowd workaround, and no way to scale past the number of radiologists willing to do it.

Meanwhile the clinical shortage is well documented. The US workforce gap is estimated at roughly 1,500 radiologists, with projections toward 3,100, against imaging volumes rising 3% to 4% a year and only about 1,400 funded first-year training positions in the pipeline. Some systems have temporarily closed outpatient imaging centres to let radiologists clear backlogs.

One useful complication. A 2026 analysis of radiology job postings argued the shortage is not uniformly national but concentrated in places radiologists will not relocate to. If that is right it strengthens rather than weakens the case for asynchronous remote work, because the mismatch is geographic and reading does not require you to move.

Put the two together. Clinical scarcity sets the price of a radiologist's hour, and the data market has to pay against that price to get any of those hours at all.

The honest position for a US radiologist. AI evaluation does not beat teleradiology on rate. Per diem reads at $100 to $180 an hour and locums to $330 are at or above what this work pays. What it offers instead is no clinical liability, no worklist, no RVU target, hours you set yourself, and volume you can turn up or down. For radiologists outside the US the arithmetic is different and simpler, because these rates sit well above most local benchmarks while the credential bar stays exactly the same.

Joining the Skillora Experts radiology bench

Skillora Experts supplies verified radiologists to companies building imaging AI. It is radiology only, deliberately, because the bottleneck is specific.

What the bench looks like from the inside:

• Verified registration. Your registration number, issuing council or board, degree and current status are matched against the official medical register. Nothing is taken on self-report, which is the point: it is why clients pay bench rates rather than marketplace rates.
• A recorded clinical interview. Proctored and structured, on imaging interpretation and clinical reasoning, scored against a common radiology rubric so readers are comparable before anyone touches data.
• Calibration before scale. Reference cases, measured inter-reader agreement and adjudicated disagreements, so you are calibrated to the project rubric rather than discovering it through rework.
• Re-assessment on a cadence, so your record reflects who you are now.
• We contract, you read. Engagements, cross-border payouts and tax documentation sit with us. Payment runs on our cycle, not the client's, so a client's payment terms never become the reason your work stops.
• De-identified or synthetic imaging only. We do not accept protected health information and that is written into every engagement.

Coverage runs across CT, MRI, radiography, ultrasound, mammography and PET-CT, and across neuroradiology, chest and thoracic, musculoskeletal, abdominal and body, breast imaging, and emergency and trauma.

Radiologists in any country are welcome. Verification is against whichever register issued your licence, so an MD, a DNB or the equivalent all work.

To join: email support@skillora.ai with the subject line "Radiologist bench" and include your medical registration number and issuing council or board, your degree, the modalities you read clinically today, and your subspecialty. That is enough to start verification.

If you are not a radiologist

The general clinical evaluation work in category four is open across specialties and is aggregated on Skillora's AI training jobs board, which collects live listings from Mercor, micro1, Alignerr, Outlier, DataAnnotation and Terac into one feed, refreshed daily and filterable by pay and experience. The medicine and healthcare listings are the relevant slice, with published rates and the stated credential requirement on each card. You apply and are paid by the marketplace directly. Where one runs a referral programme Skillora may earn a fee if you sign up through our link, at no cost to you and with no effect on ranking.

If what you are really weighing is leaving clinical practice rather than supplementing it, the non-clinical physician jobs guide sorts fifteen roles by whether you can go back, which is the question that decides the rest. Boards require re-entry activity after an average of 2.9 years out, and your licence is not the thing that expires first.

Two practical notes. These marketplaces screen with a recorded or live AI interview rather than a CV review, and physicians used to oral boards do well once they treat it that way: think aloud, structure the differential, justify the call. The format is covered in the Mercor AI interview guide, and the screening guide compares how many attempts each platform allows. The best AI training jobs roundup ranks the platforms on pay and entry bar, and the Mercor review covers the one paying most for clinical credentials.

The short version

Rank physician side gigs by what the buyer is paying for, then price each one against your own clinical hour.

Buying your hours pays the most and changes the least. Buying your opinion on a record pays the highest rate per hour with the most friction attached. Buying your market knowledge has the widest spread on this page, and the loudest end of it is the worst-paying. Buying your judgment as training data pays on scarcity, carries no liability, and fits hours nothing else can use.

If you read imaging, you are the scarce input in that last category rather than a participant in it, and you should be paid accordingly.