¶ Locums Scheduling Mistakes
When I first started after fellowship , I said I'm going to do locums . I started working with a locums company and there was that one point where I just said look , here's my calendar , you can fill it up for me , right ? And that was a big mistake , guys .
I worked for a whole week and then the last shift was on a Tuesday and I did a 24-hour shift and I finished Wednesday morning and I was supposed to be at a place two hours away and work , starting at like one o'clock pm . You know , and the locums person knew this , but you got to remember , like their focus is how much can I get this person to work ?
You opened yourself up to a vulnerability . He essentially took advantage of that .
Nobody's going to care about your money more than you and nobody's going to care about your schedule and your working life more than you . Yeah , what is that ? What up up everybody ? This is another what y'all say .
I'm Dr Nii joined by Dr Rene .
Listen , this is a great question that we have coming up . We're going to be talking about locums . It's funny . When we were at SNMA I , low-key , caught Love , so he was Dr Love . He's a great . He listens to our show , emergency medicine physician , excellent guy , does great work .
He was leading the talk that we were doing on how we , you know , make $300,000 each in different , various specialties and he was saying , yeah , you know , docs Outside the Box is a great place where you can learn about X , y and Z . They do focus a lot on locums lately and I was like , oh wait , I caught you on that one . What you trying to say ?
Right , you know . But so , yes , so today's episode is going to be about locums . So , guys , if you're not interested in locums , don't turn away . This stuff is actually really interesting . I'll tell you why .
If you're like , let's say , you're a pre-med student or you're a medical student , or even in attending , that's in private practice , and you're like I don't need to worry about that , I think it's super , like you said , I think it's super important for you to understand , like there's just multiple ways that you can practice . It's super important , right ?
And like if you didn't get it in med school which you're not going to get it in med school , you're not going to get it in residency and you're not going to get it as a pre-med then when are you going to get it ? You might as well get it while you're listening and having fun listening to us , right ?
So you know we just going to talk and answer some questions real quick about you know , folks who are interested in you know working as an attending , but just kind of working on their own terms , which , for a lot of people , is working as an independent contractor . So let's jump right into this . So , dr Renee , you have the question . You want to read it .
Yes , so we have actually two questions from Mona One . I think we'll start with this one , because this one is a follow-up to a question that we did in a previous episode . But she says hi , dr Renee , excuse me , hi , dr Nee and Renee .
Get it right . Thank you very much . Get it right , thank you . Thank you , hi , dr Nee , dr Nee and Renee . Thank you , and I hope they did your name . I hope they put Renee lowercase . Thank you .
Really , nee , move on , you're just so petty . Hi , dr Neen . Renee , thank you again for the helpful insights you've been sharing . I had a follow-up question regarding the choice of state for setting up your LLC . I'm currently living and doing residency in New York City . I like the city but , as you know , taxes are pretty high After residency .
I'm not tied to any particular state , though I do feel somewhat connected to New York . I was wondering in your experience , is it worth setting up a locums-focused LLC in another state solely for the purpose of reducing taxes ?
Also , when you chose to set up your LLC in New Jersey , was that decision influenced by tax considerations or were there other factors that played a more significant role ? Thanks so much in advance . So that's our first question , or first group of questions . So thank you , mona , for writing in .
I'm going to actually let Dr Nee have first stab at this one , because you tended to do more of that side , yeah , I'll be honest with you , mona Hopefully we got your name right .
No , I didn't think about any of that stuff . And I'll be really honest with you to this day I still don't think about that stuff because it's a lot of work , right Like so . Setting up an LLC , you have to go day . I still don't think about that stuff , because it's a lot of work , right Like so .
Setting up an LLC , you have to go to , you have to fill out some state paperwork , um , and then you know , once you become an entity , once your business becomes a business , then you know you're going to realize that there's a lot of work that needs to be done to maintain that business , right , whether you do it in New York , new York City , idaho , new
Jersey , florida , wherever it is , there's a lot of stuff that you have to do . I don't think it's stuff that is so much that you can't really , you know , work in that fashion and it's like prohibited from you being able to do locums on your own .
