Todd Barnes knows the business of neurology. With an MBA and more than 20 years of experience he has become an expert in navigating the financial travails increasingly faced by this group of physicians.

He knows that sometimes neurologists want to supplement their income, and he knows what opportunities are available.

He gave a talk on this subject at the last meeting of the American Academy of Neurology. We were fortunate enough to meet him then and more recently ask him more about this issue.

The result was a series of articles we published on medical legal work, consulting for insurance companies, and doing intermittent locum tenens. This post is the last of that series and it focuses on doing side work for the U.S. Department of Veterans Affairs.

Todd Barnes

The VA has hospitals and medical centers across the country and “the money can be good, especially for the amount of work you are asked to do,” says Barnes.

The VA uses a system of “eighths” to determine the amount of work each employee puts in. Each eighth represents five hours of work. Someone ranked as having an 8/8 appointment would work full time, or 40 hours a week. Someone hired as a 2/8, which Barnes says is usual for the kind of supplemental work he is talking about, would work 10 hours a week.

“Years ago, they were fairly rigid about what they would allow you to do,” he says. “If you were 2/8 you had to be there a day and a half a week, Monday through Friday, between 8 and 4:30. They’ve gotten more creative around this and they are far more flexible.”

Today, he says, he sees the VA letting physicians work 10-hour days, even on the weekend. And if you get a couple of 8ths “you can get some really good [health insurance] benefits, too,” Barnes adds – likely paying a lot less for insurance for you and your family than you would using a commercial carrier.

He’s also had neurologists work for the VA on a contract basis. They get paid by the hour and that rate is probably more than you are going to make in your clinic. While this has typically meant you had to have your own malpractice insurance, that seems to be changing.

“I have one fellow moonlighting at the VA on the weekend right now, and the VA malpractice is covering him,” Barnes says. “I was shocked to see how open they were and how much flexibility they seem to be having. This just changed within the last three years.”

As the VA continues to build more community-based clinics all over the country, opportunities for neurologists are continuing to grow.

“There are a lot more venues than there used to be. You don’t just have to work at a big VA medical center,” Barnes adds. “If there is a VA location near you, talk to their chief of staff or their chief of neuro and just ask if they have any need.”

Special thanks to Todd Barnes, MBA, Clinical Business Administrator Departments of Neurology/Neurosurgery at the University of Oklahoma Health Sciences Center in Oklahoma City, Oklahoma, for his insights on this issue.