locum life

Feeling Adventurous

Listen up! This is the time to really consider your future and consider starting your business. If you are looking for something in addition to anesthesia or even entertaining a business in anesthesia, this is the time. You all probably know that I am starting a laundromat, and some rental properties. I am always looking to how I can further develop and grow business in the Locum world and outside of it. I use locum anesthesia in order to have these investments. This is, however, the first time I have had to take a business loan. I thought for sure I would be raked over the coals. The contractors for the rehab are making an extensive penny or two from me. I’m still using them because of their reputation and that I know the job will get done. This is sometimes how it works in anesthesia as well. If you have a good reputation and have worked with people before, it bodes well that even with an increased rate, that you will be called over another person. It doesn’t always work that way, but you have a better chance.

I really wasn’t going to write a lot about locums except to say that you can utilize this lifestyle in order to make your entrepreneurial side hustle a real life adventure. I had no idea how I was or … if I was going to get the loans to make this Laundromat work! Here is what has happened so far. I had bids from a great contractor but it would be may before they finished. I had a bid from someone that was not exceptionally or commercially adept, and finally the bid I ultimately took which was based on recommendation and experience in commercial development. I also had the laundry equipment person out to help in design, layout, function, setup of equipment and then the company designed the necessary templates for the construction crews. I talked to a bank which was willing to help but wanted me to be in person and in place all the time so after weeks and weeks I made a switch to another bank. This banker has been awesome. He was proactive in getting the city and state co-loans processed and ultimately approval for all the rehab. The laundry equipment was fully financed by the equipment maker.

I had expected the personal guarantees as I just don’t have millions in assets and it was 100% financed. That said, I expected high interest rates and was thinking that I would be up the creek and paying for it. This is the time to get a mortgage, a business loan or go for a dream. I think it will be harder as time goes forward in the coming years and interest rates are increasing.

This business is less than $2500/month to make an amazing attempt. Yes, there are incidentals, insurance, bills, utilities and the like that will cause some creep but those are operational expenses. Did you think you could have a business with upside potential at $2500/month?

OK, if you don’t want to take on a risk like this. I completely understand. That is where your multi-level marketing companies come in.. Don’t like that?? Then consider your on-line businesses or the many opportunities for growth within anesthesia. You have to take a leap. Listen to the goals Youtube presentation again and make your audacious goals. You can do this!

Are you thinking gees I couldn’t take that risk? It’s not far off from Locum Anesthesia. One day you can have a contract at $160/hour then have a $120/hour assignment. Things change and some day you’ll look for when you can take that vacation and realize that no work = no pay and that you wish you had even a $100 coming in from some investment.

Just a couple thoughts as we are still in the new year…. but tomorrow is Feb 1 and the year will be flying by! Learn, grow, and stay on the journey. You CAN do this!

Lesson from the movies

I went to the movies and I'm sure I didn't take from the movie what they hoped.  I tend to take little bits out of life and try to make them part of my life.  From Financial Independence to Anesthesia I take a little bit from every day.

I went to the movie "I Feel Pretty".  It's a little different now that we are raising a little girl.  I don't know why it is but the way I look at movies and media in general.  I also look at many things that come at me from my MBA program (I'm in week one)  to Anesthesia and Locum work.  

I feel pretty tends to try to show that it's not about how you look.  Great story on confidence and looks.  If you take this concept and expand it to the comments of: 

It's what you know

It's not what you know but who you know

It's all in the experience

It's all about the environment (Nature vs Nurture)

It's the fact that you had an education that not everyone could

I'd say "it" is about all these things and none of these things.  This movie can take all those things and say It isn't about just those things but the APPLICATION of each of these things and the most successful people take all the principles and they apply them in different ways.  

I say that because you can know all the right people but if you don't apply the lessons from each person "the 5 people your closest to" can't change you.  You have to change you. You have to be open to the application of lessons learned.  

You hear about this or that and think you want that ... but you have to be "on the ball" and do what has to be done to "be" the change you want. 

It's the same idea of me always listening to financial reports and to stories of those that developed business and climbed the non-existant ladder of success.  Very few people just rise to the top without taking specific actions in those areas above.  

So, for today, I'm leaving you with the actions you take and the application of the principles mentioned that will elevate your practice, life, education, and the bring the road into focus to where you want to be.  So, take action and apply yourself to becoming better each and every day. 

Is it difficult to set-up a sep-IRA?

