About three months ago, I decided to actually give physician expert witness work a shot.

It was something that had been on my radar for a while. I knew other physicians did it. I knew it could be a lucrative side gig. And, at least on paper, it seemed to check a lot of the boxes that I look for in a physician side gig.

But I had never really done it.

So I decided to start.

And three months later, after a bunch of cold outreach, a lot of conversations, a course on expert witness work, and several actual cases, including one involving a zebra, I figured it was a good time to share what I've learned so far.

The Beginning Is Pretty Slow

The first thing I learned is that getting started in expert witness work is not particularly exciting.

There was no moment where I signed up somewhere and cases suddenly started pouring in. Instead, there were a lot of emails, Zoom calls, and phone calls.

I reached out to lawyers. I talked to physicians who were already doing expert witness work. Plus I joined physician expert witness networks. I introduced myself, explained my expertise as a reconstructive plastic surgeon, sent my CV, and basically said, “If you ever need someone like me, keep me in mind.”

And I'll admit, this felt a little uncomfortable. We aren't really trained to market ourselves. For me, there was definitely a little bit of a feeling that I was shamelessly promoting myself. But eventually I started thinking about it differently.

We really are experts in our fields. And there are legal cases where an objective medical opinion can legitimately help a patient, a physician, or both. My job isn't to advocate for whichever attorney happens to hire me. It's to review the information and give an honest opinion based on my training and experience.

Once I reframed it that way, the outreach became a lot easier.

Learning How to Actually Be an Expert Witness

At the same time, I quickly realized that being an expert physician doesn't automatically make you an expert witness. I understood the broad strokes. Review the medical records. Understand what happened. Form an opinion. Explain it.

But I didn't really know how to structure a case review, what attorneys were looking for, how to write a report, how to create a fee schedule, or even how the business side of expert witness work typically operates.

That's when I took Amy Fogelman's High Rock Academy expert witness course. I found it incredibly helpful, particularly because it wasn't just theoretical. There were actual resources and templates that I could use when cases started coming in, including report templates that I ultimately used for my first cases.

That preparation ended up being pretty well timed.

About six weeks after I really started pursuing this, I got my first case.

My First Case Came From Somewhere I Didn't Expect

Ironically, my first case didn't come from any of the cold outreach I had been doing. It came from a local physician friend who knew an attorney looking for someone with my expertise.

There's probably an important lesson in there. You can send emails and join directories and market yourself all you want, but relationships still matter. The case involved aesthetic breast surgery and, to this point, has also been my most extensive case. There were a lot of records. There were depositions. And there were hours spent reviewing everything and figuring out exactly what happened.

Then I got on the phone with the attorneys.

This was probably the first time the work really clicked for me. They had very specific questions, and my job was essentially to do something that I already do every day as a physician: take a lot of complicated medical information, figure out what actually matters, form an opinion, and explain that opinion clearly.

That case is actually still ongoing, so there may be more work to come.

But after that first case, others started showing up.

And Then There Was the Zebra

I've now reviewed a handful of cases. Some have been relatively run-of-the-mill. And then there was the case involving an injury from a zebra.

Yes, an actual zebra.

I don't remember that particular scenario coming up during plastic surgery residency.

But even that case reinforced what I've come to think is the biggest advantage of expert witness work for physicians: we already know how to do most of this. We spend our careers reviewing information, identifying what is relevant, synthesizing it, forming an assessment, and communicating that assessment to someone else. Sometimes that someone is a patient. Sometimes it's another physician. And sometimes it's an insurance company or hospital administrator.

In expert witness work, it happens to be an attorney.

That's why, after only three months, I think this may be one of the better physician side gigs available. I used to list expert witness work as something I hadn't personally done yet. Now I can at least start filling in that blank from experience.

The Economics Are Pretty Good Too

Obviously, the income is part of the appeal.

One of the harder things when I started was figuring out what to charge. Talking to physicians who had done this before helped, as did seeing how others structured their fees.

I ultimately landed at $750 per hour with a five-hour minimum retainer.

So when I'm retained, I receive payment upfront for those first five hours. If the work goes beyond that, I bill additional time. I've had cases that exceeded the retainer and others that didn't. But what matters to me isn't just the hourly rate.

It's the flexibility.

I've reviewed records early in the morning before my kids wake up. I've done work during their practices. And I've worked on cases in between operations while waiting for turnover.

I decide when the work gets done.

That's a meaningful distinction from clinical medicine, where income is about as directly tied to our physical presence as you can get. If I'm operating, seeing patients, or taking call, I can make money. If I'm not there, I generally don't.

Expert witness work is still active income. I'm certainly not going to put it in the same category as the passive income streams I've built. But it's active income on my terms.

And that makes it very different.

There Are Definitely Some Downsides

Not every potential case turns into actual work.

This is particularly true with expert witness directories and referral companies. You may get contacted about a case, review some preliminary information, give a brief response, and then never hear anything else because the attorney chose someone else.

Do that enough times and it can become a real time suck. That's one reason why, so far, I've preferred building direct relationships with attorneys.

And once you do get a case, my early impression is that the best marketing strategy is probably incredibly simple: Do a good job.

Be responsive. Be timely. You also need to be thorough without writing a 47-page treatise when three pages will do. Answer the questions being asked. Be easy to work with.

And most importantly, be honest. If your opinion isn't what the attorney wants to hear, that's still your opinion. The entire value of being an expert witness comes from being objective.

Do those things consistently and, I suspect, repeat business and referrals will follow.

The Biggest Piece I'm Still Missing

There is one major part of expert witness work that I still haven't experienced: Testifying.

I haven't been deposed or testified at trial yet. So that's an obvious blind spot in everything I'm saying here.

From talking to more experienced physician experts, my understanding is that most cases don't ultimately involve courtroom testimony. A lot of the work is record review, conversations with attorneys, and written reports. Still, testimony is different. Being questioned by an opposing attorney while defending your opinions is not something we routinely do in clinical medicine.

When I eventually have that experience, I'll write about it.

So, Three Months In…

So far, I'm a fan.

Physician expert witness work isn't passive income. It's scalable but requires effort, much in the same way that other physician side income streams can potentially require. And it isn't something where you send a few emails and immediately have an overflowing pipeline of cases.

But it does something that I think is incredibly valuable for physicians.

It takes expertise that we already spent years, really decades, developing and gives us another way to use it. And unexpectedly, I think it has already made me a better physician.

Reading cases retrospectively makes you think differently about documentation. It makes you think about how clinical decisions will look when someone reviews the chart a year later without any of the context you had in the moment. I've already found myself bringing some of those lessons back into my own practice.

Then there is the financial side.

A handful of hours of expert witness work can generate income comparable to working an extra clinical shift. Except I can do those hours before my kids wake up, at a practice, or whenever else they fit into my life.

And that gets back to the whole reason I'm pursuing financial freedom as a physician in the first place.

The goal isn't just more money. It's more control over my time. Three months in, expert witness work seems like a pretty good way to create a little more of both.

And I'll keep you posted as I go.

What do you think? Have you done any physician expert witness work? If so, what has your experience looked like? If not, what has stood in your way? Let me know in the comments below!