What about earnings?

What about earnings and potential earnings?  So, many offered the advice of... 

Selling off all assets in order to pay off debt and then re-buy assets.  

Selling the houses in a stagnant market that doesn't really go up or down would basically mean selling at a loss and then trying to re-buy them later as they are money making assets vs stocks or retirement which doesn't really make $$$.  Now, if you said take a leverage your IRA for a reduced interest rate that might make sense but I don't have enough in those IRAs to make it worth doing.  

The homes are a life insurance policy that my family would be ok if they had to go and return to a home and I died.  They would have money coming in for life that would ultimately cover the bills.  So, to sell them would give no piece of mind.  The life insurance would more than pay the bills and what's owed and they would be ok.  

The goal in going through all of this is to think about earnings as a 1099 and where the $$ go.  I may not have $200K in student loans but $100K in credit cards is pretty bad but not Rock Bottom as someone mentioned.  I say that because I have never been at the point that I can not pay the bills.  

There are some slow months that came in at about $10K for the month and having 2-3 of those months and not actively paying down the debt is what caused me the point of freaking out a little.  As a locum though, I know that if I'm willing to travel and work hard with a plan... I can wipe out most of this debt over the coming 6 months.  So, that is what I'm writing about.  I'm tired of not wondering if I can pay my bills... I'm just tired of having the bill altogether.  

I figured out the payment of the bills comes to just under 7K/month with the house-payment, rental payments and income not included as those are a long term play.  That doesn't include paying extra or paying much in taxes.  Sounds like a ton to those not sitting in the position that I can work hard and pay down over 100K in just about 6 months and be much more healthy from a balance sheet perspective.  

I have a monthly running total of debts and will be updating all of this over the coming week.  That said, I have paid in 9K to my Sep IRA this month, 10K in tax payments and 10K toward credit card debt.  That is substantial for being 2 weeks into the month.  As I continue down this path to financial independence... I don't expect it to be easy.  I don't expect to be blowing 10K here and there but making a concerted and real effort to be more responsible.  

With that said.  We are holding off on baby number 2.  This process will have to start over in 6 months as it is a 2 year process each time we do it.  We started the process and made a valliant effort with our surrogate without the agency fees etcetra. However, that attempt failed twice.  Had we been successful the $50K would have been well worth it.  Unfortunately, we did not have success and that means we have to stop, regroup, re-fund that savings.  We are not rushing into this and we are not trying to our detriment.  We knew that this was possible but we also discussed that had we failed we would have to take the time before starting over.  

I took the truck to car max and offered to sell it back but they took blue book value and slashed 20% off of that value and then offered that for the truck which would have put us at zero for the truck.  Then when I went back to wanting a truck I would have been paying carmax more for a truck in 6 months than I would have saved in truck payments and that they had offered for a smaller less equipped truck and so it was a better option to keep the truck and just continue the plan to pay it off after the credit cards.  

The house in Virginia.  We like the home and need a place to be.  We have friends in the area and it is central with good community and school for Elizabeth in the coming years.  It's not perfect and hindsight being 20/20.... I'd have done that differently but there isn't a way to sell the house and just go down the street.  We could rent it in a year or two and be just fine or at least break even but the family is happy there and I can hopefully get credentialing done and start locums in the future ... in that area.  Had the credentialing not been delayed for 5 months by ... I don't know exactly whom, I wouldn't have to be traveling away from family so much.  

So, maybe this helps with some insight into the thinking.  Honestly, this is so all can see the flexibility and ability to pay down significantly utilizing locums to do so. This also will show how in the future that debt pay down can then be used to advance my rentals and our savings to a more comfortable place and the same locum job used to bust my butt working.... can become an opportunity to slow down and be with the family as we grow the family.  

Have an amazing weekend and enjoy the journey!  I know we are :)

Think

Every day I spend time with podcasts or learning in some way.  I listened to multiple this week.  Some of the things I learned this week. 

Be Better:  Every day or every week work on how you can be better.  A little change that will help you approach your goal or commitment.  It doesn’t have to be something earth shattering.  If you do 52 weeks of little changes toward your goals you will find yourself inching toward it and be there before you know it.  I read my books this way.  I’m paying down my debt this way. I’m growing the websites this way.  I grow my life, family, & relationships by spending seconds or minutes to interact and tell people thank you or awesome job.  Make a commitment and not get overwhelmed by doing something everyday.  

Attitude:  The attitude you approach something with is how it’ll go in most instances.  You can’t say I hate I hate I hate and then get to the point of doing and expect not to hate it.  I get to work and genuinely say good morning, hi how’s today and yup I’m annoyingly upbeat.  I do this for everyone and myself.  If people see me pissy and depressed everyday I’m adding an attitude that just brings down the whole team.  I’m there to work... not to complain, be unhappy, & just be a body.  I’m there because these groups have people that act this way or they can’t keep people because they are all stressed... if I can be a stress-free person at work.  I’m more likely to be asked back. I’m more likely to feel like my days go well.  I’m more likely to truly have fun and make the days go by.  I miss my family at home and I’m so excited to see family pictures or video and I share this with the people I work with.  Kids and dogs make everyone light up a little.  

