¶ Docs Outside the Box Locums Update
What's good everyone . Welcome back to another episode of Docs Outside the Box . Yo , this is like our third time of doing this intro . My name is Dr Nii , host of Docs Outside the Box . I'm joined by the habitual line stepper , otherwise known as my co-host , otherwise known as my wife .
Dr Rene Yo , here comes the line stepper habitual . Alfred hook up the music in there Habitual the line step habitual , alfred , hook up the music in there .
Habitual , habitual , all right that's enough right there , because we got to pay sampling fees if you go past five seconds so stop after that .
Welcome back everybody .
We are excited . I'm excited . For the last several weeks we haven't done an episode where it's just me and you and I miss that , I know . Mano y mano , darko y darko , mano y mano . How do you say that ?
Wu mano y mano . Hey mano y mano .
That's the way they say it . I know the pronouns are a big deal nowadays and stuff , but from what I remember it's mano y mano . But whatever you want to say , he , she , we , it , it , oh , but anyway , y'all I love podcasting like this . But anyway , y'all I love podcasting like this . But listen , for the past , what four or five weeks we've had interviews .
We spent the entire year last year not doing any interviews , so this year we said look , we want to bring on some people and talk about some different things . We had the Glockenfleckens on , which was a great episode . You guys really enjoyed that . That was a dope one . So I encourage you guys go back and take a look at that episode .
That will be in the show notes for you all to check out and take a look at there's a lot to talk about . Yeah , there's a lot to talk about from me getting back from locums to beef with rap to .
Who you beefing with . No , not me , but beef and rap , you got beef with 50 Cent .
I don't want those problems , but there's a lot in the world to talk about . But let's keep it on to what I talked about . I was on the Advice Residency . What is that ? Like a seminar that was put out by Tyler Olson , who's one of the CFPs out there .
He's doing a really good job Fee-only CFPs who are out there trying to give advice to people who just recently matched . We just had to match right , so everybody who's ? transitioned , yes , into a position . You see why I say transition . I didn't say match , I just said transitioned into a pgy1 position or pgy2 position or whatever position position congratulations .
I know it's tough in these streets .
Round of applause .
The match is no joke .
Yes , Stressful times , yeah , stressful times . I remember those times .
Then we got Q&A from somebody who wants to know about locums and then we might finish it off with what's going on in the UK . We'll see In TMZ .
Why don't we tell people actually what we're going to be doing at the end of the week ?
Why don't we tell people actually what we're going to be doing at the end of the week . At the end of this week , guys , we're going to be at AMEC , at the Annual Medical Education Conference for the Student National Medical Association . Y'all , we coming , we coming , we coming . We coming , we're going to be there , put an umbrella in my hand .
Alfred , we're going to be there what Thursday till Sunday . Yeah , I feel like Eddie Murphy in Boomerang .
Yeah , we'll be there from Thursday to Sunday and we'll be talking about actually we're going to be on the main floor interviewing people , almost like a red carpet type thing , interviewing people about . You know , just in general , whatever we want to talk about , we're going to be doing a show from there . Yeah , we'll also in the exhibitor fair .
Then we're gonna be doing something on global medicine , on global health , talking about medical mission work .
Yeah , and then we'll be meeting with the members of the snma um the lounge yes um podcast and we'll be talking about medicine and media if anybody listen , when me or when docs outside the box and snmas the lounge gets together , it's some hot potting going on .
So for me I really enjoy potting with other podcasters like real podcasters , right , like it brings out the energy , like the um , the competitive spirit , like the like just you want to just talk , right and you're talking to just want pod . I love , I love it . I don't like potting with people who are amateurs .
And please , if you , if you're listening to this show and you we've potted together , you'll know who I'm talking about but don't take it personal you is . Don't take it personal you is , but it's just when you're potting with people who really enjoy the spirit of podding and like to talk the truth and like to speak in a certain way .
I really , really enjoy that . So we're going to be there for that .
Yeah .
Is there anything else we're going to be talking at that ?
No , those are the two main things . Well , three main things Just being in the exhibitor hall doing the lounge with SMAMA , and then the global health webinar , because everything's online . These days , but this time we are not going to be online , we're going to be in person so , yeah , can't wait till Thursday we can dump the kids off and have fun .
Dump them kids off out of here . Yo F them kids all up on us and it's spring break so we got to deal with them all the time . Damn , anyway , let's get to this podcast , let's jump right into it . We love our children guys , the latest on
¶ Importance of Financial Planning in Residency
locums . I just got back from locums . I did my stint for about a week no , a little bit over a week of just night shift Crazy . I'm going to just leave it to you like this On my way back my last shift , I just learned the importance of everybody listening .
Right now , listen , you need to kiss your kids , you need to hug your wife , your husband , say your prayers before you go to bed . Let me tell you something right now , in these streets , on these highways , anybody's life can get taken .
Even when you're trying to be altruistic .
Even when you're trying to be nice . If you're trying to be altruistic , like what I've seen over the last week , it is crazy .
Obviously based off of what I do as a trauma surgeon , I can't get into specifics , but all I gotta say is wear your seatbelts , drive at the speed limit , tell your family members that you love them and , if you ever have a chance , donate to the goddamn blood banks . You know we need you .
The blood banks need you like crazy especially in these small rural communities . It's .
It's just crazy how your life can just just like that , and I remember you asked me a question of what's the one thing that people don't understand about trauma , don't understand about what I do , and I think it's the notion of waking up , thinking one thing and then the next minute , next hour , like your life is completely changed .
Yeah , off of one decision .
It's crazy , yo , but that's my thing . So I'm back , kissed my kids , everybody's back and we're potting .
I didn't want to start it off on a negative note , but I just want people to really understand the power of just being really careful and telling people you care about them , because tomorrow's not guaranteed Shit , the rest of the day is not guaranteed Nope , you know what I'm saying yeah . Anyway , so started off the week being on the advice residency seminar .
