Taxes and Investing

Many times our default is to say I don't know anything about taking care of the taxes or the accounting.  Maybe it's time we take on the task of learning as we continue in the understanding of the business of anesthesia.  

I'm not that smart and I don't know either investing or tax code.  But, I am taking control of the time to learn about these things.  I'm investing in my own understanding so that I can utilize the Locum world and combine it in order to provide for the family without providing more than my share to uncle sam, provide educational opportunities to my family, and increase my available time home.  I have to save the taxes in order to fund the financial/investing side.  I currently invest in real estate but hope to someday expand on that into the business, real estate, and stock markets as I learn.  

What are you doing?  I ask this not to sound like I'm doing much but just to be real.  I take the time to learn in each aspect by reading the business books, listening to podcasts, and continuing to ask questions.  

Recommended learning... Consider listening to the Bigger Pockets Podcast on Real Estate.  They have two Tax episodes by Amanda Han... so I would listen to those.  The application is to the 1099 type of income however passive income is different than active... so be careful on the full application.  Business books that I like include things like 4 hour work week (not for the 4 hour part but understanding how to maximize your time), Rise and Grind (the effects of early work and long term benfits), and Motivational books that will inspire increased relationship building.  

That's all I have for today.  

How can I help?

I think some are confused at this point.  I think some of you truly think I'm a recruiter for BlocHealth or National Anesthesia or some other company.  Some think that I'm some fancy dude that is just rolling in bank.  I hate to tell you that this is just so far from the truth.  

I'm a CRNA.  I've been a CRNA since December, 2009.  I have made my way through the locums world since 2011 and have been relatively happy.  I share my experiences and what I've learned along the way.  Yes, I've learned the hard way because honestly half the most out-spoken people just don't know everything and if they say they do... ask yourself if you know everything after being a XYZ of 10-20-30 years.... I'm betting the answer is no.  I prefer to state that I'm no lawyer or accountant but this is my experience, as it's the truth.  I'm not a financial expert or licensed as such so to give counsel... I can't do that.  I can tell you the things I have done or the people I have talked to.  

I can tell you what has and hasn't worked for me.  That's what this site is about, educating you so you don't make the same mistakes I have or collectively understanding where we are and where we go from here.  Giving you options and helping you to be able to figure out decent people to work with.  I can't tell you they are all perfect because part of the information is gathered from our peers to make this a more wholistic site.  I'm trying to give you all the information and not just one perspective.  

So, I'm not a recruiter because I don't call hospitals and get contracts for work.  I don't place CRNAs with hospitals or groups. I ask people to say that I referred them to all the agencies (when this site is instrumental in doing so) when they are going to go the agency route as the referral helps me make this site stronger for you and helps support the number of hours put into this resource. 

How many have looked at the other links at the bottom of the main page?  Anyone see the Store, Financial information that has Accountants and Financial advisers, Mortgage information, and maybe even the Where we go page that has the article by one of our own on RV'ing it across the country?  Take a moment to see all there is to offer.  Jobs come and go from the job board too.  

Any time I discuss with someone I try to make sure I ask.. How can I make this better?  What would help you more?  So, I'll leave you with my E-mail LocumCRNAs@gmail.com  

I did get a request from an undergrad resource wanting to place links to anesthesia schools and feel that first one has to be done with school and should get their practice down before considering locums... so unfortunately, I declined that request.  I'm trying to keep this a clean but solid resource.  so... How can I help?

Check

it’s always interesting going new places.  I love it.  I have fun and treat people as if I’ve known them for years.  I have fun at work while getting the serious things done in a quick and efficient manner.  I believe that this relaxes the crew and the patient.  I always state that I’m not new to anesthesia but am new to the facility and why I’m going through the paperwork a little more. 

I expect to be checked on a little more or observed more closely if in a “Care team”  model.  CRNA group the same happens just because they don’t know me or what I do/don’t know.  It’s just how things go.  I also expect them to vary the assignments from big to little to tiny and see how they wish to utilize my skill-set... it’s a way of interviewing me.  They see if I complain or fumble or have issue with those that have the most awesome personality.  These things are part of the locum political environment. I generally say that I stay out of the politics by being a locum.  I should have been saying that I remain outside of the political arena that most ACT CRNAs are in.  It’s not that it doesn’t exist ... it’s just significantly less than full-time staff typically experience.  

I have some docs and CRNAs that try to teach me at times ... from how I should hold my Miller to doing a CVP fall whenever doing a central line.  I’m not above learning and I’ll simply nod or oblige if they want something simple that’ll re-assure them that my intervention is done safely and efficiently.   

I guess what I’m saying is that each place I go I expect a period of assessment in some way.  I expect to be thrown in to the mix quickly and handed around to the different personalities and surgeons.  I always listen too.  When I hear “oh, they put him there...” I know it’ll be an interesting day.  I think we, as locum providers, need to know whom the client is, how to handle interpersonal communications, and have to be more knowledgeable in a broader scope of practice than most institutions utilize.   

I think it takes about 4-6 weeks for a place to get used to a new provider whether it be locum or permanent... then 5-9 months to understand how a place operates and if they are a good provider fit.