I have been a CRNA for quite some time, as you might be aware.  I have tended to keep my earnings and retirement away from the stock market.  As many would chastise me for not taking advantage of tax sheltering, and even I wish I were a better saver.  

I have always invested in real estate.  For a while it was my own home.  Then it was the start of rental property in Kansas.  I am still invested in Kansas and started on my current home in Virginia.  

I have avoided the stock market though.  I have used an E-Trade account as if it were a casino.  I haven’t been an investor but a speculator.  I have invested over the years in the military Thrift Savings Plan ... 1% for 9 years... you know how little that is.  I forget to take time to learn about those things.  I know I need to shelter my taxable income so I am actually doing this.  

I went for weeks totge website for Vanguard but then they said they couldn’t verify me.  Then I had to fax things for the Solo 401K but... I missed 2017.  So, I decided I would do a simple Sep-IRA if I could.   

I was checking my E*TRADE to make sure my Roth IRA transaction went through and then I had an epiphany.  Why not try to set up just an IRA.  I saw the set-up a retirement account button and so I clicked on it.  Bam, Sep-IRA option right there.  Two minutes later i had $6k coming out of my account to fund a Sep-IRA for 2017.  I have until my taxes are filed toget those dollars cought up. I would prefer a Solo-401k but I didn’t get it set-up in 2017 which means no $$$ can beplaced in it for 2017.  So, i now have a sep and I’m working on saving a tax bracket or two by saving more pre-tax dollars toward retirement as my rentals are post tax.

Is it possible to invest in retirement with real estate?  Yes, but have I done this... no.   

Every year, I will try to be more active in my tax planning and save betterfor my family and child or children (someday).   



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

Five Ways CRNAs Can Minimize Their Tax Burden

Five Ways CRNAs Can Minimize Their Tax Burden

by Jeremy L. Stanley, CFP®, AIF®

One of the great things about being a CRNA is the lucrative salary. What’s not so great are the high taxes that accompany it. A 2015 Gallup poll showed that 63% of Americans are dissatisfied with the amount they pay in taxes, and many CRNAs fall into this category1. With an average salary of $160,2502, CRNAs can pay between 28% and 35% just in federal taxes (depending on their filing status and spouse’s income)3. On top of that, CRNAs receiving a W-2 face limited tax deduction options, as they often can’t take advantage of deductions for business, travel, and other expenses.

Beyond income taxes, many CRNAs are bumping up against the Alternative Minimum Tax (AMT). The AMT is a supplemental income tax required in addition to the baseline income tax for select taxpayers who have deductions and exemptions that allow for lower payments of standard income tax. This means that some taxpayers must calculate their liability twice (first under income tax rules and second under AMT rules) then pay the higher amount. While this tax was initially designed to keep wealthy taxpayers from using loopholes to avoid paying taxes, it now impacts more than 5 million filers. The AMT exemption is similar to the standard deduction for calculating your alternative minimum tax. For single taxpayers, the 2017 exemption amounts start at $54,300 and phase out at $120,700, and for married couples filing jointly, the amounts range between $84,500 and $160,900.4

Working with a tax professional throughout the year can help you legally minimize your overall tax liability and chances for owing the AMT, including CRNAs who receive a W-2. Here are a few strategies for minimizing your taxes.

Understanding W-2 versus 1099 Tax Planning

Before diving into tax strategies, it’s essential for CRNAs to understand the differences between W-2 tax planning and 1099 tax planning.

As a CRNA receiving a 1099, whether full or part-time, you can take tax deductions that a W-2 employee cannot take, including deductions for travel expenses, insurance, office and medical supplies, and other business-related expenses (as well as saving significantly more money each year in tax-advantaged retirement accounts). Depending on your job status and goals, you may consider working as a business owner or freelancer and using a 1099, which gives a wider array of options for tax deductions. A tax professional may also help you take advantage of deductions you weren’t aware you were eligible for.

Use the Correct Filing Status

Your filing status determines your filing requirements, standard deduction amount, eligibility for a variety of tax deductions, and the amount of tax owed annually. When it comes time to file, make sure you determine which filing status is most appropriate for you.

Currently, there are five IRS filing statuses:

  1. Single

  2. Married filing Jointly

  3. Married filing Separately

  4. Head of Household

  5. Qualifying Widow with Dependent Child(ren).

It is important that you select the correct filing status for your given situation. The IRS provides a few basic tips to help you determine which filing status is most appropriate for you:

  • Your status on the last day of the year determines your status for the entire year. For example, if you were married on December 27th, even though you spent the majority of the year working as a single professional, you must file your return as married.