So this was a seminar for three days , four days put together by Tyler Olson and it was mainly for fourth year medical students who are moving on to residency , and it's talking about all the things that they just don't even teach in medical school . Right so um , you know , should you pay off your loans early or should you get deferment ?
You know all the things that , from a money standpoint from student loans to how to handle your first paycheck , to how to invest , to how to handle all the things related to money that 10 , 15 years ago , 30 , 50 years ago , that nobody taught your ass what to do , right , and they still not teaching you ? Yeah , they not teaching you .
yeah , they're not teaching you yeah so props , props for him for doing that . Um , I got asked to talk about like how to how to um set the foundations for res or for retirement yeah which who's out there thinking about retirement when they're a fourth year medical student about to graduate ? precisely , precisely right , so that that is a tough subject .
Right Like student loans . Like everybody knows , student loans is something that's going to come coming for you as soon as you get through your first six months of residency . Right , you're like , right Alfred , cue the end of this is America Right . But that is the truth , right , like y'all , like the , they coming for you . Right , you can see that um what else ?
What else like ?
there's just so many different things but retirement yeah , like you don't have time , yeah , to be thinking 20 , 30 years down the road well , people are thinking about how they're going to live , right , like , what is the next stage of my life ? So student loans is going to be a huge one , right ?
Then the next thing is going to be like , well , should I get a new ride ? Should I buy a house ? Like people are thinking about what's the next stage of life . They're not necessarily thinking about , you know , the next stage in their careers financially .
But you know what's interesting , though , that's to that extent You're talking to a whole bunch of different people who are used to deferring a whole bunch of shit , though , right , right .
Delayed gratification . You cannot delay the gratification of retirement , trust me , because you will not be gratified at the end of that .
So it's a tough topic to talk about , but I think the way in which we approach it you helped me with that . Guys , I just want to let y'all know if you ever , if you ever I'm looking at the screen right now for those who are watching on YouTube .
If you ever ask me to speak on a topic , if you ever ask me to do a PowerPoint presentation , just know I ain't do it .
The habitual line stepper to my left did it , dr renee I hate doing powerpoints .
If you just ask me to do a q a and I'll tell you about my life , the school of hard knocks that's me . I'll tell you about all of those different things you can learn a bunch you can learn a bunch of from what I tell you .
but if you want something that's academic , if you want something where you get objectives and shit on there , don't look at me , don't ask me for that , because you're not going to get it . She's doing it . So Dr Renee helped me put this presentation together at the last minute , but I think it was dope right .
We got people thinking about no , because we got a lot of questions and we have people thinking about the things that they should be thinking about and you were right . Like we had them thinking about their first apartment , we had them thinking about their first home possible . We had them thinking about their whip . We had them thinking about .
What else did we have them thinking about ?
No , moving costs , moving , we did that .
But you know , but we , the way in which the presentation was , it was like listen . The other thing that you also need to be thinking about is listen , like how long do you want to work for ? Need to be thinking about is listen like how long do you want to work ?
for right and that process starts in residency , yeah , and then we transitioned into some of the vehicles that they could use to kind of just start laying the foundations for a healthy retirement right . And you know , you , that's either your .
I'm not going to get into much of the specifics but , like you can either use your residencies 403b program right or whatever cash savings plan , or you can open up your own individual retirement account , or you can do an hsa account if you got a high deductible plan , or you can do yeah , you know your own brokerage account , without getting too much into the
specifics where people start get boring or start thinking that it's bored because that's my phone without people starting to get bored , or without people thinking that it's bored because that's my fault .
Without people starting to get bored or without people thinking that it's boring ?
Thank you , Ms Goody Two-Shoes .
That's right Once again line step .
And PowerPoint presentation maker you was a Goody Two-Shoes in the goddamn like when you was growing up , weren't you ? Yeah , I really was . I know everybody hated your guts . I was actually putting a damn apple , putting an apple on a teacher's desk and shit .
Nah I didn't do all that , but yeah , I was a , I was a goody , two shoes , sheesh man , yeah , I was a goody .
Two shoes . Can you let me talk and let me say what I gots to ? Say sheesh all right anyway we back we back anyway , listen . So it went well .
We talked about all of those different things and then we had a whole bunch of questions during the actual talk , and then they put me into like these little breakout rooms where you know you go talk to other people , and so there was at least like five people in the room and they had really good questions .
Some of them were asking really in-depth questions and I I was like slow your roll . Like you know where to go to get those in-depth questions . Docs , outside the box , is not it ? Like yo , we're here to give you the 30,000-foot view . Like you need to save , you need to invest .
Point you in the right direction .
Some people talk about doing backdoor rafts . I was like , guys , you the hell down , bro . Like , focus on , like them , student loans , like start putting some money in that 403b , maybe open up your own ira . You know budget , slow it down a little bit . You know what I'm saying . You know who to go to .
I'm not even gonna name names because I don't feel like giving props to other people at this point . I got beef . You know what I'm saying . You know who . It is right , but if you want to know where to think , what to think , you know without getting too overwhelmed , and how to incorporate into your lifestyle , that's who we are right .
Yeah , I mean I think that the presentation was really good , like you said , just to lay the foundation right , like , don't get too crazy into it . You're going into residency , you know the first thing you have to think about is not being afraid to actually invest .
Because if you're going into residency , you know the first thing you have to think about is not being afraid to actually invest . Because if you're , if you're too afraid to invest , it doesn't matter , you're not gonna , you're not going to invest in retirement if you're too afraid to invest .
So that's the first thing , that's the first hurdle you got to get over stop being afraid to invest did you invest in no , in no , you did yes , you did , because I remember we had Not in residency
¶ Understanding Financial Decisions for Medical Residents
.
No , that was during my fellowship , because I know we did a rollover for you .
That was for my fellowship , because you was trying to hide money from me . And then I found that money . And I was like oh , you had some TIAA craft craft type thing , no , no no , that was in my fellowship , that was in my health policy fellowship and that's when I was at Morehouse .
