In my previous article, I urged you to embrace scarcity if you wanted to be irreplaceable, in control, and rich.
If you have yet to read the article, here’s a quick gist of what it is about …
As a doctor, you can embrace scarcity in 2 ways:
- by location (moving to a place without many doctors)
- by specialization (acquiring skills few doctors have)
The first option is pretty much self-explanatory. Thus, I wanna focus on the second option.
In this article, I will show you examples of doctors who have specialized without completing a fellowship. Most people will consider the following examples unorthodox. That is why, in each case, the doctor is doing very, very well for himself. Other doctors are not brave enough to thinking outside the box.
(Personally, when I practice medicine, I will most likely focus on something very similar.)
8 Uncommon (but Highly Profitable) Specialties
Here they are in no particular order …
1. Medical Marijuana
There is a medical practice in Maine that specializes in alternative medicine (namely Reiki, osteopathic medicine, and medical marijuana). Most of its patients go there for the marijuana prescription.
The practice charges $300 for an initial, 1-hour visit. And it charges $150 for each 30-minute follow-up session. It does not accept insurance. It only takes cash. And yet, the practice is pretty much full. Assuming that the doctor works 40 hours a week, 50 weeks a year, that is $600,000 before expenses. Not too shabby at all.
Oh by the way, he only finished a 1-year internship. He didn’t even do a full residency. And yet, he makes more than some specialists.
When I originally heard about medical marijuana, I wasn’t sure what to think. Is it really helpful? Or is it just a way for users to get their drugs legally? In Breaking Bad (what an awesome show), Hank Scrader — an agent for the DEA — described marijuana as a gateway drug. Supposedly … it’s use will lead to the use of harder and more harmful drugs, like heroin and cocaine.
Sounds terrible, doesn’t it?
But after watching the only season of Weed Wars, featuring Harborside Health Center, I fully support the use of medical marijuana. The show briefly interviewed a wheelchair-bound woman with cerebral palsy. Her body was contorted into a ball. She was in constant pain and has tried everything for a bit of relief. She tried all forms of conventional medicine, but nothing helped. Finally, as a last resort, she turned to marijuana … and found relief at last.
Who am I to deny marijuana if it helps her?
I’m not gonna push weed down anyone’s throat. But if they want it (and if it is legal), why not prescribe it?
2. Weaning Off of Opioids
There is a medical practice in NY that only treats opioid-dependent patients. The doctor help them quit their habits by prescribing them suboxone. Suboxone is a combination of buprenorphine and naloxone. Buprenorphine is a partial opioid agonist, while naloxone is a opioid antagonist.
From what I have learned, under federal and state laws …
- a doctor may have at most 100 suboxone patients
- a suboxone patient must follow up with doctors once a week (not sure if this is true)
Because a doctor can only take so many patients, there is usually a bunch of people on the waiting list. And according to the immutable law of supply and demand, when supply is restricted, price goes up. One doctor charges $250 per visit — cash-only.
In a practice with 100 patients who follow up every week, at $250 per visit, that comes out to $1,300,000 before expenses.
Assuming that the 100 patients only follow up once a month, at $250 per visit, that is still a cool $300,000 before expenses. You can do this just by working 1 week a month.
If you’re interested in suboxone, you can read an eye-opening article about it here.
Near my parent’s house, a medical doctor has a practice that does nothing but acupuncture treatments. The demand is obviously there, because he is booked solid for 3 months.
I’m not sure what this doctor charges, but another doctor I have shadowed charges $80 for a 45-minute session. It may not seem like a lot … but unlike most medical treatments, you can scale acupuncture.
Lemme explain …
An acupuncture session does not require your presence for the duration of the treatment. It takes only a total of 5 minutes to insert and remove needles. It takes a few more minutes to write your notes. Patients spend the bulk of the session lying on the table.
So if you have more than one exam room, you can run multiple sessions at the same time. If your office has 4 exam rooms, you can make $320 every 45 minutes. That is about $425 per hour.
If you work 40 hours a week, 50 weeks a year, you’ll make $850,000 per year before expenses.
The great thing about acupuncture is that you are not injecting or ingesting any drug. Therefore, side effects are very, very minimal.
4. Osteopathic Medicine
This is a field where osteopathic doctors (DO) have a definite advantage over allopathic doctors (MD).
Although some of my classmates are absolutely crazy over osteopathic medicine, I don’t particularly love it. (If I have to, I can do it.)
If you are skilled enough and can relieve patients’ pain through your hands, you will make a killing. I know of one doctor who only does osteopathic medicine and only takes cash. He makes $300,000 a year by working only 15 hours a week.
Assuming he works 50 weeks a year, he makes $400 per hour. That is not too shabby at all.
He could work more hours if he wanted to, but he would rather spend the bulk of his time with family.
