Lesson 5: Make money for the office, not yourself.

The typical medical examiner often finds himself in an all-too-typical dilemma.

Because of low salaries, medical examiners and coroner’s pathologists frequently supplement their income with moonlighting. The moonlighting can take many forms. Some medical examiners with more experience and notoriety often offer their services as expert witnesses in both civil cases and criminal defense cases. Some provide autopsy services to nearby rural counties. This often entails trips to funeral homes in these rural counties to perform autopsies. On occasion, some medical examiners get themselves into trouble by making moonlighting income during their normal duty hours or by using public governmental facilities and property to make supplemental private income.

I refer to this as a dilemma, because in this situation, nobody wins. The county or state government is deprived of the medical examiner’s energy and creativity because much of that energy and creativity is applied to making money and not to developing an excellent system. The medical examiner is deprived of much needed rest and recovery and deprives his or her family of the time he or she should be spending with them.

When I accepted the chief medical examiner position in Kansas City in 1995, I found it no longer necessary to spend long hours in moonlighting activity. My salary was sufficiently substantial to allow me to devote my full time to running an office and correcting the problems of the office. Although my predecessors traveled to surrounding counties to do autopsies, I worked out arrangements between Jackson County and these outside counties, both contractual and fee-for-service arrangements, which allowed bodies from outside counties to be transported to the Jackson County facility for autopsy.

This accomplished two things:

It allowed autopsies to be performed in a better-lit environment with adequate assistance and equipment—much better than what would be available at a rural funeral home. It enabled better autopsies with more information and few mistakes.

It also made money for the county.

You may wonder why I would be interested in making money for the county. What benefit do I gain for bringing in money to the county coffers?

Consider this. The medical examiner department is one of the few governmental agencies capable of generating an income. Few other departments have that capacity. Often, the potential income is substantial. Consider the figures in Table 2:

TABLE 2: Revenue generated by the Jackson County Medical Examiner in 2004
Source Account Title Amount
Platte County Contract for Medical Examiner $74,000
Clay County Contract for Medical Examiner $173,411
Cass County Contract for Medical Examiner $80,000
Missouri DHSS* Child autopsies $114,000
Other counties Autopsy services $63,000
Missouri DOC^ Autopsy services $24,000
Courts~ Testimonies/Depositions $5,000
Total ——————————————- $533,411
*Department of Health and Human Services ^Department of Corrections ~Civil cases only

The total income was nearly one third of our total budget!

This money did not go directly to our office. This money, much of it generated from our voluntary activity, was deposited into the county general fund. How did this help the office?

I have come to learn that if politicians understand anything, they understand one thing.


During county legislative meetings, the legislators consider a wide variety of issues, and the great majority of the issues have to do with the disbursement of funds. “How much does it cost?” or “How much can we make?” are the main questions in their minds and on their lips.

I focused on how good death investigation helped the people where I live, but I found that if I made my proposals favorable for the bottom line, I would get further with what I believed needed to happen. I was able to justify increasing personnel, equipment and salaries if I demonstrated how my proposals could either save or make money for the county.

Regarding moonlighting, I occasionally received requests to do private work. The requests from attorneys for consultation came from cases that had nothing to do with the office, and the volume of these requests was low. I accepted these cases privately because it did not make sense to involve Jackson County in them. It may be in the best interest of the county or local government you serve to take care of these requests privately.

It is important, however, to keep several things in mind. First of all, your primary responsibility is to your job for the government. The additional work should not negatively affect your job performance in your primary and most important job.

Secondly, if you are a salaried county employee, you must not use government time, resources or personnel to perform private work. Many a medical examiner has ended up in trouble on these matters. If you do any privately remunerative work on government time or with government resources, you must not do it without the expressed permission of the local government, and the government is not likely to give that permission. The public does not countenance public servants who “double dip” or make both a government salary and a private income during the same hours. You should do all of your private work after hours—evenings, early mornings or weekends—using your own resources. You should take scrupulous care to avoid mixing the main job with the extra work.

Thirdly, if involving yourself in a private case has the potential of negative repercussions for your job, you should turn the private case down. When I turned down a case, I gave the requesting attorney or family my recommendations of particular doctors who might be able to help them with their case.

Finally, if you agree to do private work, do not give it away cheaply. Demand a high amount of money. After all, money equals appreciation, and you should get all the appreciation you deserve.

Because money equals appreciation, the way you manage the finances for the office will reflect on the type of appreciation you will receive from outside agencies.

Every employee in my office had his or her salary and benefits translated to an hourly scale. My secretary maintained the hourly scale. If a private attorney or any non-governmental entity made a request for work to be performed by the office, the office billed that attorney or entity for the time it took the employee to fulfill the request and for the resources that were expended. As a county employee, I was not allowed to bill on behalf of the county for more than the actual cost, so I made certain that we accurately billed for time and expenses. For example, if my deputies or I were required to perform depositions on civil cases, we would bill for the time according to the hourly scale set up in the office. If we had to sit at the courthouse waiting to testify in civil court on a case, we billed for the time accordingly. We did not do this on criminal cases, because court testimony in these cases was a part of the regular job description.

It is not acceptable to give away county services to private entities free of charge. You will command respect and appreciation if you are willing to make money for the office and not yourself.