But , if you remember , we tried to do the rollover but I wasn't at Morehouse long enough to be vested . So , morehouse , I got one more year to get out of you . We moving to Atlanta I'm cool with Atlanta . I'm cool with that .
But yeah , so you didn't invest . I damn sure didn't invest , and that's what I'm telling you .
Like I think that's one of the biggest mistakes that I made , because you know , what I said on the panel is like when you are making like five figures , right , like I remember going from going from , you know , making , literally taking money out to live as a , as a med student right , so now I'm literally instantly .
Dr love talked about this , and this is true . Like some of y'all don't understand what it means to begin residency and already be making more than some of your parents right , that was me I was making more than my and you know like the responsibility that comes along with that .
But then you know you're also entering into something that you've never done before and you just trying to survive . You just trying to come home and eat . You try to come home and sleep . You try to come home and get ready for boards .
You try to come home and just like call family , so you ain't got time to be learning about something else that you ain't go to school for . So as a result , you're like I ain't got time for that .
And then you all of a sudden you think that when you become an attending and you start making six figures , that you're going to feel comfortable and make those decisions to invest . It doesn't work like that .
Right , la , la , la Wait till I get my money .
Yeah , you sounded like Kanye .
Seriously .
The good old Kanye . Well , because you got to be careful which Kanye we quote .
I'm not trying to get my show canceled over the now Kanye , all right . This is Red cap , kanye .
Yeah , this is book bag , Kanye , y'all all right , but yeah , I mean you can't expect to be able to flex that muscle or to feel confident investing your money yeah just quote-unquote adulting , if you didn't exercise that in residency . That's why I think that's the time to at least start making some decisions .
You ain't gotta have all the answers yeah but at least like just make the mistakes when the stakes are low right , right .
Open up an IRA and don't put money in . Learn that lesson the hard way . Well I did that .
I opened up an IRA and was putting money in and then I ended up taking that money out because my sister needed something for something medical she was doing and I was like BBL . No , no , damn BBL .
Not no damn .
BBL knee , but she had some medical . That's what she gets for not listening to the show . She don't know what you're talking about .
That's what everybody gets See . If you don't listen to the show , you're going to get talked about .
My nephew listens to the show . But no , she had a medical procedure and I was like , hey , take it . And you know what I remember saying to her I'm not doing anything with it , Just take it .
Mistake number two yeah , line stepping again .
Well , mistake number two was not having the right mindset around what that money was for . Of course , I wasn't doing anything with it at that particular point .
Did your parents teach you about that ? Did you know , if your parents invested parents ? My father was the one that told me to open up the ira . He was the one that said I didn't get that lesson at all . Yeah , I got the lesson of save .
Yeah , save where I used to do my taxes and he was like put whatever amount it was in the in the ira right then and there , because then he was like you , you'll , you know , you'll be able to get a tax deduction or whatever it was . So he used to do my taxes , so he's the one that made me open up the IRA .
Even that right there , making you open up the IRA , that's a very powerful move right there .
Yeah .
Right , Like there's a lot of people who don't even get that .
They don't even know .
You have forgotten about that people who don't even get that . They don't know you have forgotten about that . You know because you know when , each when hr meets with you during your residency .
I'm just gonna let y'all know , guys , there's gonna be one day where hr meets with y'all , right one , and that's not even a whole day , it's like half a day right where you got to put your name , and you're gonna be more focused on putting , making sure your name is right , making sure your w4s are , which is the one , the w4 right .
You just want to make sure you're getting paid right . You're going to spend more time doing that stuff just to make sure that you get paid right , and they're going to be like yo , we got this thing for retirement . You're like let me get the fuck out of here , man , let me just get my badge , let me get my paycheck coming .
You're going to be so confused as to should I take an exemption or not .
Because I want all my money .
You , you know you're always like should I take the exemption or not ? How many dependents do I have ? Do I count as a dependent ?
Does my dog count as a dependent ? Who's the head of the household ? You remember all that . You're just worried about all the wrong things .
Yep Like . Which health insurance plan should I choose ?
But that's important though , I know , but you're going to be so worried about that , you're not going to be worried about retirement .
All of those things become very overwhelming , so that the new thing that you have to learn you're just like . I don't want to learn this .
Yeah , that's true , you know .
So you're going to gravitate towards the easier things . That's it .
And I definitely think that if you're older , like if you're a nontraditional student , you grab a hold of those things way more than the younger students , maybe because I was nonttraditional and I did not no , that's true . So well , you got a good point there well , that that was all that it was . I'll put the links for you guys to see the videos .
You can not only see my videos , but you can see everybody else who was involved with it . Shout out to tyler . That was great . He's got a good twitter following also , like his twitter page is really good . He always has some really good information out there .
So shout out to tyler for asking me to be a part of it , and then also shout out to everybody else who was a part of this . This was a great opportunity for the medical resident , for the medical students excuse me who are about to be residents , to understand some of the financial decisions that are very important to them as they transition into residency .
So that was dope . Make sure you guys check that out . Listen , guys , we are going to transition into q a . All right , y'all , we are back . Um , let's get into some q a . So it looks like everybody you got questions people who are listening to us . Um , obviously we work as locum tenants . We've been working as locum tenants for well over 10 years now
¶ Starting a Locum Agency
. For people who don't know , locum tenants is basically independent contractors . If you don't know what the hell that means , that means that we work for ourselves . Just consider us a plumber that works at the hospital Renee is the OB plumber , the general surgeon plumber and we're not employed . We get everything on our own .
We get our health benefits on our own . We do our own retirement plans . The only thing that , depending on which hospital we work at , is medical malpractice . That usually gets covered by the hospital , but we like this . We get to determine our own schedule . We wear our own white coats , we just do our own thing and that works for us .
We work really hard , take care of our patients , but then when we out , we out All right . So we got a question . This is from Dr Caesar . You ready ?
