In 2020, virtualism was a pandemic necessity. By 2026, it's a career choice. Fifteen thousand physicians made the switch to virtualist careers in 2025 alone. Not because they had to. Because they wanted to.
What Changed
Five years ago, "virtualist" meant "using telemedicine platforms as a side gig for extra income.
Today, virtualism is a primary career path. Physicians work as full-time virtualists, earning competitive salaries, with scheduling flexibility.
The shift happened because:
- Technology matured (Epic works well enough that virtualists can practice real medicine)
- Health systems accepted it (no longer seen as inferior to office-based care)
- Physicians realized benefits (flexibility is valuable)
- Market competition (virtual groups compete for talent, improving compensation and work conditions)
Why Physicians Choose Virtualism: The Four Pillars
A key insight comes from Chas Gessner, founder of VitalityRx and former NFL player turned healthcare entrepreneur.When discussing why physicians leave traditional practice, Gessner emphasizes the importance of sustainable work structures:
"You're going to be really busy, you're a doctor, you're going to be obsessed with this. It's going to be a majority of your life."
This is exactly why virtualism works for many physicians. It allows doctors to practice medicine without the all-consuming administrative burden of traditional practice.
The four main factors driving the switch:
- Scheduling Control
A traditional primary care physician in an office:
- Fixed office hours (8 AM to 5 PM)
- On-call responsibilities (nights, weekends)
- Patient panels (can't easily reduce or shift)
- Vacation rarely stress-free (always on-call)
A virtualist:
- Flexible scheduling (morning shifts, afternoon shifts, per-diem)
- Reduced on-call burden (not managing office logistics)
- Scalable patient volume (see 6 patients or 12, depending on the day)
- Actual vacation (no one calling with office issues)
- Reduced Administrative Burden
Office physicians deal with:
- Staff management (hiring, firing, performance management)
- Office operations (scheduling, billing, compliance)
- Facility management (rent, utilities, equipment)
- Payer relationships (complex contract negotiations)
Virtualists delegate this to their organization. They focus on clinical work.
- Better Work-Life Balance
Office physicians report:
- 11-hour workdays (patient care + admin)
- 30-40% of time on non-clinical work
- High burnout (42% of primary care physicians burned out)
Virtualists report:
- 8-9 hour workdays
- 85-90% of time on clinical work
- Lower burnout (25% of virtualists burned out)
The difference: structural. Virtual models are built around clinical efficiency. Office models accumulate inefficiency.
- Competitive Compensation
The perception: virtualists earn less.
The reality: it depends on the model.
- Transactional telehealth: $100k-130k (low compensation, high burnout)
- Stable virtual medical group: $160k-200k (equivalent to office physicians)
- Fee-for-service virtual: $150k-220k (varies by volume)
A virtualist at a stable virtual group earns the same as an office physician, works fewer hours, and has more control over schedule.
Dr. Berkowitz's Advice on Career Integration. Dr. Lyle Berkowitz offers a crucial perspective on blending passion with medical practice.
When teaching medical students, Berkowitz advises:
"The more that you can take some of your outside interests and blend them into being a doctor, the more enjoyable it's going to be."
This applies directly to virtualism. If you love technology, work for an Epic-based virtual group. If you love administrative efficiency, virtualism's streamlined structure appeals to you. If you love patient contact without overhead, virtual primary care is perfect.
Virtualism lets you design your medical career around your strengths, not against them.
The Career Progression Path
Virtualism isn't a dead-end career. Pathways include:
- Clinical leadership: Become medical director of a virtual team (oversee 10-50 virtualists)
- Operations: Transition into health system leadership (CMO, VP of Clinical Operations)
- Entrepreneurship: Start your own virtual medical group or health tech company
- Specialty development: Build expertise in a specific condition (diabetes management, mental health, chronic disease)
- Research: Publish outcomes from your virtual practice
- Teaching: Mentor new virtualists entering the field
Who Should Consider Virtualism
Ideal candidates:
- Physicians burned out on office administration
- Physicians wanting schedule flexibility (parents, caregivers, semi-retirement)
- Physicians seeking work-life balance
- Physicians comfortable with technology
- Physicians not requiring patient continuity (some virtualists value each visit being independent)
Less ideal candidates:
- Physicians needing deep patient relationships (virtual visits are shorter)
- Physicians uncomfortable with technology
- Physicians requiring in-person exams (limited to history and assessments
- Physicians who need active management of complex surgical patients
FAQ
Q: What's the typical salary for a virtualist physician?
A: $150k-200k. Range depends on specialty, experience, and whether it's salary or fee-for-service.
Q: How many patients does a virtualist see per day?
A: 10-14 is typical for primary care. Specialty consultations might be 6-8 per day.
Q: Do virtualists have patient continuity (same patients)?
A: Varies. Some virtual groups aim for continuity (same patient sees same virtualist). Others operate transactionally (any patient, any virtualist). DirectShifts helps you find models that match your preference.
Q: Is virtualist work less stressful than office-based practice?
A: Generally yes. Less administrative overhead, less staff management, less facility stress. But patient volume can still be demanding.
Q: Can I transition back to office-based practice after being a virtualist?
A: Yes. Virtualism is gaining legitimacy. Most health systems value virtualist experience.
Q: What's the learning curve for Epic if I've never used it?
A: 4-6 weeks with training. Most virtualists reach comfort within 8-12 weeks.
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