No , it's not that , it's just that you have to be on your P's and Q's and make sure that , for example , you have a system so that , if , let's say , the IRS or the state federal government or the state agency wants to write you information . Where's those letters going to , right ? Let's say , someone wants to connect with you for any reason .
Where's that information going to ? Let's say , someone just wants to ask you some questions , like there's all these different things that you should start thinking about , right ? So , um , I get it . So , basically , what it is is I live in New York city , which is a high cost of living area , should I , and the Texas taxes are always high .
Whenever you hear about athlete contracts , a lot of times you're here People will say look , I don't want to play in New York because the tax is too damn high . Let me go to Texas , where there's no state tax , or Florida , where there's no state tax , and I can keep more of my money , blah , blah , blah , blah . People say this all the time .
Right , but we got it front and can't front . Like living in New York city is dope , right , like being able to get on a train or it's just being in New York is just a different vibe .
So I would say this um , I would make sure that you figure out a way to start your business and maintain your business in the most tax efficient way , as well as the most time saving way that you can do that , right , I don't know if , okay , if you work , if you live in New York City , but you have an LLC that's created in Delaware or in Pennsylvania or
anywhere else outside of New York City , if that's going to save you in taxes , that's really a question that we should be presenting to our CPA and we'll probably I'm going to submit that to our CPA and ask what they think about that and I'll get back to you on that .
I don't know about that , but just know that if you create an LLC in another state , right , let's say , for example , you get a locum's job , you live in New York city and you get a locum's job and you're working in New York city but your company is in , let's say , pennsylvania .
Well , the fact that your company's in Pennsylvania , you're going to have to pay state taxes to Pennsylvania anyway . Right , and let me listen the fact that your address , your home address , is in New York . I'm assuming that if you do an LLC , you're going to want your locums company to pay your LLC , and then you're going to want your LLC to pay you .
Well , guess what , when your LLC pays you , they're going to pay you according to where your address is , which is New York city , and New York city taxes are high . That's just how it is Right . So , um , there's just a lot of ways that you can get around it . The question is do you want to deal with that ? I don't know .
I don't know if it's worth it , you know . So sometimes what people do is they just they work a little bit harder to bring in a little bit cash so that they can live , you know , in New York City . So that's one thing to consider . So if you want to know what we did , you know I started off my LLC in New Jersey .
I started off my LLC in New Jersey , and I just started off in New Jersey because , after I finished fellowship , I started working locums and I was living with my parents and I was helping them pay their bills and everything , and I would live in one of the bedrooms and then I would just be gone for several weeks , come back home and help pay their bills and
do all the things that I wanted to do . So I started an LLC in New Jersey , even though I was working in Pennsylvania . I was working in Wisconsin . I was working . Where was I ? I was working in Minnesota .
Remember I was working in Minnesota , wisconsin , idaho and some other state I can't remember , but I would do like a four-state , like I had a four-state cycle . I'd just go around and I'd come back to Jersey chill out for a week or so or what have you do ? Barbecue , whatever . Help dad with you know all those different things that we needed to do .
It was really great times when it came time for taxes . You know I do have to let you know that we had to file four different tax returns with all the different states that we're at . So we still had to do all that .
My lawyer or , excuse me , my CPA had to , you know , help me manage all of those different things and that , being my first year out of fellowship , that would have been really difficult for me to do by myself .
So I feel really good that I had a CPA , but that's just something to consider that it's going to be tough , you know , to you know , really coordinate everything based off of where you're going to have low tech , like it's just hard to avoid .
Because you live in New York , you're going to have to pay city taxes and you're probably going to have to end up paying state taxes because you live there and if you have your business in another state , you're going to have to pay taxes just to have your company in that state also . So my advice is just talk to a .
We'll see if we can find a CPA about that .
Yeah , the other thing I was going to say is , you know , just keeping up with what is going on in that state , right ? Because you don't live there . So now you have to keep tabs on what's going on in that state just because it doesn't have , you know , income tax now and chances are that it will .
