As a primary care physician (PCP), your take-home pay doesn’t always match your effort. Inflation, debt, family responsibilities, reimbursement upheavals, and the desire for greater control are driving physicians of all specialties to seek additional income streams.
But the reality for PCPs is uniquely intense. You carry high patient volume, constant inbox work, chronic disease complexity, preventive care, acute complaints, and administrative overload. Despite the breadth of your responsibilities, compensation often lags behind that of procedural specialties.
Fortunately, moonlighting can be a smart profit and upskill lever for PCPs when done correctly. In this article, we cover how to choose shifts that align with your training, stay within scope, protect your license, and ensure you’re paid what you deserve.
Who is eligible for moonlighting as a primary care physician
Across multiple sources, 35% to 40% of physicians report consulting or moonlighting to generate additional revenue across all specialties. In Sermo’s own survey, 54% of physician members reported already having a side hustle.
As a primary care physician, moonlighting is best aligned for fully licensed family medicine, internal medicine, and general practitioners who have independent clinical autonomy and can credential for per diem work. In most cases, eligibility comes down to a few core requirements: an active medical license in the state where the patient is located, appropriate board status or board eligibility, and a scope of practice that fits the role you’re taking.
Eligibility varies significantly based on training status. Residents and fellows may moonlight, but only in accordance with their program and accrediting body rules, and those hours count toward duty-hour limits. Fully licensed attending PCPs typically have the broadest menu of options because credentialing, privileges, and payer requirements are easier to satisfy when you’re not constrained by training-program policies.
Why do primary care physicians seek moonlighting opportunities?
Sermo surveyed over 2,000 physicians about the main benefits of a side hustle: 41% said earning extra income, 21% said improving their skill set, 17% said expanding their network and 12% said building their reputation. Here are some of the specific factors that may be driving PCPs to seek additional jobs through moonlighting:
Compensation vs. workload
As a PCP, you manage complex chronic disease, preventive care, and acute complaints at high volume. Many physicians feel their work is undervalued under current productivity compensation models and escalating administrative expectations.
A Sermo member and Oncologist from the USA put it bluntly: “Financial health maybe is the biggest challenge for many professionals in any area.” Moonlighting provides a direct way to convert clinical effort into predictable hourly income, often with clearer start and stop times and fewer admin headaches.
Administrative overload and RVU fatigue
Moonlighting doesn’t automatically eliminate documentation, but many gigs are paid purely by time worked, not by RVUs and not by the invisible labor of inbox management, staff management, prior authorizations, or endless care coordination that come with your regular clinical job. The result is simple: the work can feel more financially efficient, even when it’s still hard work.
Monetizing generalist expertise
Your PCP graduate and clinical experience prepare you to triage and manage a wide array of undifferentiated patients, and quickly. That skill set can fill gaps in urgent care, inpatient coverage, and tele-triage models, where speed, judgment, and safe disposition planning are key requirements of the role.
Flexibility and autonomy
You can schedule moonlighting shifts in advance, choosing from short blocks, evenings, or weekends, to fit your existing schedule. It’s not about adding a second workload but about picking the right shifts, at the right cadence, that match your energy, availability, and income goals.
This is also why “passive” or semi-passive income is top of mind for physicians. In a Sermo poll, 46% of physicians reported having a passive income source, while 54% said they do not.
The income goals from side hustles vary. In the Sermo poll, 40% of physicians say they want to earn an additional $50 to $1000 per year, 19% aim for $1001 to $5000, 19% say $5000 to $15000, 12% want $15000 to $50000, and 10% aim for $50001+.
That tension between work and life is palpable. As a family medicine physician shares on Sermo: “Although it is sometimes difficult, you have to try to leave time for family and friends, even if it means losing money.”
Where to find moonlighting opportunities as a PCP
The best PCP moonlighting opportunities often pass through physician networks before reaching broad job boards. Start with your inner circle and then expand outward.
Within your own health system, ask about per diem urgent care coverage, weekend rounding needs, same-day clinic gaps, or cross-coverage pools. Externally, consider specialty job boards, locum tenens companies, and reputable telemedicine staffing pathways. Locum agencies can be especially useful when you need fast credentialing support, temporary assignments, or coverage in underserved areas.
