She has worked as a consultant for The Strategy Group for Media, and she published a book titled True and Constant Friends in April 2015.

[2] Rand Paul was completing a surgical rotation at Georgia Baptist Hospital while working on his medical degree at the Duke University School of Medicine.

[2] Paul would go on to help her husband with producing newsletters and mailings for his practice, running the payroll, keeping the books, and managing a remodel of the building where he saw patients.

[2] Leading up to her husband's election to the United States Senate, Paul began freelance writing, and focusing more on her own career as a private citizen.

In addition, she also worked for the political consulting firm The Strategy Group for Media, with one of her clients being then-U.S. Senate candidate Ted Cruz of Texas.

[19] In 2018, Paul advocated for passage of the First Step Act, meeting with senators and conducting public interviews (including appearing on Fox News) to try to build support for the bill.