  • If your spouse died during the tax year, and you didn’t remarry, you may choose to file a joint return for that respective tax year.

  • Married couples can choose to file separate returns, but depending upon their state of residence, a financial benefit may not result.

  • The term ‘head of household’ applies to filers who are not currently married. In order to claim this filing status, the individual must be financially responsible for at least 50% of all costs resulting from maintaining a household, including those costs of another qualifying person.

If more than one of the available filing statuses is applicable, choose the one that results in the least amount of tax owed.5

Use Tax-Favored Retirement Accounts

If you are an employee of a hospital, you may not have as much room to strategize regarding your tax-favored retirement savings. However, if you are a freelancer or business owner, you can employ a variety of strategies to lower your total tax bill. As highly compensated professionals, pre-tax contributions into qualified retirement plans can reduce your adjusted gross income. The most common employer-provided qualified plans are 401(k) and 403(b) plans.

As of 2017, CRNA employees with a 401(k) or 403(b) can defer up to $18,000 of their annual earned income on a pre-tax or after-tax basis. Participants over the age of 50 can also take advantage of the catch-up provision and contribute an additional $6,000 (These amounts can change annually).6

One of the many benefits of being a business owner or freelancer is that you can lower your total taxable income even further. Solo 401(k)s and SEP IRAs are the two primary qualified plan types available. With a SEP IRA, you as an ‘employer’ can contribute up to 25% of your compensation or up to $54,000.7 For solo 401(k)s, the annual employee contribution limit is the same as the traditional 401(k) plan ($18,000 for the 2017 tax year, or $24,000 for those over the age of 50). In addition, ‘your company’ can also contribute a profit sharing contribution of up to 25% of your income allowing total combined contributions to the plan of up to $54,000 (or $60,000 including the catch-up contribution if you’re over the age of 50).6 Some solo 401(k) plans also offer a Roth provision which will allow you to designate some of your elective salary deferrals as Roth contributions. This means that you can put post-tax dollars into a retirement plan which will grow (including the earnings) generally tax free.8 Because of their high salaries, many CRNAs are not eligible to contribute to a traditional Roth IRA, so this may be a good option to diversify funds for retirement.9

Search for Eligible Tax Deductions

The amount you are taxed is based on your taxable income. The lower your taxable income, the less you’re taxed. Tax deductions can help you reduce your taxable income; two-thirds of all tax returns use the standard deduction because many taxpayers aren’t familiar with this strategy.10 Don’t overpay your taxes by not taking full advantage of available tax deductions. You may be eligible to take advantage of one or more of the following tax credits, exemptions or deductions:

  • Earned Income Tax Credit: For CRNA employees who earned less than $49,078 from wages or self-employment, a tax credit up to $5,751 may be available.

  • Child and Dependent Care Tax Credit: If you have paid ongoing expenses for the care of qualifying children under age 13, a disabled spouse or other dependent, including a parent, you may be eligible to take advantage of this credit.

  • Child Tax Credit: If you have qualifying children, depending on your income, you may be eligible to take a deduction up to $1,000 per child in addition to the above mentioned child care credit.

  • Education Credits: These education credits are available to help offset higher education costs for yourself or eligible dependents. There are two primary education credits currently available, which include:

    • Lifetime Learning Credit: Up to 20% of the tuition costs, limited to $10,000 of expenses, may be deducted for each eligible student for higher education expenses such as tuition, fees and books required to complete courses. The credit is eligible for married couples filing a joint return with a modified adjusted gross income of $120,000 or less.

    • The American Opportunity Credit: Up to $2,500 per eligible student may be deducted for up to 4 years of postsecondary education. Each eligible student must be pursuing either an undergraduate degree or approved credential. Full credit is available to married couples filing a joint return with a modified adjusted gross income of $160,000 or less.

  • Sales Tax Deduction: While this tax offers benefits for all U.S. residents, it offers the greatest benefit for residents of states not currently imposing state taxes. Why? Filers can deduct the greater of their state and local income taxes or state and local sales taxes. If you completed large retail purchases within the most recent tax year (car, boat, furniture, etc.), then this deduction could result in significant federal income tax savings. Additionally, if you live in a state with income tax, the sales tax deduction can limit the federal tax-ability of your state refund.

  • Real Estate Deductions. If you own a home, you can deduct expenses by itemizing deductions on a Schedule A. You may be eligible to deduct mortgage interest on up to two properties as well as real estate taxes all properties, if not listed elsewhere on your return. Note, mortgage interest in excess of $1 million in acquisition debt, or for home equity debt that is not used to buy, build or improve your main home is subject to AMT calculations.

