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!

Investments without large fees

Investing is not one of our best endeavors and many just don’t take the time to learn. With only a few minutes left in the year, here is some information you might not want to miss.  

I was just listening to the ChooseFI podcast and found out a few things to pass along.  First, I recommend listening to them as you journey through life whether you are planning to retire early or not.  

HSAs or Health Savings accounts for any high deductible insurance plan that is define as 1350 for an individual or 2700 for a family.   You can put away 3450 individual or 6900 for a family in an HSA TAX FREE.   Any medical expenses can be taken out TAX FREE at any time / any year!  This of course means you have to keep your receipts for your accountant for years.  After age 65, it acts like a traditional IRA or can be used for medical expenses later in life.  If your plan started dec 1 you could find the entire amount.  Fidelity now has a zero fee HSA management account (funds or investments places in the account may have some fees).  

This is way different than an FSA as those funds don’t fully roll-over year to year.   these funds are for your yearly medical expenses and are typically use or lose.

We are typically interested in low fees and trying to keep our income in our pockets.  Mutual fund investments are just about the most common across the nation and ChooseFI often touts the Vanguard total stock index fund or VTSAX which had a hefty $10k minimum which has now changed to a $3k minimum for getting started.  This opens the fund up to those who are wanting to get started investing at one of the lowest fee mutual funds on the market at an annual fee of just 0.04%! 

Some of you may know these things but the mutual fund information is pretty new.  If you are thinking of setting up the Solo401k it has to be done and funded by the end of the year and if you are looking at a sep IRA it must be done and funded by April 15.   

It’s time to get your investment on! 

Locum Travel

I love being a locum, on most days. This is definitely one of those days!! I am so happy I chose to become a Locum CRNA.

I am not traveling extravagantly; but, Francisco and I were able to take airline miles, bumped from flight $$ and get our coach tickets to Paris!  Ok, so we spent ~$150 on air United tickets. 

We packed our baggage (you can see my SwissGear luggage on the store of the website). We used the United Airlines mileage card to sit in the club for our forever long layover to have drinks and food.  We did do Starbucks as we went for our walk in the airport just before getting on the airplane. 

Unfortunately, I forgot my most loved wired Apple headphones in the car on the way to the airport.  Because I worked hard the last two weeks, I decided to get my first ever set of AirPods!  I’ve always liked the fit of apple headphones and now I like these with no wires!!!!

We are about to land and we’ll have some time to clear customs, baggage and coffee!!!! Then, it’s off to the train to London. 

Ok, so travel or really time off is a benefit of being a Locum CRNA but it’s about using the leverage of your travels as well.  If using a credit card are you taking the benefits from that?  If at a hotel, did you add your rewards number to the reservation?  The only rewards I’ve found I can’t get are the car rental rewards as the reservations with Avis was at a higher cost for adding the rewards. 

We also have two free nights in the Best Western because I had some nights that a hospital put me up at the BW.  So, we are paying food, fun, & 8 of 10 days in an AirBNB. 

This isn’t to brag about vacation, but it is to tell you that you can take more vacation, plan, and have some rewards that make it more affordable! 

New Apple EarPods  

A long trip in coach... we survived! 

Eurostar to London

LocumCRNA.com and a new investing page?

I’m thinking it might be interesting to go through investments?  We work hard and make a decent income. What do we do with that income, or how do we invest and protect our investments? 

I’m thinking about using my continuous growth in showing what I have been up to on the investment space.  I can show the websites and what I’m working on in that space.  I can go through real estate holdings and what that looks like.  Not to forget sep IRA V’s Solo 401k and stock market investments.  Then businesses and the different types of investments that I look at and consider. 

I wonder if this is something you would want as a page as it only somewhat relates to our site because locums is the way I finance life and the investments?  

Credentialing, A Recruiter Perspective

I asked questions of an agency for their views on credentialing.

Credentialing is a beast and can cause major headaches for the CRNA as well as the recruiter.  I’m taking time to ask a recruiter some big questions.  

What is internal credentialing and how does it vary from the facility credentialing?

 --Often times there is internal credentialing for the agency which just looks to make sure all items are up to date and in hand for presenting an Anesthetist to a facility. A cursory look that all information is up to date and filled in is just the start.  

The credentialing packet that is recommended by LocumCRNA.com at https://www.locumcrna.com/credentialing/is a great start and the FREE CV template available at the bottom of https://www.locumcrna.com/store/are a great set of tools to provide a recruiter.  

It’s highly recommended to put all documents in a folder on your laptop or iPad so it can easily be sent to a recruiter or hospital administrator.  For example Dropbox is one place.  

Is there a credentialing packet for the hospital too?  

--Yes, some agencies will have someone to pre-fill data for you and others will send you the packet and have you fill out the packet with an overnight return envelope.  The faster and more complete the information the more likely all will be submitted and done on-time!  

Does TIVA pre-fill in data?

--Yes, our credentialing team will pre-fill our internal on-line app as well as any hospital applications.  Some facilities have a pre-app as well as a hospital application.

How long does internal credentialing take and what is the estimated time for most Sheridan facilities to finish credentialing?

