The deal was never supposed to work this way. A physician spends a decade in training — four years of medical school, three to seven in residency and fellowship, years of licensing, boards, and accumulated debt — and emerges into a career that is, by almost any external measure, successful. High salary. Social standing. A sense of purpose. And then, quietly, many of them start building something else on the side.
It is not burnout alone, though burnout is real and the numbers are grim. It is something harder to name: a hunger for ownership, for creative risk, for a kind of impact that the current structure of clinical medicine makes increasingly difficult to find inside the hospital walls. Coaching practices. Entrepreneurial ventures. Side projects that start as experiments and become second careers. The physicians building these lives are not abandoning medicine. They are expanding what medicine can mean for them — and for the patients and professionals they serve through other means.
MedStory Studio asked two physicians to answer three direct questions: what made them finally start, what it actually cost them in time and money, and what they know now that they wish someone had told them. Their answers are below, unfiltered.
The side gig — and the trigger
Dr. Balakumar is a certified physician career development coach — a credential she pursued after recognizing that the stress and expectations of her role kept shifting in real time, and that the source of that pressure had nothing to do with actually being a physician. Something had to change.
"I realized the stress and expectations for my role were always changing in real time — but it had nothing to do with being a physician. I was very unhappy. Coaching doctors and healthcare workers keeps me in the space of medicine, to give back to the professionals that are the foundation. Also to build something for myself."
— Gita Balakumar, MD, Pediatrics
She still practices direct patient care, but has chosen to work in a different way — a decision she notes has met with real resistance. The coaching work lets her stay inside the world of medicine while serving the professionals who form its foundation. It is also, plainly and without apology, a way of building something that is hers.
The real cost
The coaching certification itself took six months. The business — the actual work of turning a credential into a practice — is still in progress. Dr. Balakumar is candid about what that process feels like: she is venturing into territory she was never trained for, navigating genuine uncertainty, following dead ends, and starting over.
"I am venturing into areas I am not 'schooled' in — so lots of uncertainty, trial and error, and dead ends. The process is creative too, so I like it. Money-wise, it's not nearly as expensive as medical school, but aside from the cost of the program, other costs start accumulating — money and time and effort. Social platform utilization, networking, business cards, professional photos."
— Gita Balakumar, MD, Pediatrics
None of those line items are catastrophic individually. Together, they add up — in money, yes, but also in time and energy drawn from the same finite reserves that clinical medicine already taxes heavily.
What she wishes someone had told her
"Getting that first paying client is difficult."
— Gita Balakumar, MD, Pediatrics
It is a short answer. It is also one of the most practically honest things a physician building a coaching or consulting practice can say. The credential does not sell itself. The clinical reputation does not automatically transfer. The first client — the first person who pays money for your time and expertise outside of the medical context — requires a different kind of work than anything medical training prepared you for.
The side gig — and the trigger
Dr. Khokhar's answer to what his side gig is does not resolve to a single thing, because entrepreneurship — genuine entrepreneurship — rarely does. Over the years, he has launched ventures in sports, events, collectibles, and healthcare education. The common thread is not an industry. It is a drive toward building: organizations, communities, solutions to problems that clinical practice alone cannot address.
"I've always been drawn to building organizations, creating communities, and solving problems outside of medicine. The trigger was the realization that waiting for the 'perfect time' was keeping ideas on the sidelines."
— Omar Khokhar, MD, Gastroenterology
The framing is worth sitting with. The trigger was not a crisis. It was not burnout or a dramatic rupture with clinical medicine. It was the slow-dawning recognition that the perfect conditions for starting would never arrive — and that waiting for them was itself a choice with costs. That insight, as simple as it sounds, is the one that separates physicians who launch from physicians who spend years thinking about launching.
The real cost
Dr. Khokhar does not minimize what it took. Years of nights and weekends. Early mornings. A full-time medical practice running in parallel the entire time. Financial investment across multiple ventures, for a long time, before meaningful returns appeared. The currency that mattered most, he says, was not money. It was time — and the consistency required to show up for something uncertain, repeatedly, without a guaranteed outcome.
"The biggest investment wasn't money — it was time and consistency. Success rarely came from one breakthrough. It came from hundreds of conversations, partnerships, lessons learned, and constant tweaks along the way."
— Omar Khokhar, MD, Gastroenterology
This is perhaps the most important thing to understand about physician entrepreneurship that the optimistic version of the story tends to obscure: it compounds slowly. The payoff is real. But it arrives after a long period of investment that looks, from the outside, like very little.
What he wishes someone had told him
His answer turns outward, toward other people — which is itself revealing. What Dr. Khokhar underestimated was how important it is to build a network of mentors, partners, and supporters who can open doors and challenge your thinking in ways that no solo effort can replicate.
"People are willing to help. There will be setbacks, failed projects, and moments when you question whether it's worth it. What's most rewarding is the relationships and the network."
— Omar Khokhar, MD, Gastroenterology
Entrepreneurship, he argues, is less about having a great idea than about execution, resilience, and relationships. The idea is the starting point. The network is what keeps you going when the idea runs into the reality of the market — which it always does, and which it always will.
What these two physicians share is not a business model or a specialty or a particular vision of what medicine should look like. What they share is the decision to act — to stop waiting for the perfect moment and build something outside the structures that trained them. That decision is, in its own quiet way, a form of staying in service to the profession, and to themselves, on their own terms.