I'm ready .
Hello Dr Darko . My name is Dr Caesar full-time locum hospitalist interested in opening my own agency . I saw two of your YouTube videos about starting a locum agency and had a couple of questions .
Number one if I do locum work in a hospital that , for example , is through I think he meant some group , does that mean I can't recruit hospitals in other places that work with the same group that work with the same group ? Number two what is the best way to approach a hospital to see if interested in contracting a locum agency ?
I ask because I work in different states . My plan was to ask around in other hospitals around the area I'm currently doing locum work at the moment . And number three damn bro , how many questions you got . Also , in one of your videos you mentioned a couple of times that you needed a VA . What does that mean ?
And then , number four do you know the best source links for malpractice , depending on state , type of attorney to help with contracts and who to ask about licensing or paperwork to have , besides the LLC escort for the company to make it official before trying to attract hospitals ? Dr Caesar , that's a lot of questions , man I'm going to charge you for this .
But he's a good question . So the first question is if I do local work in a hospital that , for example , is through some group , does that mean I can't recruit hospitals in other places that work with the same group ?
Habitual line stepper . What do you think ? Oh , that's a tough one . I would say it depends . I think it depends on . So he's talking about recruiting hospitals .
Yes .
And he works at a hospital already . So I would say because right now he doesn't have his own locums agency .
It looks like he wants to start his own locums agency .
Yeah , so he probably is , is working through an agency himself .
Either that yes . So I would say Either that or he's on his own , but he doesn't say we can't really tell , right .
Okay . Well , if he is working through an agency , I would say it very highly depends on how the contract is written .
Yeah .
Because , excuse me , if the agency has an agreement with the hospital system and that covers all of their hospitals , then yeah , like that might . I don't know that that might be an issue but .
If he only works at one hospital but I think it also depends on this dude if you are a locums hospitalist and you are by yourself , you're a free agent , you can do whatever you want to do right , right . So if you are like I mean , you are by yourself , you're a free agent . You can do whatever you want to do , right , right .
So if you are like I mean , you are by yourself , like you negotiated everything on your own , your contract has your company's name on it , they are paying you , you did everything , you're not going through an agency except your own , then I think you got free reign to do whatever you want to do , and the worst that they can say is no Like .
And the worst that they can say is not no Like . We like the there's a there's a locums agency that covers hospital A , b , c , d of our entire network .
Right , but if you're asking that , you're already with an agency and you're doing locums at that hospital and they just happen to have other hospitals in that system and you want to go and work at those other hospitals . Yeah , that's dicey . That's a tough one .
That's dicey because even if you're just at one campus right , that's that's kind of how , like sometimes , employed contracts are written right where they'll be , like , yeah , you work for this hospital system , but they don't ever put the campus on your agreement .
Bro , it happens , it happens it happens , because what they want to do is to be able to send you to any hospital within a two-hour radius . Yeah , you got to be careful with that , especially with mergers A lot of mergers have been happening .
So you know you can join a hospital system . And then you're looking at your credentialing paperwork and it's like hey yo , why you got me credentialing at a place that's two hours away . It's like well , you will never need to send you there , but we just want to make sure that your credential to all these different places .
Now what ends up happening is if you end up leaving that hospital , right , let's say you end up leaving that hospital because your credential at all the other hospitals .
Your restrictive covenant Right Goes for all of the hospitals , and that's very similar to what a lot of employed positions do .
And so careful man Got to be .
Yeah , If you do that , you know it's like , yeah , right now the assignment is for here , but your credentials here , here and here . So that's why I said it depends on what the contract is .
Like you said , if he's on his own , then that's what it is , but if he's not and he's working through an agency , you got to look at the paperwork , you got to be dicey , make sure you look at your physician contract with the locum's company with the agency because a lot of times they'll just say yo , you can't solicit nobody right and that obviously will
include everybody at your local hospital but more than likely probably includes other parts of the hospital system also .
Just be careful about that but , that's a good question , good question . Second question is what is the best way to approach a hospital to see if interested in contracting a locum agency ? What is the best way to approach a hospital to see if interested in contracting a locum agency ? I asked because I work in different states .
My plan was to ask around in other hospitals around the area . I'm currently doing locum work at the moment . So basically he wants to know how do you get a hospital basically to bite ? On you as a locum agency .
Yeah , I mean .
The habitual line steppper .
what do you say ? So , first things first is , I always say , start in the area of most need , right ? So , for example , if you're going to start in an area that that you know is very medically underserved , has a lot of physician shortage , has a lot of vacancies , those places are going to be your . More you know , your highest , like high , what is it ?
What do you say ? The , the highest return .
Right .
In terms of your , you know , in the highest return . Right , in terms of your , you know , in terms of biting Right , so that's , that's the first thing . Secondly , it's always good to see , like , exactly how many vacancies does this hospital actually have ?
Right , because if a hospital doesn't have a lot of vacancies , it's probably saturated , right , it's probably already saturated , so it's probably not worth it to go after a hospital that you're like man , like you hardly have any vacancies . So if you see a lot of vacancies , that's where you go and you bite .
Then , thirdly , be upfront with what it is that you're doing , because if you're not , what's going to happen is they're going to bring you on or bring you in to talk , right , and they're going to bring you on or bring you in to talk , right , and they're going to bring you into talk thinking that you're going to be w2 employed , yes , and it's going to leave
a bad taste in their mouth when you start the negotiation process and you're like , oh , by the way , I want to . You know , I want to do locums . Like don't , do't do that If you have other docs . That's the fourth thing . If you have other docs that want to , that you know , want to work with you .
You know , in doing your own locums agency and you know that this hospital needs other doctors , then one of the things you probably should do is one solidify with those other doctors that , hey , if I solidify a place , would you be willing to come and work ? That's number one .