Don’t underestimate physician communities. On Sermo, verified physicians share real-world experiences and advice, discuss moonlighting strategies, and expose lucrative opportunities.
Urgent Care Chains
Urgent care remains one of the most common per diem destinations for PCPs because the work aligns with generalist training and there is consistent demand for evenings and weekends. Pay varies by region, volume, and expectations, but published benchmarks often land in the low-to-mid $100s per hour for urgent care physicians.
Community Hospitals
Community hospitals often require hospitalist-style coverage, observation units, and short-term inpatient rounding support. Some settings also use PCPs in lower-acuity pathways when credentialing and protocols allow.
ED fast-track units
Can a primary care physician work in an emergency room? In many hospitals, the answer is: sometimes, in the right lane. ED fast-track or low-acuity areas may be open to appropriately credentialed physicians, depending on hospital bylaws, staffing models, and state-specific considerations. The key is not the label “ER.” It’s the scope, supervision structure, and credentialing rules at that facility.
Telemedicine Platforms
Virtual urgent care, triage, and chronic care follow-ups can be a strong fit for PCP workflows, especially if you’re already efficient at remote decision-making and safety-netting. Telemedicine doctors earn as much, and sometimes more, as they do during their regular clinic hours.
Locum Tenens Agencies
Locums can be ideal for short-term, high-pay contracts, especially in rural or underserved settings where physician shortages are dire. Some PCPs use vacation blocks or lighter clinic seasons to pick up a compact run of shifts, rather than committing to longer assignments.
7 moonlighting opportunities for primary care physicians
Below are several options to consider for moonlighting, tailored to your PCP training. The right choice depends on how you want to trade time, stress, and complexity for income. Pay rates often increase in rural locations, high-volume scheduling, or short-notice coverage, and decrease somewhat in saturated urban markets or for longer-term quasi-permanent assignments.
PCP locum tenens
Locum tenens moonlighting is distinct from full-time locum roles. Here, it means supplemental, short-term shifts taken in addition to your primary job. Examples could be:
Inpatient and hospital coverage: Temporary blocks of shifts, sometimes a week at a time, covering inpatient rounding or hospitalist-style service needs. Average published locum ranges often place family medicine around $90 to $125 per hour, and hospitalist work around $140 to $180 per hour, with meaningful variation by geography and expectations.
Outpatient clinics: Part-time coverage in clinics for established practices or health systems, is sometimes needed to backfill vacations, seasonal surges, or recruitment gaps. Pay for outpatient locum tenens ranges from $120 to $160 per hour.
Internal hospitalist programs
Some healthcare systems offer internal moonlighting pools for employed physicians. If you already know the EMR, the order sets, and the culture, it’s easier to get started. For many PCPs, this is the most “efficient” moonlighting because credentialing is simpler – plus workflows and expectations are familiar. Pay ranges from $120 to $200 per hour.
Specialty-specific shifts
PCPs are generalist physicians, and that makes you valuable to other specialties in specific, bounded ways. Think pre-op clearance support clinics, perioperative medicine consult pathways, inpatient co-management, or specialty overflow coverage where the work is primarily evaluation and medical decision-making rather than procedures. The pay varies depending on location, responsibilities, and specialty, but it can easily pay you the same or more than your regular rate.
Telemedicine services
According to a Sermo poll, 78% of physicians on Sermo work in clinics or practices that offer telehealth services. Telemedicine moonlighting can include virtual urgent care, primary care triage, medication counseling, and chronic care follow-ups.
If you want to find telemedicine moonlighting shifts, start with established telemedicine employers, locum agencies that staff virtual roles, and health systems building internal virtual pools. A practical tip: look for roles with clear protocols, defined response-time expectations, and explicit coverage rules, so that promised “flexibility” doesn’t turn into always-on work.
Correctional and occupational medicine
Correctional medicine and occupational health can offer structured shifts, clear documentation expectations, and strong demand in many regions. For PCPs seeking predictable work and defined boundaries, this can be an underrated option, provided you’re comfortable with the patient population and the operational environment. Compensation for correctional and occupational moonlighting ranges from $80 to $150 per hour, with rates varying by location, experience, and shift length.