  • Rental Property Deductions & Income. Keep track of rental property deductions on a regular basis. If you or your spouse are a qualified real estate professional, you may be able to include potential losses on your annual tax return.

Other common tax deductions CRNAs may be eligible for include:

  • Interest paid on a first mortgage for your main home, as well as a second home for up to $1 million in loans.

  • Interest paid on second mortgages or home equity loans for your main home, as well as a second home for up to $100,000 in loans.

  • Interest paid on student loans (depending on whether or not your income is within allowable limits-many CRNAs may not qualify).

  • Investment losses.

  • Medical expenses (including health insurance premiums)

  • Professional fees exceeding 2% of your adjusted gross income (e.g. investment, financial planning, accounting, and some legal fees).

Deduct Eligible Charitable Contributions

Annual gifts to qualified charitable organizations may be deemed an eligible itemized deduction. Each gift must be noted on Schedule A of your 1040. If your annual non-cash gifts are in excess of $500, you must also complete IRS form 8283, which must be attached to your completed return. If you received benefits as a result of your charitable donation, only the amount in excess of the benefit received may be deducted. Non-cash property as well as investment donations can be deducted at their fair market value. If you donate clothing or other household items, consider using available online value calculators to determine the total value of your contribution, saving these records in the event of a tax audit. Records for all donations must be maintained, including bank records, payroll deduction notices, charitable donation receipts from the qualified organization, or phone records for text message donations.

Deduct Eligible Business Expenses

There are a number of benefits of being a 1099 CRNA (or business owner), and one of those is
tax deduction availability. Business owners, freelancers, and sole practitioners may be eligible
to deduct qualified business expenses on their annual tax returns. In order to qualify for these
business expenses as an employee, you must be itemizing using Schedule A.
Along with business owners, CRNAs working in traditional hospital settings may be eligible to
deduct the following non-reimbursed business expenses:
● Business travel (airline tickets, car rentals, taxi cab fees, business meals and
● Use of your vehicle for business purposes
● Business meals and entertainment (Be sure to note who you dined with, how long it
lasted and what was discussed on the receipt for verification purposes when it comes
time to claim the deduction)
● Continuing education (particularly that which is required to maintain professional
licensing requirements)
● Supplies and tools required for your position
In order to deduct qualified business expenses, you must maintain records to serve as proof
(bank statements, receipts, mileage logs), and the expenses claimed on your tax return must
not be part of a reimbursement plan at work.
In addition to taking advantage of each of the credits and exemptions, be sure to spend a few
minutes annually reviewing your tax withholding status. If you receive either a sizable tax bill or
refund annually, it may be wise to adjust your paycheck’s withholdings. If you owe, you need to
increase the amount taken from your paycheck in order to balance out your payments. If you
receive a refund, you are essentially providing the government with an interest free loan by
providing your hard earned capital over the course of the tax year. Instead, adjust your
withholdings so that you receive these funds over the course of the year. Additional
discretionary cash flow can be utilized for a variety of purposes, including debt repayment, cash
reserve accumulation, or retirement investments.
Business owners may also be eligible to establish material participation for tax purposes. In
terms of income taxes, tax law distinguishes between types of income, including income from
passive investments and active businesses in which a taxpayer “materially participates.” Many
sole proprietors are qualified to claim material participation because they often spend a
significant amount of time handling the day-to- day management of their business.
While there are a myriad of opportunities for reducing your taxes, CRNA business owners and
1099 filers have even more opportunities to minimize their tax liability. However you decide to
invest and plan for your financial future, it’s important to work with both an accountant, as well
as a CERTIFIED FINANCIAL PLANNER™ practitioner who specialize in serving the unique

needs and circumstances of CRNA business owners. CRNA Tax Associates ® specializes in
working with CRNAs to make the most of their earnings and collaborates with CRNA Financial
Planning® to keep your strategies aligned. Do you have questions about how we can help you?
To learn more about CRNA Tax Associates®, visit www.crnataxassociates.com or to schedule
an appointment, call 336.793.2264 or email jstanley@crnataxassociates.com.