And number two go ahead and let that hospital know , like , hey , I'm willing to work , but I can also kind of fill in that schedule for you with other doctors . So then that way they know that's less recruiting that they have to do because you're going to do it on their behalf yeah , and I agree with you , but I'll be very frank with you .
Uh , dr c , it's in this game , it's race to the bottom this is . This is a commodity yeah , so basically they want to know can you get them doctors at a cheaper rate ? than the other locums companies . That's it .
But I do agree with you if you represent yourself as a doctor , bro , you're gonna have a hard time trying to convince the hospital take you seriously . I don't care . Whatever things you want to do , you can get your lead ahead . You can have a lawyer , you can drive a bmw , you can drive a bugatti , I don't care .
Once they find out that you are a doctor , they are going to try to get you to come in as employed . They're going to try to get your group to come in as employed and it's going to be sometimes hard to get like am I talking to a wall or not ? I told y'all we a locums agency and they're going to be like we don't get that .
Like , why would doctors want to be locums , right ? Doctors want to be locums , right .
They really don't understand .
So be prepared to deal with that . A lot Right , that a lot of hospitals will be like yeah , I'm not taking you seriously Like I want to talk to the big boys , I want to talk to the big dogs .
But I do think that , doctors , I want to talk to the person who studied Spanish in college and turned it into a locum's agency .
We laugh , you laugh , but that's what it is BA in Spanish and then went back got their MBA .
That's what it is Like wait what .
So what I would do if I were you is I would . Whatever I would . I think invariably it's going to be really hard for a physician-run locums agency to have multi-specialty that can really provide and go to a hospital and say , hey look , we got multi-specialties that can come here and help you guys out .
I think you're going to have to find your specialty that you're really good at .
There's one agency that has done it that I know of . But yes , you're absolutely correct .
So it sounds like you are a . If I'm reading this correctly , you are a hospitalist . So I think , if that's your specialty , that you're really strong at , and you have other people who are really good at it , I would go to local hospitals .
I would take the Facebook approach and I would go to all of these smaller hospitals in the very rural areas and I would just say , hey look , it looks like you have a vacancy , or you have a couple of vacancies . Me or our company can provide locums coverage for X , y and Z amount of dates .
And then , once you get in there , you just keep impressing and then you kind of just get bigger and bigger and you garner more and more contracts and go from there . I think that's the best way to do it . So that's the way . And then , number three you say also in one of your videos you mentioned a couple of times that you need a VA .
What does that mean ? So VA is short for virtual assistant , right ? So virtual assistant is someone that basically a virtual assistant is an independent contractor , someone that you pay a certain amount of money to do certain routine jobs or tedious jobs for you . Ie clean out your email inbox . Ie send emails on your behalf .
Ie clean out your or fix your calendar , or do your social media or you know , whatever it may be , they are not employed by you . You just are contracting with them to do a job for you , and then you pay them on a regular basis and then you go from there , right ?
So we had a VA that would help us create the calendars for all the other doctors that were working with our , with our company , and that will go to different hospitals . So remember , like at the same time that we had , or that we have , our agency , full time trauma surgeon , you know , full time OB .
Part time OB . Glad you saidtime ob . Glad you said it .
Glad you said it ain't no full-time nobody well , but we both busy , right we're both busy full-time mom outside of outside of you know , negotiating contracts and running like the overall things with the , with the , with the company there was certain like routine things that just happened over and over again that I just didn't need to do .
Right , and that's what we would have a virtual assistant do . She would basically create these letters that would make the or let the doctors know . Hey on . January 30th of 2025 , you are supposed to be there and if you ain't there , this is how much we gonna charge you .
Right , basically right , like those type of letters , or making sure that you know they get paid , or you know making sure , like that their hotels are taken care of . Those type of routine , daily , menial things that , frankly , I just had no interest in doing yeah .
And you start to think about how much that costs versus how much it costs for you to divert your attention from negotiating or making the big dollars versus doing the smaller things . That's why we elected to get a virtual assistant .
Yeah .
You can find them on Fiverr and .
Everywhere , upwork Everywhere . Upwork or you know , wherever else , just anywhere , online , anywhere .
You got anything you want to say about that habitual line stepper .
No , I mean , I think you covered the VA pretty good .
Yeah , I know I did . I got it good , I knocked it out the park you did a good job . Knocked it out the park yeah .
¶ Navigating Contracts, Licensing, and Malpractice
Do you know best source links for malpractice , depending on state , type of attorney to help with contracts and who to ask about licensing or paperwork to have besides the LLC escort for the company to make it official before trying to attract hospitals ? Let's answer the second half or the last part , which is who to ask about licensing or paperwork .
Listen , number one , you're going to need a physician contract , like in a physician agreement contract that is , between your agency and the doctors that you are trying to basically be the middleman for right , you got to be able to hold them to some type of um obligations right there's got to be some clear language .
Same thing they have to be able to hold you to obligations as well there's got to be some clear language so that you know .
they know , like , what's kosher and what's not kosher , what's halal and what's not halal , what you know what I'm saying .
How do we get into food ?
We in Ramadan right now .
Oh Lord Right .
Right . We got to know what's for real , right . So you need to have a very clear and concise contract that you need to create with the doctors who are going to be working with you . What else do we need to do ? What else do we need from licensing and stuff ?
Well , he also asked about like the LLC and things like that . We use LegalZoom to make that official to actually create Easy peasy . Yeah , that was easy to create the LLC . We use LegalZoom . You just go on there and you follow the instructions and then they'll tell you you're an LLC .
Dr Caesar , everything that you did to credential yourself at the hospital is the same thing you got to do with these doctors . Everything Right . When they ask you for your diplomas , you're going to need that . When they ask you for your letters of reference , you're going to need to do that .
When they ask you for how many medical malpractice cases you're going to be in , you're going to need to go and do that . Everything that you did to credential yourself at other hospitals , it's the same thing , bro .
Yeah , and don't skimp just because someone's your friend or because you went to school with them and you just know that they graduated Like listen .