These are just my thoughts on the day. 

A Good Time

I’m waiting until... it’s a good time.  I’m waiting until after ....  

When is it time to become a locum?  I’m waiting for fall or winter to start?!?!  I’d caution you that it’s harder to start in fall or winter.  

As you might well know, the surgery schedule slows as people want to put off cases until the next deductible year.  New grads have trained up over the past few months and passed their board exams.  Contract Take-overs have leveled out their needed number of locum providers.  Snow birds have found their winter retreats and things have mellowed.  

Spring is a season of prepping for children to move in between school years.  Vacation coverages are needed for those in care teams that try to get their people the needed weeks for family vacation.  Aana state and national meetings abound.  New grads are taking positions but are pending boards or credentials.  The summer leaves places hurriedly scrambling to accommodate elective cases and vacations.   

Spring and summer are the times for a locum to find some steady work and prepare for a wintertime slowdown or intermittent coverage.  Time for vacation, CEUs, recertifications and generally preparing for the times ahead.   

So, it’s the very beginning of spring so... what are you waiting for?  It’s time to go through the Credentialing list and talk to a couple trusted agencies to get your spring and summer rolling!  If you need a recommendation contact Jared info@BlocHealth.com or Randi at RCarter@nationalAnesthesia.com

if you have questions for me... locumCRNAs@gmail.com

Cleaning out the office

It has to be done right.  Organization, files, and keeping the house in order.  Just like updating your credentialing, reviewing your licenses to see which ones are coming up for renewal and ensuring the CEUs are all up to date, and finally ensuring the CV has your affiliations, contacts, npi, coi, etc etc etc  all up to date. 

Not an easy task as I continued on the road for a while and returned home to stacks of paperwork.  Yes, my office is a general mess at any given time.  I start to file and realize I don't have files for everything.  I then write out a list for the store so I can get the files and then something happens.  Then Francisco comes in and says hmm... I'll make it neat and clean in here and all my papers are neatly stacked in the same mix of OMG stuff that never was sorted or filed away.  

Long story short... get the files in order.  Just like all those credentialing items you need to have in a file ready to go at a moments notice.  Just like the CV being up to date.  Your office needs to be organized enough that you can tell your partner, child, mom or dad, or maybe even a neighbor... whomever is there to go look for that one thing you need while you are on the road. 

There will be something that is missing, unless you moved your whole life into an RV and sold every possession (ie no storage or other).  Someone will have to look for something you need at some point.  We've all been there.  

This is my week.  I'm off.  I only have a few Pampered Chef things.  I only have an application for school to do.  Francisco flies out for the weekend and mom flies in for the weekend.  This will get done.  I'm excited to get going.  I ordered additional files from Amazon so I wouldn't get sidetracked.  I'm ready for an exciting office day.  

This is also time to review insurance, investments, IRAs, Accounting documents, and those business pieces that keep you going even when your working.

Summer Needs

Vacation coverage time is coming up and those that are wanting to get some of the summer coverage. This is at the same time new graduates are looking to start so you need to work on getting the contracts secured and credentialing completed.  Credentialing takes longer due to multiple credentialing needs with new grads starting after passing boards.

It is not unheard of for credentialing to take 3-5 months.  Tack on time if you have to apply for state licenses.  Are you thinking you can wait until next week or next month as it won't matter that credentialing could take a while?  Think again and start acting on it now.  Remember the credentialing paperwork you need to get together?  If not click here

Are you credentialed at a few facilities that need help consistently or is there something just in case the credentials take a little longer?  Have you talked to them about the spring and summer?  

This might be a place to discuss a plan B?  You know in anesthesia we talk about plan A/B/C/D

You say I'm going to apply to this Full Time job.  It sounds awesome but then 6 months later you are reviewing your options.  You have just moved to this town that you love but the work is less than stellar.  Maybe the opposite is true.  You didn't think about the school systems and now the kids are not getting the education you want for them or the house is amazing and the rest is just ok.  Maybe, just maybe, life is awesome and you work 2 weeks on and 2 weeks off.  

Locums can be plan B or just the extra work in between.  Locum work tends to be intermittent and the need drives up and down throughout each year and ebbs and flows in a cycle.  This is dependent on both needs and compensation structures.  The new workforce creates a moderate need by being fluid as millennials change positions at hospitals more regularly and/or are working less trying to take on more of a life outside of employment.

Plan C D E There are a multitude of plans further down the list from independent contracting.  I do Pampered Chef for fun and some correlation to other side hustles.  That said I'm also looking at how I can make an impact with my side hustle.  There are a huge number of side hustles that people have but the only one that might make sense for you is the one that will actually be worked by you.  If you want information on side hustles.  Contact Betsy Majma re Rodan and Fields.  Me on Pampered Chef (even if you just want to host a party and get free Kitchen utensils, gadgets, cookware, and more).  There are so many others that I just don't know.  