Global health and travel medicine consulting
For PCPs interested in travel medicine, vaccine counseling, destination-specific risk guidance, and pre-travel planning can be a natural extension of preventive care skill sets. Some physicians also blend travel assignments or short-term work with broader career flexibility planning. Global health and travel medicine consulting pays from $100 to $170 per hour on average, depending on state and experience.
Some doctors take the flexibility even further. One U.S.-based family medicine physician shares on Sermo, “I’ve done locums for years, traveled 1000s of miles, would fly weekly, and sometimes 5-6 times a month back and forth. The pay is well, depending on the area and your lifestyle, but it can be a suitable job, long term.”
Urgent care shifts
Urgent care is often the cleanest clinical match for PCP moonlighting: defined shifts, defined handoffs, and high demand for evenings and weekends. Benchmark data suggest that urgent care physician pay averages are typically in the mid-$100s per hour, though rates vary with volume, staffing, and geography.
In a Sermo community discussion, some members describe a steady cadence rather than constant overtime. In response to the question “How often do you moonlight?” physicians shared “3-4 times per month” and “2-6 shifts per month.”
One Sermo member summarizes a long view of stacking clinical and non-clinical work: “I ran an emergency medicine corporation and coincidentally two urgent care practices and eventually one urgent care/family practice and with the exception of only a handful of years, I moonlighted in emergency rooms every chance I got and did medicolegal work whenever it came to me, for extra income.”
Non-clinical side jobs for primary care physicians
If the idea of more clinical shifts makes you feel tired before you even start, you’re not stuck. Many PCPs build non-clinical side income through medical writing, consulting, leadership work, education, chart review, and medico-legal projects.
Medico-legal consulting specifically can range from record review to expert opinion work, depending on your experience and comfort level. If you want to explore a broader menu of options, see Sermo’s article on primary care physician side gigs for non-clinical paths that better protect your time and energy.
Sermo paid medical surveys as a means to reach your goals
Not every income goal requires more time in the clinic. Paid medical surveys are a flexible, low-friction supplement for physicians seeking extra income without adding another shift to their schedules. Sermo surveys are designed to fit around clinical realities: you share real-world insights, contribute to healthcare decision-making, and get compensated for your time. Surveys can be completed between patients, during downtime, or even on your lunch break.
For PCPs, that extra income can support tangible goals: paying down debt, building a buffer against reimbursement changes, funding a secondary certification, or simply rebuilding financial breathing room. If you want to increase survey earnings efficiently, the highest-impact behaviors include checking for survey opportunities consistently, responding quickly, and keeping your profile current so you match the right studies.
The best way to start moonlighting
For primary care physicians, clinical moonlighting should be seen as a strategic asset rather than a sign of excessive work. Done right, it can help you to stabilize finances, reduce reliance on low-control compensation models, and give you more autonomy by leveraging your high-demand generalist skill set in urgent care, hospital coverage, and telemedicine environments.
But guardrails matter. Before you accept any moonlighting shift, confirm state licensure requirements, credentialing expectations, and malpractice terms. Pay attention to coverage type, including whether a policy is claims-made and whether tail coverage is required. And if you’re earning 1099 income, plan for taxes early, including potential quarterly estimated payments, so “extra income” doesn’t turn into an ugly surprise in April.
If you want moonlighting ideas grounded in real physician experience, join the Sermo community to see what peers are doing, compare rates and roles, and share what’s working. If your goal is extra income with minimal schedule disruption, explore Sermo paid medical surveys as a practical way to earn on your own time.
Key takeaways
- Generalist skills are in exceptional demand: PCPs are uniquely trained to evaluate undifferentiated complaints and make independent clinical decisions, making them ideal for moonlighting roles that prioritize speed, autonomy, and breadth; often at hourly rates competitive with or exceeding traditional outpatient compensation.
- Highest-yield clinical moonlighting roles: Urgent care, hospitalist/nocturnist coverage, and telemedicine shifts consistently offer the best income-to-time ratio for PCPs, leveraging their internal medicine and family medicine foundation without requiring subspecialty retraining.
- Compliance is non-negotiable: PCPs must confirm state licensure eligibility, scope-of-practice alignment, and independent malpractice coverage for all external moonlighting activities, especially when working outside their primary employer.
- Sermo benefits: Sermo offers a platform where PCPs can connect to share information and earn extra income through paid medical surveys.