Bro , you don't know what they'd be doing when you leave the hospital .
You don't know until you have that paper in your hand , and so you're going to need to hold on to those papers . So , even if they're your friends , ask , ask , ask for the credentialing papers .
So best source links for malpractice , depending on the state . So we got a source . I don't know if they want us putting their information out on the podcast , so what I'll do is I'll email you , but we have a broker that we use and we just put in the information .
We let the person know what state we're going to be in , what kind of practice if it's going to be full time , are we going to be traveling , all these different things and they come back with a rate Heads up , A rates as high as hell yeah , and apparently . Since COVID .
Yep , I was going to say Rates as high Since COVID it's been a little bit more difficult to get malpractice coverage for locums .
Yeah . Apparently , apparently , according to the one broker we talked to Now the type of attorney to help with contracts , that's , any attorney that helps with physician contracts . I think that you can go with that . I'll leave it to you like that . That's the best way . So those were the four questions that we got from Dr Cesar . Good luck to you .
I'm glad you're doing this , as you know , as I already said , I feel that every doctor in the country should be an independent contractor . They don't have to do it 100% , but I think the way how hospitals are merging and they are like literally Private equity .
what is it ?
Either way , it's really hard for one doctor to really compete or consider themselves on the same level as a huge hospital system and I think that it's .
This is not like apple or the tech industry versus its workers , right right like in apple or in google or in the tech world , like all of those ideas for all these great things comes from the top and then the people down below they are like making it happen , they implement they make it happen Right . In medicine it doesn't work like that .
The brain , the brain power , in essence comes from the bottom , from the doctors Right , and if you think that doctors ain't at the bottom people who are listening doctors at the bottom .
Well , we're at the bottom because we allow ourselves to be at the bottom .
Right . So the doctors , they're the ones who are bringing all the brainpower .
So for me .
I'm like well , listen , if I'm bringing all the brainpower and you can't function without the brainpower , then I think that that should be right there .
You ain't got no business . I got a business .
Well , I think that they should separate . That should be separate Right . Let the hospital put up the money for the structure , the institution . Let them put up all the things that you need to have a hospital running you need beds , you need lights , you need you know all those different things . You need an operating room , but you need the person .
You need the person with the brain to come in BA in Spanish . Ain't got no business .
So that's my thoughts . It's extreme . I said it with the glockensreckings . I don't know if they caught it or what have you , but I think that all doctors should be independent contractors you don't have to do it 100% of the time . You can still be employed , but I still think you should be practicing that muscle .
That's my thoughts . Yeah , no , I totally agree with you .
Hey , one more question . We got a question from Dr or no , this is student Dr J . Yeah , this is student Dr J . She says Hello , dr Renee . First of all , she didn't even thank you . She even a friend of mine . A friend of mine just shared with me one of your videos where you talk about how awesome it's been doing locums . I just love that .
I'm a second year medical student and have always wanted to go into OB . I'm all about the work-life balance , and I think locums would give an opportunity for just that . I just have one question , though how do you navigate the health insurance and retirement plan component ? I'm not sure if locums provides that , jay .
What is with the reading voice tonight ?
Answer the question .
So how do I navigate what ? I got distracted by the reading voice .
How do you navigate the health insurance and retirement plan component ? I'm not sure if locums provides that .
Well , no , locums doesn't provide that . Thank you first for the question and thank you so much for not including Dr .
Neal Listen . Student . Dr J , you acknowledge me all right . Acknowledge me all right . I'm in this also , okay , so it could be , you know , dr Neal , and Renee , or Dr Darkos . You know what I'm saying , dr Renee ? What I started this 2016 was by myself Humana , humana , humana , humana . This is Dr Nee . Where was you All ?
right . Excuse me , I was in the background . I was definitely in the background .
Over here , Ignore it . She came here like oh , Dr Renee Coming on this , Dr Renee idea since 2014 , when you started this podcast .
Who got you your first mic ? Who got the first mic ?
don't ?
we have a joint account who pulled the trigger on the joint account and pulled out the money to buy the first mic where you hummina , hummina , hi , this is Dr Ne , and welcome to Doctors Outside the Box . I was like that's not the name of your podcast , that's not what name of your podcast .
That's not what I said , okay , anyway , you know I'm right , because you have to re-record it . Let's answer the question . Anyway , let's answer the question .
Yes , I'm having to re-record until the question . Move on , man , next time . Student Dr J , you write in . You say Dr Ne and Dr Renee .
Dr J ruined our marriage . It's my house , so no Locums does not provide for health insurance , and what we do is we go to the healthcare marketplace , ie Obamacare or whatever they call it now the Affordable Care Act , I don't know what they're going to call it next week .
It depends on who's the president .
Right week .
It depends on who's the president .
Right depends on who's the president . But yeah , basically we go to the marketplace and we buy our health insurance there .
And we've been doing that ?
since what ? 2017 ? Since 2017 17 , right , yeah , we did .
Let me tell you all the story , guys , we were employed and the plan was to not be employed and to work locum starting january 2017 . What kind of didn't really anticipate was that renee was going to be pregnant renee was pregnant . Anticipate that no , because we were doing ivf well , no , when before we made the plan to leave ? When ?
We made the plan to leave when we made the plan to leave in 2017 , you were not pregnant yet and we did not start IVF yet .
Wait 2017? .
When we left ? Oh , when we made the plan , you were not pregnant and we weren't trying .
Oh , oh , no Okay , I see what you're saying when we first made the plan , so when 2017 comes you are what I think you're 20 weeks by the time January comes . I was . I got pregnant in August , yeah , and it was January .
Yo , I was so scared to pull that trigger . I was like yo , I can't believe I'm going to be getting .
I had already quit my job . I'm going to be buying health insurance . I'm going to be getting . I had already quit my job .
I'm going to be buying health insurance . I'm going to be buying health insurance on his marketplace . Are we going to be able to keep our same doctor ? Is Renee going to be able to keep the same OB ? Oh man , that was nerve wracking , but I persevered . You have done it and you will see we got . We got the same type of health insurance . That .