The biggest thing is staying active and making a plan with decisions.  Decisive action is necessary.  Find the time today.  Reach out to an agency or two.  Three recruiters are listed here.  tell them Jonathan Wildy sent you :)

info@BlocHealth.com

Rcarter@nationalanesthesia.com

smasinelli@odysseystaffing.com

Looking for a Full time 1099 in a small town vibe?  Jared at info@BlocHealth.com has some options for the Full time job seeker as well.  If you want me to keep you in mind for when I'm asked... send me an E-mail at locumCRNAs@gmail.com

Credentialing

I just had the nightmare.  A recruiter for a company that didn’t follow-up on my credentials despite my repeated requests to ensure all was ready to go for my March 1 start.  I received an e-mail after hours and very late that questions 4 parts of the credentialing packet which makes no sense.  This means they could not have ever looked at my credentialing paperwork.  I’m telling them that I am taking other work and if they desire to credential I will give them days as I have them available.   

I have called them every two weeks and this failure is blatantly unacceptable.  This is the reason agencies get a bad reputation as they fail to perform at the job.  Credentialing, follow-up, and ensuring an easy contract is the whole reason I see to utilize an agency.   

I am now having to go back to some standby work in order to fill a month but those fill in days don’t pay what they should as a day here and day their do not pay for the days missed in-between.   

I honestly don’t know how I could have been more on top of this.  I have written each of the people at the company and told the how unacceptable this is.  I am now scrambling to be able to pay my financials as I have been biding my time since January to start in March.  

I have been saying more and more that I have to get to zero (credit) debt as I know things happen.  I’m now kicking myself for these things.  So, learn from me and at least have more than two months of savings.  I do have multiple places I am credentialed so work isn’t the problem... it’s work in the area I wanted that is more of a challenge.  

I am contacting several contacts ASAP.  I’ll let you know what happens.  

At the Grind

Here I am back at the grind of everyday life of a locum.  I met with BlocHealth yesterday and it is so exciting to be meeting with agencies and making sure they are actively seeking great opportunities for you!  I made sure those getting credentialed are well on their way and doing well.  They are actively gaining daily contracts with groups across the US that are big and small!  

I was on call last night and I'm currently in the hospital enjoying being back at a facility I have had a long standing locum relationship despite a change of Anesthesia Management Groups.  

Relationships in Anesthesia are where it is at.  Keeping a good working relationship and providing services that can be dependable and cost effective are the keys to mutual respect.  

I've added a Newsletter to the main page so as strategic relationships and major advancements come to the site I can keep you informed and up to date.  I'm not anticipating doing mass e-mails or annoying mail on a regular basis so I hope you sign-up and stay up-to-date as we grow!  

Write off or included in your contract?

Here are a few things I didn’t think about when negotiating my next two weeks.  

1.  How am I getting to the airport?  I typically drive to every assignment so when it came to the airport I didn’t think about ... Will I Uber there?  Do I leave my car in airport parking?  Do I assume my husband will take me?  Ok the later is typically true but, now he is sick and didn’t want to take me.  I have$7 in tolls just to get that trip to the airport.  

2.  When I get the rental car in Massachusetts will they pay the tolls to and from the airport?  It’s not in my contract per say.   

3. I have clothes for a week but they don’t have baggage as an expense for taking the flight so now I don’t have enough to wear for two weeks without doing laundry.  Has anyone been reimbursed for laundry?  I also can’t take fluids or razors so no toothpaste, shaving cream, razor.... that stuff can be expensive right?  

4.  It’s a travel day before my assignment starts ... a day with no family and a day that i can’t work.  Non-productive and a loss of income.  Does anyone get paid a travel day on either end?  Usually if I drive ... I at least get travel expenses.   

These are a few things we might look at for future travel contracts.  does everyone consider these written off expenses or do you get them paid out so you get to save the expense in the first place?

A little independence

It’s been a great start.  Do you ever get to the point of I’m going to a new place and you are super excited until a little before you actually go?   

After all the excitement dies, the nerves kick in. You wonder why are they having such difficulty? Why am i needed?  What are the surrounding politics and issues? Then it’s a myriad of conjecture that has you just about to say “nope, I’m good to stay home.” Yes, after multiple years i continue to get those pre jitters.  This time was more because it was very temporary and only a couple weeks work.  I need the work but I could just ride the debt wave just a little.  If you don’t know debt and your a Ramsey fan... i sooooo applaud you and I’m jealous.  

Anyways,  I’m here & so happy i didn’t just give in to staying home.  I’m at a GI center with just myself and another CRNA and it’s nice.  Just enough work to pay some bills. Yet, I get home in time to do things and relax.  We even went to find a YMCA to join while we are around the country! (Did you know they have babysitters for two hours a day?!) yes, that last comment makes me sound ... older.   

Today is another day that will be busy with deliveries and paperwork that is all being pushed to Francisco and my parents as I’ll be working!  It’s awesome to be able to say that I’m sorry and have to work. It’s very true as i had more available weeks and they just couldn’t use me.   

I’ve supplemented with work back in Massachusetts for two weeks!  That’ll be somewhat more of a challenge but still fun to see people i worked with in the past.  

I can’t wait to keep you updated on locum life.  this weekend I start making my presentation for Costa Rica! What an adventure the next 6 months will be!