-- Internal credentialing with TIVA is about 2 weeks and the facilities range from 45 days to 90 days from the time the hospital application is back to the MSO. 

 Does a group ever tell a credentialing department how long they have to approve or deny credentialing? 

--The group does not dictate the time to credential; that comes from the Medical Staff Office and the hospital by-laws.  Having everything together and in with the first submission will make it significantly easier for everyone. 

Robert Moore – Senior Recruiting Consultant/Key Contributor

Ads now on the job board at LocumCRNA.com

Office 954-939-7010

Cell 954-232-5323

Robert.Moore@tivahealthcare.com

www.tivahealthcare.com

Leveraging Relationships

  you relationship building and keeping up with your previous facilities, colleagues, and friends?  Are you taking opportunity to go to state level CRNA meetings for continuing education?  

Everyday facilities are looking at the cost of anesthesia and if they can keep expenses low.  Groups are turning over, people go on vacation or maternity/sick leave, & independent practitioners are looking for quality people that don’t want their job but can come in and help.   

Update your resume and keep people aware of your ability to help them given your scheduling.  Keep your files up to date so your credentialing would be easy.  Keep some of you appointments at facilities you might like the opportunity to return to.   

Maintain quality interactions and keep your social media up to date and appropriate so that people know your personal and business life are together.   

Debt reduction as a locum.

I’ve been so fortunate that Francisco is an amazing parent!  Elizabeth has been at home with Francisco 90% of the time and we found a great babysitter through a friend.  Francisco has been knocking it out-of-the-Park with his YouTube channel/ website ConMuchoSabor.com.   

I looked at our debt 7 months ago and was so stressed that we were over $250k in debt not including our home.  I traded my truck for less than half the cost new SUV.  I went to work on locums and raised my rate while telling the place I needed any hours or call I could get.  I’ve been away from the family returning about every 4 weeks for a few days to a week.  We’ve still had time to visit family and a good “working” vacation.  I’m happy to report that our net worth is positive and debt is below 100K.  I’m going to a 2 week on 2 week off lifestyle with intermittent days on my weeks off that will allow us to keep decreasing our debt and allow me more time at home!  Our rental properties have picked up and are now paying for one new property per year and paying thier own expenses.   

I have approximately 3 more weeks away before getting started on my new locum contract!  I’m 12 weeks into my MBA carrying a 3.8 gpa and learning weekly.  I get to pour over financial reports and am doing better each week with my own reports as well!   

I continue to consider business opportunities and think that with time 1,2 or 3 could become something just like the rentals, YouTube or the websites.   

I just wanted to check in and thank you all for the positivity and thank our Locum professionals for keeping us in great standing so we can work, travel, & provide for our families!  We are so blessed!   

Mid Year Assembly

I am admittedly non political by nature.  It’s very different for me here at the mid-year assembly and I sometimes feel an almost uninvited vibe being here.  Maybe it’s not uninvited but almost disingenuous vibe.  That feeling of people meeting people to say they know them but no uniform familiarity.  I have to say I came here on a whim and not as a planned event to where I would meet with certain people or advance specific agendas.  I am excited that I have seen some people that I knew from years ago.   

I’ve seen some of the very active and vocal people in the profession and learned from the sessions despite my critiques.  I think we all have our roles and I’m still wondering where mine will be in the coming years.  Totally worth trying new things though.   

I feel like I’m trying to grow but I’m still at the kids table.   I look forward to my meetings over the next few days and will totally share with you some pictures of our trip in DC.  It’s a great time to be out and about and I know Francisco and Elizabeth are getting plenty of pictures while here :).

Work a little more

I seem to be one that says... “OK, I’ll just work a little more...”. I think it’s fine to say that once in a while for a one time expense but I have learned that saying that on long term expenses... stinks.  I honestly think I’ve thought about this and am much more attuned to.  It always seems there is something that happens just about the time that you make a little extra.  The dog has a vet visit, a crown is needed at the dentist, or a plumber is needed.  So, FI movement says pay off things rapidly and get 6 months or more in savings etc... I get it, I have to work on this and I know it’s do-able!  This is the first weeks of my 6 month run on this.  I get a paycheck next week and that already has it’s assignment.  But I’m assigning 3/4 of it and leaving 1/4 in the bank account for safety.  I know most emergencies can go on a credit card but I have a tendency to fear over-drawing an account ... it happened once 20 years ago!  Mom would tell me to get a checkbook register and write it all down.  Many people recommend writing down every single expense but I have yet to do this while on the road.  

This week I’m home and I want to go through and make sure I’m not stuck in subscriptions or reoccurring payments for apps or things I don’t need or worse just don’t use.   

I’m so exciting to be sitting in the airport and heading home for the week.  Many people tell me it’s about being home and taking the time to be present.  I totally agree and know that in the coming 6 months I’ll be going against that somewhat but those 6 months will make possible time to be home with the family more often and more in tune with all.  I’m feeling so excited to just be working toward a little freedom from payments ... not to mention the anticipation of the road of financial independence.  I hope all know I appreciate the comments... despite my reluctance to get rid of everything in a fire sale ;).  Have an amazing weekend and I’ll write more while at Mid-year Assembly!