1. http://www.gallup.com/poll/181241/americans-satisfaction- federal-taxes- low-side.aspx
2. http://www.bls.gov/oes/current/oes291151.htm
3. https://www.irs.com/articles/2015-federal- tax-rates- personal-exemptions- and-standard-

4. http://www.taxpolicycenter.org/briefing-book/what- amt
5. https://www.irs.gov/uac/newsroom/determining-your- correct-filing- status
6. https://www.irs.gov/retirement-plans/plan- participant-employee/retirement- topics-401k-
and-profit- sharing-plan- contribution-limits

7. https://www.irs.gov/retirement-plans/plan- participant-employee/sep- contribution-limits-
including-grandfathered- sarseps

8. https://www.irs.gov/retirement-plans/retirement- plans-faqs- on-designated- roth-

9. https://www.irs.gov/retirement-plans/plan- participant-employee/amount- of-roth- ira-
contributions-that- you-can- make-for- 2016

10. http://www.usatoday.com/story/money/personalfinance/2015/03/14/irs-taxes-

11. https://www.irs.gov/publications/p527/ch03.html
The opinions voiced in this material are for general information only and are not intended to
provide specific advice or recommendations for any individual. This information is not intended
to be a substitute for specific individualized tax advice. We suggest that you discuss your
specific tax issues with a qualified tax advisor.
About Jeremy Stanley
Jeremy Stanley is the founder of CRNA Financial Planning ® as well as CRNA Tax Associates ® .
He has been providing advice and guidance for Certified Registered Nurse Anesthetists
(CRNAs) for over two decades. As a CERTIFIED FINANCIAL PLANNER™, Jeremy has met
rigorous certification and professional standards set by the CFP Board. He is committed to
adhering to the principles of integrity, objectivity, competence, fairness, confidentiality,
professionalism and diligence when dealing with clients.

Jeremy is also the author of The Wealthy CRNA and A CRNA’s Life After Anesthesia. The
Wealthy CRNA features insights into becoming a financially successful CRNA and how to start
planning for your financial future, and has been prior approved for up to 4 Class A CE credits by
the AANA. A CRNA’s Life After Anesthesia serves as your financial roadmap for a smooth
emergence into retirement. It reviews recent changes in the CRNA industry along with the new

rules of retirement and the final steps of legacy planning. This book has been prior approved by
the AANA for up to 2 Class A CE credits.


i don’t know about you but it’s pretty crazy around our household.  My calendar for January is looking busy. Next week will be a crazy time and my husband might disown me.  

Wednesday, like all days I’ll be up and going to work at 6 AM.  The difference is that the movers will be walking in the door at 6AM.  They are packing everything then loading the Uhaul.  Then, I’ll get home from work and we drop off the keys, fobs, and say see ya later to Philadelphia.  We are to make it 2.5 hours south into Maryland.   

Sounds totally easy right?  We only have to put the dogs up front in the Uhaul.  Get the kid in the back seat of the Jeep and have everything packed/loaded in 10 hours.  The next morning we have to leave by 7AM.  If not we miss the walk-through on the home that has caused some stress over the past weeks.  

We’ll drive another 2.5 hours and arrive immediately at the house.  Park in the driveway walk through the home and make sure all is in good order.  We’ll rush to the hotel and drop off the dogs, check in for my parents and us for the two whole nights.  Then it’s again off to closing in Virginia Beach.  When that part is done we’ll again be home-owners.   

It doesn’t sound like too much.  But, I start work the following day so again it’s up to Francisco to get things unloaded from the Uhaul and unpacked.  my parents are coming to help install, set-up, baby-proof, and shop.  I don’t know if they are ready for what they are in for!

The one-day move and in-between contracts.  It’s going to be a bit stressful but i know we can do it!   

The rest of the month is just surrogacy, 3 work places and contracts, two birthday parties, and having a fence built.  

Planning just like all things is key but being able to maintain the plan as a fluid work is key.  Happy almost New Years! 

Getting ready for a change

We are getting ready for our next adventure.  I am packing up the desk and supposed to be doing that so I decided to delay the inevitable.  I have credentialing papers to notarize and get back to the agencies.  I will be going through Austin Major and Odyssey.  Neither of which are paying what I have been making and Odyssey isn't paying housing at all which makes it a bummer of a short term contract.  It is intermittent GI coverage for just two months while I await credentialing with Austin Major. 

It is definitely a different story for us as we tend to look for places that have both the pay and hours/work types that I want.  This is the first time I have said I want to be in this area and need a specific area or work radius.  I was trying to independently do a contract but the group/anesthesia Management Company figured I would just take a full time job with them and I wouldn't stick with locums as I have reason to be in the area for a year or so.  They were mistaken and although they need people they have decided not to use me as I am the cost of a standard locum.  Unfortunately, this group doesn't know my work, ability, or flexibility.  However, I do have the ability, albeit at a lower rate, to find a couple more groups that will know for the future.  

