For many physicians, the path to career fulfilment seems straightforward: medical school, residency, fellowship, and then decades of clinical practice. But when the day-to-day realities of that practice start to diverge from the passion that first led you to medicine, a career transition can sound appealing or even necessary.
Sermo conducted an internal poll asking U.S.-based members for their main motivations to consider non-clinical roles. Desire for work/life balance (66%); burnout (64%) and interest in business, tech, or another industry (28%) were the most popular responses (Note: respondents could choose more than one response).
For rheumatologists, whose specialty is defined by intellectual rigor and long-term patient relationships, career alternatives may offer an escape from daily pain points. “Patients are more aggressive nowadays and demand a lot from us doctors,” one rheumatologist on Sermo writes, while another laments that “loss of physician autonomy due to insurance constraints” is a key reason that they would seek an alternative career.
No matter your reasons for considering a change, you can consider opportunities that leverage your specialized knowledge outside the traditional clinic walls. Discover some of the best alternative careers available to rheumatologists in 2026.
Why do rheumatologists seek alternative careers?
In a poll of the global Sermo community, physicians said that emotional stress and burnout are the top reasons physicians leave medicine (26%), followed by long hours (21%) and poor work-life balance (19%).
Rheumatologists can encounter these concerns while they manage complex, chronic and often multi-system inflammatory diseases that require ongoing patient engagement. A typical day involves diagnosing and treating conditions like rheumatoid arthritis, lupus and psoriatic arthritis. While intellectually stimulating, the specialty comes with its own set of challenges. These are some of the specific pressures driving rheumatologists to explore alternative careers:
Administrative burnout from biologics PA
One source of frustration is the administrative burden associated with navigating prior authorizations (PAs) while prescribing biologics. Managing these complex PAs consumes unreimbursed time and energy, which can contribute to burnout and moral injury as physicians fight to get their patients necessary treatments. In a 2024 survey conducted by the American Medical Association (AMA), 95% of physician participants said they think the prior authorization process increases burnout.
Cognitive load and chronic care
The very nature of rheumatologic diseases means patient encounters are rarely simple. Rheumatologists contribute intense cognitive effort to manage conditions, but reimbursement often doesn’t align with the complexity of the work involved. One U.S.-based rheumatologist on Sermo recounted time wasted on non-medical conversations, like debating clinic vaccination policies with patients, calling it “not useful and a waste of time.”
Monetizing specialty drug expertise
On the flip side, the expertise required to navigate the world of biologics is valuable outside the clinic. Your understanding of these therapeutics is a critical asset for pharmaceutical companies, biotech startups and insurance firms. This creates a significant opportunity for rheumatologists to pivot into lucrative consulting roles, though some physicians aren’t aware of what’s available to them. In an internal Sermo poll, 55% of members said a lack of clarity about which roles would fit their skills presented a challenge when considering a career switch. On that note, keep reading to find out the best ways you can apply your skills across industries.
Strategic alternative careers for rheumatologists
Your knowledge makes you a prime candidate for several high-value, non-clinical roles. Here are some of the most promising rheumatologist alternative careers for 2026, with average salaries in the U.S.:
Medical Science Liaison (MSL)
A MSL is a scientific expert who acts as a bridge between a pharmaceutical or biotech company and key opinion leaders (KOLs) in the medical community. In this role, you’d use your clinical expertise to educate physicians about new therapies (especially biologics), discuss research data and gather insights from the field to inform company strategy. It’s a role that leverages your scientific acumen without direct patient care responsibilities.
Median salary: $212,000, according to Glassdoor
Clinical trial investigator/consultant
Your experience treating conditions like rheumatoid arthritis and lupus can aid companies developing new drugs. As a consultant, you can help design clinical trial protocols and interpret trial data. You could also serve as a Principal Investigator (PI) or Sub-Investigator (Sub-I) for trials, overseeing their execution at a clinical site.
Average salary: $96,206 for clinical trial consultants, according to ZipRecruiter.