You know that the states that don't have income tax now will continue in that particular state . So just using you know , just using that state , whichever state that you decide because it doesn't have income tax , may not necessarily be enough , right .
You may need to know a little bit more about what's going on and just how you potentially might be affected , which becomes difficult because you live in one state and now you're like , are you really going to keep tabs ?
So I think that's really important , because not all states , obviously , are created equal that's the only thing that I would add there , and I mean I .
The other thing is , well , should you consider just moving , right ? I don't know , man , like , for me , I think that's the whole point you know of once you become like you . You've been doing that for med school and you did that probably for residency .
Right , you had to go someplace to go fit in , got into a med school , you decided to go there , you had to move . It may not have been in the area that you wanted to be , residency , I'm not sure . Well , I guess your residency is in New York , possibly . But for me it's like , once you become an attending , just choose the place that you want to live .
That's what I would do , unless it's some type of extenuating circumstances . Now , for us , we didn't live where we wanted to live . Initially , we lived in central Pennsylvania because we had almost , you know , $700,000 in student loan debt .
So we knew living in New Jersey or living in New York like a significant portion of our money was going to go towards paying off , you know , going towards housing , living expenses and living expenses . Yeah , and yeah , to be honest with you , we didn't want to work in New York .
Yeah , I didn't want to work in New York . Yeah , I didn't want to work in Jersey . Yeah , I didn't want to work in New York . I still don't want to work in New York . I'm like you know ?
you know what I'm saying . So we just said , look , let's , we found a spot . It was good , and it was like , yeah , let's make it work .
Being a patient in a New York City hospital has made me not want to be a doctor , but yeah . But thank you for submitting that question , Mona . I hope the answer was at least somewhat helpful . At the very least , I would say go and talk with the CPA , see if it's worth it .
Talk with other people maybe who are doing what you're considering doing and see how it's working for them them . But I wouldn't just make that decision just kind of based on this one notion that well , these , you know , these particular states don't have taxes .
So therefore , I'm going to do that right , Because there's never just kind of a one reason to do something right . You want to weigh your pros and cons , so that's , that's what I would do .
And I would say , mona , like , the best way to get around this at this point right now is um , like , instead of like focusing . Like I said , you still got to talk to a CPA . They can give you the best advice . You are a tax lawyer .
They can give you the best advice , but I think , from our standpoint , I think the best advice right now is um , don't worry about chasing a tax friendly States like . Focus on things like maximizing business deductions .
Right , with your LLC , making sure that , you know , in your apartment is there a spot that's deliberately , deliberately that's going to be there for doing your business right , doing notes , you know , billing the hospital , taking phone calls for your , for your work ?
Right , you need a home office , because you can get a rather nice deduction which decreases your tax burden by having a home office . Right , and that's based off of the square footage of your house . That's something to consider . Make sure that you get , like , a retirement plan right , I'm talking about a SEP IRA or even a solo 401k .
We've talked about that on plenty of episodes . Right , that also reduces your taxable income and you want to try to maximize that right . Right , then , what else ? Your health insurance , oh yeah , health insurance , like those are things that you can do to really like control that you know of , to really decrease your tax burden .
And I think hiring a CPA is always like hiring an expert to walk you through this process , who can teach you through this process , is super important , very , very important .
Yeah .
Wish you luck . Wish you luck , Mona Great question .
All right , so our next question is for Mona again , and we are going to be talking about whether or not she should share her CV with the Logan's company at which point she should do it . So make sure you guys move on to the next segment of the podcast so that we can answer that question .
What's good everyone . This is Dr Nii Yo . This is the end of this segment . I appreciate you for listening , but this ain't the end . If you want more , go ahead and click the next button on your favorite podcast app Listen . That's next for more banter between me and Dr Rene . That's next for more topics . That's next for more segments Listen .
Did you hit next yet ? Go ahead and click next . Hit it Next Peace .