So, I'm packing up things.  We have hired Uhaul movers to pack everything and load all into the Uhaul on the 3rd of January.  I will drive down to Virginia either late the third or the fourth.  Maybe close on our house.  I start work on the 5th of January when things are unpacked.  It will be crazy times.  I will be at a GI center for the day and some intermittent weeks.  

Things are crazy with the 11 month old that turns one year 2 days after we arrive in Virginia.  She is starting to crawl well and some surfing some while standing.  We still have the two dogs that will join us in the trek from Philadelphia to the Virginia Beach Area.  

The house is still a big question mark as we have had to push back closing due to a tax problem where they are saying we didn't file although they were sent back in 2016 :(.  This has now caused the builder to impose a $150/day penalty on not closing and the IRS is saying it'll be weeks.  How does one sue the government again?  Oh right, you can't.  Bonus they might even charge me a penalty for them saying they didn't receive my taxes!  Bad week this week.

Things have a way or working out... I'm just hoping somehow all comes together like it should.  Getting ready for the crazy that is January.  Are you ready to do another new environment with me?


I was listening to someone talk in the lounge saying they would never leave this area.  Her husband was offered an amazing opportunity and they said no as it wasn’t in the city.  Their kid was going to college and they begged to have them closer to home and now they think they might return to the same city.   

I guess this idea of staying in one place for life or not entertaining moving for career or home is foreign to me.  I’ve moved around and met new people my whole life.  Freinds of the long term capacity can be hard to come by.  However, within the military life of moving i found lifetime friends.  I know moving has allowed me to make friends around the country and understand different types of people, culture, and demographics. 

I tend to think anyone could do the locum life if they were so inclined but I’m learning that the more rigidly settled a person is the less likely for them to do locums.  Per diem in multiple hospitals in the area might be their perfect gig and while it may be 1099 it is unlikely to be billed as locum.  Others find a w-2 job that will allow them to work 2 full time jobs.  I see them race from call shift to call shift and i wonder how they do it when i know how it feels working 60-80 hour weeks and how lovely it can be at 40 hours.   

I think it all comes down to motivation.  Part of my motivation is to keep up in all areas of practice so I’m well rounded.  My goal is to be flexible, work a fair amount and over.  I want to be capable of going into any room and being comfortable.   I love new sights and allowing family to see all that surrounds us and our opportunities as we grow together.  Others, look for safe, secure, & what is known.  Others look for moving up the ladder of success in leadership, research or business as they grow and that is their motivation.   

Its fun to learn where people are in life.  Then it is nice to remember those people and in going to new places meet those who might also mesh well with others and who might build people up to their potential.   

So, dream big and bring others along the journey.  Find a passion and a motivation!   

Busy Life

Can I just say how fast life is flying by?  I have been in Philadelphia a month and a half!  We are settled in and Rosie has broken 2 Leashes... it's a miracle the little Frenchie is not DEAD.  We live in the very busy downtown area of Philly and there are highways and significant throughways all around our apartment!!

We must be getting busy because we are talking about how busy we are and how much we have to do.  That usually means we are settled in a place and are just becoming cranky that life is catching up with us!  We love getting to do all these things here in the city but housework is not loved by anyone!  

So, when you decide you are going to locum.  You have to think about what you are going to do and how you will live in the city.  Francisco loved the hotel where they came to clean each and every day.  Life was totally different pre and post Elizabeth and the hotel was almost do-able before the little girl blessed us ... but now we move.... EVERYTHING EVERY TIME.  We plan for long term options and what we can do in the event things change.  

I have to look at what the best options are for us and where the opportunities exist.  We also look at cost of living.  We are also down to one car as our truck wouldn't fit in the parking garage here.  We only did this for a short time in Dodge City years ago but we had bikes and other activities in a small town.  Now we have lots of activities but two dogs, two of us, and the kiddo soooo we are again a little limited.  

The great thing is we are paying bills and getting ready to pay off the Jeep we have with us!  I'm so stinking excited.  Each month I see the total debt reduced in a significant way, I'm so happy.  It makes the amount of work worth while!  

Francisco is starting his food channel on YouTube and talking to me about the food truck again.  I think someday we might work on a restaurant but it will be so difficult to bring that into the mix.  

Just my thoughts on today!