And you will see , we got . We got the same type of health insurance that .
I think was a step down from what we were getting when we were employed . It was still pretty good .
But you got to keep your doc who was also your partner . Turned out to be great and since 2017 to now we've had our health insurance through the marketplace has not been an issue .
Yep .
That health insurance component is tax deductible
¶ Health Insurance and Retirement Plans
. Listen , make sure you confirm that with your CPA , because we are not health professionals . Don't try to come and see me in these streets .
We are health professionals . We are not financial professionals . What did I say ? You said we're not health professionals . I don't know about you , but I'm a health professional .
We are not financial professionals . So just make sure you double check that . Talk to your CPAs , which we're going to do another show about CPAs , lord , nobody cares about your money . Nobody cares about your money like you do . That's all I'm going to leave it to you , like this , anyway .
So when you do locums , they do not cover health insurance and they do not cover benefits like having a retirement plan .
So you go to the marketplace get your health insurance , and then at the end of the year . That's kind of bogarting my question , but go ahead , go ahead , sis . No , no , go ahead , no , no , that's you sis , go ahead , that's your sis , go ahead , okay , go ahead , wifey , go ahead , wifey , you got this .
No , go ahead up now for the retirement plan . All you have to do is you're going to need some type of retirement . Well , you don't need a retirement plan , just so you know .
But from a tax standpoint it helps if you get a retirement plan yeah , so what so what that means is , when you get your paycheck , when you get money from the locums company or from the hospital directly if you do it by yourself you are going to get a large lump sum of money .
No taxes are being taken out from that , and from that money you are basically supposed to be able to figure out a way to not only pay yourself so that you can eat , turn the lights on , drive your you know your fancy car , right , but also you need to be able to pay for health insurance , right , if you need to , but you're more than likely going to need
to . And then the other thing that the government helps you out with is they give you tax deductions if you purchase health insurance . They give you tax deductions if you create your own type of retirement plan . So that's why I say you don't necessarily need it , but if you want to play .
You need it because you're going to retire one day .
If you're going to play by the government's rules , you should get one .
Yeah , but you need it because , like , you're going to retire one day , so you do need a retirement plan . Otherwise you're going to be doing locums all the way to the grave Right , and you can get Put you on down when you're 89 years old .
You can get one through all the large custodial firms , right ? So we're talking about the Schwab's , we're talking about the Fidelity's , we're talking about the Vanguard's , and there's a whole bunch of other ones that are like off the grid also . I would definitely say check out NerdWallet .
Nerdwallet does a really good job of just basically curating all the best financial just vehicles out there Whether it's credit cards to 401ks , to HSAs , to 529s . They do a very good job and they're vetted , so I would recommend that . So , health insurance and retirement plan you got this .
I wouldn't worry too much , but yeah , you're going to have to get this on your own , but you'll figure it out and it's worth it , yeah . And what I would say is like yeah , you're going to have to get this on your own , but you'll figure it out and it's worth it .
Yeah , and what I would say is like listen , don't let that be the thing that holds you back from doing locum tenens Like that , I think , is the hugest mistake that a lot of people make , especially if you are not in a situation where you have a big health issue going on .
Right .
If you don't have a big health issue going on . Right , if you don't have a big health issue going on . If you do , that's a different story .
That's a different conversation for a different place , because it can be hard to get disability insurance and so forth Right , that's a different conversation for a different day , but if you are young healthy , your family's young healthy , you don't have any major medical problems . Or if you're middle-aged like me and healthy .
Oh okay , don't have any major medical problems , or if you're middle-aged like me and healthy , oh okay . Um then , then I would not let sexy , sexy .
I'm a sexy 45 year old .
Keep going okay , so , um , I would not let that stop you from getting um , from going into locum tenens . I think that's the mistake a lot of people make they're so afraid of the unknown . Like what , if , what , if ? Like what if we ? You know , when I was pregnant , it's like , well , what if I pull this trigger ?
and she delivers , and she delivers just now . Right , it's not going to happen , guys .
Right . So that that's the main thing . A lot of this is mindset for real .
Yeah , yo listen , if you can make it through medical school but you right now . Listen right now . I don't know , though , because you are a second year medical student You're not even addressing me first on this . I don't know if you can do this , yo .
Anyway , moving on , student Dr J , I was telling you before hey y'all TMZ , if you are listening , if you are watching right now , listen , I'm your boy , I'm your boy . Yo , you could listen .
Guys guys listen , tmz , whatever it is , whether it's BBL failures , I take care of those Right , because the plastic surgeons they don't come in after hours to handle those things right . So I take care of all these cosmetic injuries and all these cosmetic issues . I take care of that . Gunshot wounds , car accidents , abdominal surgeries , hey .
So TMZ came calling right . I called them back and they said they found somebody else .
And I'm like hey yo , you got ghosted by TMZ .
I got ghosted by TMZ . They moved on who they chose . He's a dope guy . He's got a great social media following . He's a great surgeon . He's good , but he ain't me . He good though .
He good , he good . What's the guy on TMZ named ?
What guy on TMZ ?
The guy , the man who runs TMZ .
The guy from the People's Court .
Yeah , what's his name ? I forget his name .
Oh my gosh , he's that guy on there . He didn't call me directly , but there was a representative from . Tmz calling me and stuff .
Why would he call you TMZ ?
if you listen to me , come on , man , you want to be edutained right , so you need someone who can cut people open and tell you know , come on , yo , that's me , come on , tmz , it's Harvey Levin . Harvey Levin .
Listen , I'm your dude man , you know what I'm saying .
Queens , I'm sure you're from Queens , right ?
I think he's from Queens also . You know what I'm saying . Shoot , he definitely from New York .
He got to be from New York .
So thing yo . I honestly did not know what was going on until this morning . Actually , I didn't know what was going on until this morning . The whole . Where's kate ? I didn't know she was even missing .