5. Weight Management
Everyone wants to get thinner. The demand is certainly there. And when it comes to helping people lose weight, doctors have a definite advantage over personal trainers, dieticians, and other professions.
First, only doctors can prescribe drugs. Phentermine. Topiramate. Qsymia (combo of the previous two). This is very, very attractive to a population that wants the cure-in-a-pill.
Second, doctors are still highly respected for their knowledge. People trust a doctor more than any other profession.
During my third year of medical school, I rotated with a doctor who only deals with weight management visits. What he did was so easy, I could have done it as a medical student. And yet, he had a full roster of patients.
Not only does he get to charge for the office visit, he gets to upsell. This means he gets to sell products related to weight loss to an already captive audience (his patients). He sold protein shakes, protein bars, meal-in-a-can, etc. There are a million things you can upsell.
Although he accepts insurance for the office visit, he only accepts cash for the products.
I asked my preceptor how much a doctor like him can make. The answer? $150,000 to $400,000.
If you are business savvy, you can potentially make a lot more. For example, you can create a website that sells your goods to those beyond your medical practice.
6. Integrative Medicine
As patients realize how expensive and limited conventional medicine is, they will turn to alternatives — even if alternatives are a last resort.
As I have mentioned before, alternative medicine is big business. So why not get a piece of the pie by offering integrative medicine? You can prescribe pharmaceutical drugs, herbs, vitamins, supplements, or whatever the patient wants.
Like the weight management specialty, integrative medicine also gives you the opportunity to upsell. But in this case, you can sell pretty much anything. One possible product is red yeast rice, a popular supplement to lower cholesterol. (It is not as harmful to the body as statins.)
The most well-known integrative medicine guru is Dr. Andrew Weil, who only did an internship, and is now worth millions.
7. Cosmetic Services
Browsing on SDN, I encountered a short anecdote …
I met a Vietnamese guy, around 25, did 1 year of gsurg, bailed and is now doing medical directorships for laser skin centers……..net yearly pay: 1million+.
all us working stiffs are pure suckers!!!!
I don’t know if it is true or not, but it is certainly believable.
Women spend a lot more money than men. Just go to the nearest mall and see how many of the stores cater to men. Then compare it to the stores that cater to women. I bet you that more stores sell to women than men. And you wanna know why?
Because that is where the money is at.
Women love to spend money on their appearances. That is why they love to buy clothes, shoes, accessories, and make-up. I bet more women get plastic surgery than men.
And if you can make them more beautiful, without surgery, they will flock to you. Some options are Botox injections, face peels, laser hair removal, medical spas, and more.
And the best part? They pay cash. Cha-ching!
8. Concierge Medicine
What could I say about concierge medicine and cash practices that I haven’t said before?
The alluring aspect of this “specialty” is that you don’t have to learn any new medicine. Instead, you take what you already know and fit that into a new business model.
Under the traditional, insurance-accepting practices, patients wait 50 minutes for a 5 minute visit. Under the direct-pay, cash practices, patient wait 5 minutes (at most) for a 50 minute visit.
You can afford to dedicate more time per patient because you take out the middle man — insurance companies and government. You don’t need to spend so much money to collect reimbursements. And you don’t need to waste so much time filling out paperwork.
Depending on your business model and how much you work, you can make anywhere from $150,000 to $500,000 per year. You can make specialist salary as a generalist.
If you want more accurate numbers, check out the interviews I did with various cash practice doctors:
- Deeper Look at AtlasMD and Concierge Medicine – Interviewing Dr. Josh Umbehr
- How Access Healthcare Thrived as a Cash-Only Practice – Interviewing Dr. Forrest
- MedLion: Help to Set Up a Cash-Based Medical Practice – Interviewing Dr. Qamar
Doing What Most Doctors Do Makes You Average (This Is How You Break Away from the Pack …)
If your interest does not fall within one of the aforementioned specialties, feel free to create one for yourself. Medicine is such a board field that it has something for everyone. Do not be confined to conventional medicine (i.e. the insurance system, the hospitals, the over-reliance on pills, etc.), just because everyone else does it.
Most uber-successful (and uber-rich) doctors are brave enough to do their own thing — to start their own practices or to specialize in something other doctors even think about.
They break away from what most doctors do … and embrace what most doctors won’t. That is why fortune favors the bold.
Attention! Do you want to make more money as a doctor? Do you want more freedom? Are you sick of all the useless, time-wasting paperwork? Do you wanna learn how to set up and run a profitable practice that only takes cash, from someone who has “been there and done that?” If yes, check out My Cash-Based Practice: Essential Knowledge for Creating a Successful Private-Pay Physical Therapy Practice — the best book I have found on starting and running a cash practice.
At the very least, check out the book review.
This article is part of the Money in Medicine series. Click on the link if you want all the money-making secrets available to doctors.