Medico-legal consultation
Rheumatologists are often called upon to provide expert opinions in legal cases. This can involve disability claims, where you assess a patient’s functional limitations, or standard of care cases, where you evaluate whether a physician’s actions met accepted medical standards. Physician medico-legal consultation rates are often high due to the specialized expertise required.
Average rate: $105 per hour, according to ZipRecruiter
Independent Medical Examiner (IME)
As an IME, you provide an impartial medical assessment for insurance companies, law firms or employers. This role involves reviewing medical records and examining an individual to offer an objective opinion on their condition. It’s a role that involves direct patient evaluation, but without the long-term management responsibility.
Average rate: Fees are often paid per evaluation depending on the complexity, but the average hourly rate for IMEs is $79, according to ZipRecruiter.
Consultant for AI/imaging startups
Startups developing AI algorithms for musculoskeletal and joint image analysis need clinical experts to guide their product development. As a consultant, you would help validate algorithms, and ensure clinical relevance, putting you at the forefront of medical innovation.
Median salary: Consulting fees or equity stakes can depend on the stage of the startup, but medical AI consultants have a median salary of $273,000, according to Glassdoor.
Clinical informaticist
If you have a knack for technology and systems thinking, you might find a career in clinical informatics fulfilling. In this role, you’d work to optimize electronic health records (EHRs), develop clinical decision support tools and improve data workflow within a healthcare system. Your goal is to make technology work better for clinicians and patients.
Average salary: $103,597, according to ZipRecruiter
Medical affairs director
This senior-level role within a pharmaceutical company involves overseeing the MSL team, developing medical strategy and ensuring all scientific communications are accurate and compliant. It’s a leadership position that requires a blend of clinical knowledge, business acumen, and strategic thinking. “Non-clinical medical director positions are available at insurance companies and state medical societies,” an internist notes on Sermo. “…Networking is important in finding these limited positions.”
Average salary: $177,191, according to ZipRecruiter.
Not ready to pivot? 4 side gigs for rheumatologists
If you’re not ready to leave clinical practice entirely, several side gigs can provide supplemental income and a taste of non-clinical work.
Tele-rheumatology
Leverage technology to provide remote rheumatology follow-ups and consultations. This offers flexibility and reduces your commute, allowing you to maintain patient relationships on your own terms.
Medical writing/editing
You can take on medical writing or editing projects for pharmaceutical companies, medical education websites or publications in your spare time. This can include anything from creating materials for pharmacy and therapeutics (P&T) committees to developing patient-facing articles.
Online CME course creation
Share your knowledge by creating Continuing Medical Education (CME) courses on inflammatory disorders. This is a way to educate your peers, establish yourself as an expert and generate passive income.
Utilization review (UR)
Work for insurance companies reviewing requests for treatments, particularly expensive biologic drugs. While it might feel like you’re on the “other side,” a role in utilization review offers a flexible, work-from-home schedule and provides a unique perspective on the healthcare system.
Sermo paid medical surveys as a means to reach your goals
A career transition takes time, planning and often, financial resources. Whether you’re considering a certification in clinical informatics, attending networking events or simply reducing your clinical hours to explore other options, having a flexible source of supplemental income can make a difference.
Sermo can be a powerful tool throughout your search. By participating in paid medical surveys, you can earn honoraria on your own schedule.
Even after you move into a non-clinical role, staying active on Sermo keeps you connected to the clinical world. You can continue to share your insights, learn from your peers and maintain your clinical relevance, all while earning for your expertise.
How to shape your own future
The intellectual demands of rheumatology build a powerful foundation for a variety of alternative careers. Your expertise, particularly in the biologics and immunology sectors, can unlock doors to roles offering greater flexibility or financial autonomy, or a different kind of professional fulfillment.
As you navigate this professional evolution, you can crowdsource advice from other physicians. The Sermo community is a resource for peer support. Connect with fellow rheumatologists who have made the leap, ask questions and explore the earning opportunities that can help you reach your goals.