Yeah , she just disappeared .
I don't really follow the royal family , that's not my that's not your shtick no , I don't really , I don't follow that stuff either I don't and to be honest I really don't care .
But you know , obviously from a health care standpoint , you don't want like someone in their mid-40s who's got kids and you know , but like that is really interesting that I think that for me the most interesting thing is why you got to make a video about where you've been so that's like that to me is strange .
It's like yo just let the person recover , I'll see you when I see you , but that family is so like hey , yeah .
So it's funny you mention that , because this morning I think I was watching GMA , yeah , GMA . I don't remember what I was watching , but I was watching something and it was on TV when I went to work out and I'm on the treadmill and then it comes on .
And I went to work out and I'm on the treadmill and then it comes on and I'm like , oh , and she's like , you know , I'm Kate Middleton , whatever and she starts talking about , you know , she was diagnosed with cancer . I'm like I didn't know , none of this was going on , Right ?
So during her speech , though , during her announcement , she says , well , I'm not going to get into something to the effect that she's not going to get into the type of cancer because she wants that level of privacy .
I'm like what ?
But they're making you make an announcement . It's hostage video , Right . I'm like they're making you make an announcement , but they're giving you the privacy of not saying what kind of cancer like what is this ? Yeah , and not to say and I want to be clear it's not to say that I wanted her to reveal the kind of cancer business I .
I was thinking why are you even sitting here making a video ? And it has to be because somebody was like you gotta make a video you know what I mean ?
I don't know , but I'm like this is very strange . Say this next don't say that so , based off of her age she's early 40s had abdominal surgery . What ?
in your differential could be anything . Ovarian fallopian tube uterine had abdominal surgery .
What ? Because in your differential .
It could be anything Ovarian , fallopian tube , uterine , peritoneal cancer . They said it was an incidental finding . I don't necessarily know how incidental it was , considering usually people don't have abdominal surgery , so unless she was having abdominal surgery for something else . And then they found I mean .
The only other thing I can say is colon . Colon , yeah , colon , maybe she had a mass on a colonoscopy and they decided to remove that poor I don't know . Either way , listen prayers up for Kate Middleton and her family , very young . Obviously we don't pay too much attention to that family and stuff . They do some weird things but you want the best for everyone .
So I hope health-wise she does well . But that's crazy . That's crazy .
Yeah , I just thought that was strange . I was like I don't think she's good .
All right . On a lighter note , we have gotten back into watching TV shows . Yes , One of our favorites , or actually , for a long time I stepped away from this show . For at least what five years now ? Yeah , I stepped away from this show Once I found out that Rick was going to get blown to hell to smithereens .
I was like I ain't watching this shit anymore Because to me . The Walking Dead is about Rick , but we're back to watching the Walking Dead . It's the Walking Dead , the ones who live General Hospital or something ?
No , no , general Hospital . Days of .
Our Lives . Jungle Fever , the Walking Dead , jungle Fever that's what this version is . Holy snap Yo Rick and Michonne Sheesh . Hot stuff on the screen . Sex scene on TV . Ay , it wasn't that hot of a sex scene on TV , ay , it wasn't that hot of a sex scene Anyway the ratings are back up . The show is doing great . I think it's really interesting .
It's a really interesting perspective . Yeah , basically , long story short . Rick disappeared for five years . He's like locked up in some type of I don't know what the hell it is CRM or something like that .
Yeah , some sort of community . But essentially , if you haven't seen it , it's a love story . And it's a love story of two people who lose each other pretty much in the zombie apocalypse and they eventually get back together . They find each other anyway and they're trying to get back home .
But there's like a lot of like psychological dynamics . Michonne has been on the road trying to find Rick literally for like a year . Over a year , over a year .
Which makes me pose the question to you Would you risk leaving your two kids and walking from Virginia all the way to damn Philadelphia in the zombie apocalypse trying to get Uno Nuno , your man , right here ? Would you try to get ? Would you do that ? I think I know the answer to that .
If I had the strength of Michonne and the skill set of Michonne .
What if you didn't ?
Well , that would make no sense , nii , that would mean that I would think that I could not find you because I would be dead . But if I knew I'm strong , I'm that you know , so if you could rock a katana basically , if I know that I have a sword , I know how to use it .
I'm really strong for a year , I would and don't throw on top of that we haven't seen each other in like four years already would you ?
I wouldn't recognize you , or something .
Well , you know , things happen .
Things change , you see what happens in college .
right , you're a high school sweetheart , you go to college . That shit don't last six months . I got a new study partner . You know I'm locked away you know how things happen ?
Yeah , well , technically we were study partners and got together after six months .
Yeah , we did .
¶ Predicting TV Show Deaths
That's another podcast episode , but listen , walking Dead is dope . You guys need to check it out , it is excellent . Back to the glory days , I think right , you know it's back to the glory days without actually kind of like recycling the glory days and stuff like that . Interesting new topic not getting all these other corny people in there and stuff .
Yeah , but I think I'm just going to be outright and tell you Michonne's going to die .
I don't like that prediction . I don't like that .
Listen , guys , I can predict . I'm so good at predicting these things .
Aw man you predicted power . Oh yeah , damn , and how slowly it was going to be sung the cadence and everything .
Oh , I knew Ghost was going to die . I was like , oh , he's going to die , he's going to die .
I didn't know who was going to kill him .
Spoiler alert if you didn't see Power yet . But I was like he's going to die . But yeah , michonne's going to die Because they said they're going to make three trilogies and it's going to be with Rick . It's like , ah , I get this , but anyway dope show you guys need to check it out . That's something that we are watching .
I don't want her to die and listen .
we got to end this podcast because , based off of the analysis and the statistics or whatever it shows on YouTube analytics y'all don't be watching at the end . So we're going to end this .
We'll catch you guys , on the next one , we ain't wasting no more time .
Peace .