There are several subfields in medicine that offer niche career or side gig opportunities for physicians looking for a change. From time to time, the question of how to get started with wound care job opportunities comes up on our physician communities. Jobs in wound care can be lucrative, offer great work life balance, can be low stress, and can be done as a supplement to one’s clinical work. They can also be options for physicians who are looking to cut back clinically or retire from full time clinical work but stay clinically active. Depending on the company, some companies also offer opportunities to physicians who are not board certified or board eligible, and can be an option for physicians who weren’t able to complete residency. Below we’ll cover the basics of working as a wound care physician and how to get started with exploring potential opportunities. While this article focuses mostly on the daily aspects of being a wound care physician, it also touches on the various ways that a wound care clinic can generate revenue, for those physicians interested in that business model.
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What is wound care as a field?
Generally speaking, wound care physicians manage acute and chronic wounds. The scope of this practice has increased significantly with an aging population that is living longer with chronic disease, and many institutions and organizations have tried to find better solutions for patients in need of chronic management. Each patient is likely to be a long term patient that requires regular attention and assessment to prevent complications and ideally result in wound healing, thus resulting in steady needs and a demand for physicians that are willing to serve these needs.
Companies that specialize in wound care usually provide services in long term care facilities and skilled nursing facilities (SNFs), but there are also opportunities for physicians to build niche practices in this regard and open related clinics and services, or even offer home visits to provide these services. Depending on how much of a physician’s time they want to practice in this field, there are part time, full time, and side gig type opportunities for wound care jobs.
While wound care is not currently an official specialty or subspecialty recognized by the American Board of Medical Specialties (ABMS) or the AOA, there are certifications and ‘fellowships’ in wound care that are available to both physicians and nurses.
Tangible things physicians should know about are wound healing, typical treatment options for acute and chronic wounds, how to deal with atypical wounds, complications, and infections, infection control, various skin conditions and risk factors for wounds and poor wound healing, preventative and supplemental measures to assist with wounds like nutrition, proper physical support and positioning, and more. The goal is of course to keep the patients out of the hospital and optimize their wound healing.
A wound care physician will typically regularly visit chronic wound care patients to treat their wounds and assess their progress, often performing small procedures as necessary. Some examples of things you might do are place and manage a wound vac, do debridements, perform grafts, occasionally suture, and potentially (depending on how much support staff you have) perform dressing changes. From a nonprocedural standpoint, you’ll be regularly assessing what is going right and what is going wrong to prevent a wound from healing. You may prescribe certain products that will assist with healing. You may have to study the patient’s behavior or risk factors to see why they’re not healing (nutrition, positioning, smoking, etc.), or encourage them to be compliant with instructions and best practices.
As these wounds need appropriate care on a daily basis to provide the best outcomes and minimize complications, most wound care companies take a comprehensive approach to management and utilize both physician visits and nursing visits together in the care of a patient. The physician will therefore also usually create customized treatment plans for those in long term care facilities, and educate and work together with nurses and other care teams or caretakers for proper wound management and care between the physician visits.
What are the benefits to pursuing opportunities in wound care?
From a mission standpoint, this is important work. As physicians, we know that non-healing wounds can lead to infections and decreased quality of life, as well as actually threaten a limb or even lead to systemic issues that can result in death. Wound care also offers the opportunity to build longitudinal relationships with patients who will likely require services for an extended period of time given the nature of wound healing.
From a lifestyle and monetary perspective, working as a wound care doctor can be a great gig. The pay can be relatively competitive, depending on whether you’re setting it up yourself or what the company you’re working for is offering. As previously stated, there is much demand for this work, so opportunities to get involved are abundant either through companies or by setting up your own gigs. As this is generally non-emergent work and/or related to chronic care needs, working as a wound care physician generally allows a flexible schedule, which can be good for side gigs, a main job where flexibility is needed, or for a physician who is at later stages of their career and thinking about retiring from a more rigorous clinical schedule. Note that some companies will prefer that you work 9-5, or even require you to do so, but the pace and stress of the job may be less than what you are accustomed to in your current clinical routine. As a side gig, you can do as much or as little volume as you want but supplement your clinical income, again in a relatively low stress and low liability way.