Stick to it:  If I sign a contract or give my word.  That’s it.  I’ve said I’ll do something. I’m going to darn well do it.  I’m not going to tell someone that I said I’d do their room tomorrow then not because I found out the surgeon I like has just two easy cases for the day.  If I get what I want and ask for ... I honor what I said I would do.  This makes me reliable, dependable, the person to go to, and sought out for as a provider.  I’m reasonable in my expectations, experience, and what will come.  I know the business of anesthesia, each hand in the cookie jar and the expenses that come after the reimbursement income and how the expenses trickle down.  

These are just some of the things I’ve learned this week and application is always the challenge in what I learn.  I choose to hear most of my education, so I then proceed to the application and notes to myself in how I can apply it towards my day/week/month.   

I’d like to tell all to have an amazing weekend!   

Due diligence!

I just want to make sure you know what doing your Due Diligence means.  Before you say “hmmm, the recruiter said it was a great deal” look at it & run all the numbers.  Are you having to pay to work?

What do I mean by having to pay to work.  Are you getting a stipend but you have to get your own housing?  Did you check out the deposits, fees, pet deposits, taxes, total costs for the time you are going for and if you get your 30 day notice right away?  Is your parking taken care of? Have you found out your mileage reimbursement and is it at least the IRS reimbursed rate?  

Food?  Does it cost more at your assignment?  Is there a kitchenette where you are going?  Are you getting a daily food per diem when you work especially if you are going to an area where the cafeteria seems to charge more than any should?   

Malpractice.  Is your insurance covered by your agency or the group you are traveling too?  Ask for a copy of the COI (copy of insurance face page).  Are you making extra to cover your own insurance and have you checked to make sure your insurance covers the location or that it won’t be significantly more expensive?   

Taking on the expenses and being reimbursed.  Are you trying to get the credit card miles, cash back or other points?  Does your contract state that you are being paid for each aspect and how long until it is paid? Do you have to submit receipts?  Are you certain you are fully covered on the reservations and no cancellation fee if they don’t get you credentialed?  

Please don’t take what the recruiter says as gospel that what they are paying will cover things.  Make the calls and find out the true costs if you are doing all inclusive or stipends.  

Lets journey on. 

Sunday Day off or Work Day?

It is Sunday, today.  What is your philosophy for Sundays?  Work day or day off?  If you are a locum you could consider it as either.  Even if you are not physically in the hospital.  I am one that is always learning.  It doesn't much matter on the topic but it is important to have down time.  I can honestly say that there are not to many days that go by that I haven't learned something.  Here is my weekend in a nutshell....

This weekend isn't much of an exception to the learning thing.  I try to have each day be a learning thing by reading or listening to podcasts or watching YouTube videos.  I try to share what I learn through different outlets such as this site, my family, Facebook, or other.  I try to share my experience when people message me or call.  

Yesterday, I had someone ask me about setting up a fee structure for a small hospital locum contract that just kicked the group out and the hospital still needed the CRNA to come up for a scheduled time.  I worked about an hour on my presentation for Education Adventures in Costa Rica coming in June.  It's still not where I want it.... but it's coming along.  I learned about backyard gardens for about 2 hours and am going to take people up on the learning they offered!  I listened to three podcasts. I lost $100 at the casino this was a major reminder not waste money and time at casinos.  I discussed two rental home projects that are in process, and the financials. I went for a haircut which was major down time and depressing to see how many were in-line... I think I should own the hair salon but that is a different investment I don't have money or time for.  Elizabeth (my daughter for all unfamilliar) went to the doctor yesterday for a sick visit and needed a nebulizer treatment for what sounds like a chest cold.  I spoke with two agencies about how I can work with them in presenting jobs on-line they might have, being a liaison of sorts for when questions or comments are shared, and discussed some options for feedback that are anonymous and not discussing specifics but will keep them aware of negative (negative are not shared immediately and specific details are not shared) or positive feedback on great recruiters or pay.  I think this is a way that can improve the interaction especially when they know a large forum discusses pay, agencies, independent contracts, hospitals, and the process of being a locum.  I seriously think it scares some. That was my Saturday.  

Today, I will again go to the gym (like I did yesterday) and hope not to see a kid eat treadmill. I have three hours driving that will be broken up by conversations with a small Anesthesia Management Group that is CRNA run.  They are looking for hospitals, surgery centers, endo suites or other to add to their portfolio.  I think we will have a great conversation.  I'll visit some family and see a sheep farm which will be a nice change of pace.  Then it's the drive home and some podcasts.  I'll continue to read two books that I'm in the middle of and prepare for my 60+ hour week coming up.  I'd like to say that I'll be on top of it and plan my garden but I'm not sure that I'll get that far today but I think after returning home I'll be building the garden and getting it ready for planting.  It snowed here last night so I don't think I'm behind yet :).  OK... just my laid back weekend.  I hope yours was awesome.  I know I loved mine :)

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).   

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