What are the downsides or disadvantages to working as a wound care physician?
To start with the obvious, with wound care you have to be very hands on with wounds that can be hard for some to stomach seeing or that are hard on the nose. To some degree, you have to recognize that you are dealing with the work that many other physicians are looking to offload because it isn’t glamorous.
Additionally, you have to be okay with the situations you will likely encounter, including a more medically complex patient population, patients of all backgrounds and circumstances, some of whom have a lower baseline quality of life, and potentially dissatisfying outcomes. As the reason that some of the patients have the chronic wounds is because of noncompliance with other instructions, the reality is that you should be prepared to have some patients who will continue that pattern with you.
All of that said, while it may not be the most universally appealing work, it’s important work, and can be very satisfying for some doctors. Just be honest with yourself about what type of work you will be okay with doing.
What physician specialties can do wound care work?
There are some specialties that wound care may seem like an intuitive fit for, including general surgery, plastic surgery, vascular surgery, emergency medicine, internal medicine, and family medicine, due to these specialties’ tendency to have some aspect of wound care in their daily work as physicians. Generally, wound care physicians should be comfortable with procedures. However, other specialties can also be trained to do this work. Generally speaking, most companies in this space will want at least 1-2 years of residency training as a prerequisite for hiring a physician, but don’t necessarily require a completed residency. This makes it a good job or side gig option for physicians who have not completed a residency program, as well as a good side gig for specialties already familiar with chronic wound care.
How much can you make as a wound care doctor, and what does a typical wound care job look like?
This will vary widely depending on hours worked and whether you are contracting independently or working through a company, as well as on other factors related to how you set up a practice. Some wound care companies advertise full time salaries that average $250,000-300,000 a year, or rates that average $180-200 per hour for those working part time. If you work full time for these companies, you can also get a comprehensive benefits package.
The full time jobs generally require you to work 9-5, but usually do not involve nights, weekends, holidays, or call. Of course if you do the work as a side gig in addition to your full time physician job and individually contract with facilities, most of your work will likely be after hours. In short, it depends on who you’re working for and what schedule you ultimately decide works best for you and your competing interests.
A word of caution from our members - avoid companies that push you to do more than what’s medically necessary to collect more payments from payors, and talk to other physicians working for those companies before signing on to get a sense of whether the work is a good fit for your personal and professional goals.
What are the benefits to doing wound care work independently or owning a wound care center?
Anytime that you go out on your own, you introduce autonomy and the potential for more profits. If you are someone who is motivated to start a wound care side gig or business on your own, you will be able to tap into more than just an hourly rate or salary.
To piggyback off the previous section, if you are doing this independently, the compensation can add up even more quickly. Debridements and grafting are compensated relatively well, and can get quite generous based on the size of the graft. Many of these procedures are required multiple times over the course of a chronic wound. If you actually own a wound care center, compensation can be even better. In addition to getting the procedural fees for these procedures, you may also get the facility fees when applicable. Adding on practices such as hyperbaric oxygen or negative pressure treatments are additional potential sources of revenue. Without getting too far into the weeds, some wound care practices will also have a nutrition component or provide support structures for additional revenue streams.
It should hopefully go without saying to make sure that you are ethical in how you perform and bill for this work, no matter what the environment. While reimbursements are good, you should make sure all the interventions are clearly indicated.
Conclusion
Working as a physician in the wound care field may not sound like the most glamorous job in medicine, but it can be very rewarding work. The reason that the demand for this work is so high is because of its necessity in saving limbs and lives. Our members echo that being a wound care doctor is also relatively low stress, pays relatively well, and offers flexibility. As such, it can be great either as a main gig, a side gig, a retirement gig, or a gig for those without a completed residency. For those who are more entrepreneurial, starting your own wound care center or service offers opportunities both on the professional and business side of things.