Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
When I first started
after fellowship, I said I'm
going to do locums.
I started working with a locumscompany 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 andthen the last shift was on a
Tuesday and I did a 24-hourshift and I finished Wednesday
morning and I was supposed to beat a place two hours away and
(00:23):
work, starting at like oneo'clock pm.
You know, and the locums personknew this, but you got to
remember, like their focus ishow much can I get this person
to work?
Speaker 2 (00:31):
You opened yourself
up to a vulnerability.
He essentially took advantageof that.
Speaker 1 (00:36):
Nobody's going to
care about your money more than
you and nobody's going to careabout your schedule and your
working life more than you.
Yeah, what is that?
What up up everybody?
This is another what y'all say.
Speaker 2 (00:50):
I'm Dr Nii joined by
Dr Rene.
Speaker 1 (00:57):
Listen, this is a
great question that we have
coming up.
We're going to be talking aboutlocums.
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 wewere doing on how we, you know,
make $300,000 each in different, various specialties and he was
(01:17):
saying, yeah, you know, docsOutside the Box is a great place
where you can learn about X, yand Z.
They do focus a lot on locumslately 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 episodeis going to be about locums.
So, guys, if you're notinterested in locums, don't turn
(01:38):
away.
This stuff is actually reallyinteresting.
I'll tell you why.
If you're like, let's say,you're a pre-med student or
you're a medical student, oreven in attending, that's in
private practice, and you'relike I don't need to worry about
that, I think it's super, likeyou 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 itin med school which you're not
(02:00):
going to get it in med school,you're not going to get it in
residency and you're not goingto get it as a pre-med then when
are you going to get it?
You might as well get it whileyou're listening and having fun
listening to us, right?
So you know we just going totalk and answer some questions
real quick about you know, folkswho are interested in you know
working as an attending, butjust kind of working on their
own terms, which, for a lot ofpeople, is working as an
(02:22):
independent contractor.
So let's jump right into this.
So, dr Renee, you have thequestion.
You want to read it.
Speaker 2 (02:28):
Yes, so we have
actually two questions from Mona
One.
I think we'll start with thisone, because this one is a
follow-up to a question that wedid in a previous episode.
But she says hi, dr Renee,excuse me, hi, dr Nee and Renee.
Speaker 1 (02:48):
Get it right.
Thank you very much.
Get it right, thank you.
Thank you, hi, dr Nee, dr Neeand Renee.
Thank you, and I hope they didyour name.
I hope they put Renee lowercase.
Thank you.
Speaker 2 (03:02):
Really, nee, move on,
you're just so petty.
Hi, dr Neen.
Renee, thank you again for thehelpful insights you've been
sharing.
I had a follow-up questionregarding the choice of state
for setting up your LLC.
I'm currently living and doingresidency in New York City.
I like the city but, as youknow, taxes are pretty high
(03:23):
After residency.
I'm not tied to any particularstate, though I do feel somewhat
connected to New York.
I was wondering in yourexperience, is it worth setting
up a locums-focused LLC inanother state solely for the
purpose of reducing taxes?
Also, when you chose to set upyour LLC in New Jersey, was that
(03:47):
decision influenced by taxconsiderations or were there
other factors that played a moresignificant role?
Thanks so much in advance.
So that's our first question,or first group of questions.
So thank you, mona, for writingin.
I'm going to actually let DrNee have first stab at this one,
because you tended to do moreof that side, yeah, I'll be
(04:12):
honest with you, mona Hopefullywe got your name right.
Speaker 1 (04:15):
No, I didn't think
about any of that stuff.
And I'll be really honest withyou to this day I still don't
think about that stuff becauseit's a lot of work, right Like
so.
Setting up an LLC, you have togo day.
I still don't think about thatstuff, because it's a lot of
work, right Like so.
Setting up an LLC, you have togo to, you have to fill out some
state paperwork, um, and thenyou know, once you become an
entity, once your businessbecomes a business, then you
(04:36):
know you're going to realizethat there's a lot of work that
needs to be done to maintainthat business, right, whether
you do it in New York, new YorkCity, idaho, new Jersey, florida
, wherever it is, there's a lotof stuff that you have to do.
I don't think it's stuff thatis so much that you can't really
, you know, work in that fashionand it's like prohibited from
(05:00):
you being able to do locums onyour own.
No, it's not that, it's justthat you have to be on your P's
and Q's and make sure that, forexample, you have a system so
that, if, let's say, the IRS orthe state federal government or
the state agency wants to writeyou information.
Where's those letters going to,right?
Let's say, someone wants toconnect with you for any reason.
(05:20):
Where's that information goingto?
Let's say, someone just wantsto ask you some questions, like
there's all these differentthings that you should start
thinking about, right?
So, um, I get it.
So, basically, what it is is Ilive 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 athletecontracts, a lot of times
you're here People will say look, I don't want to play in New
(05:42):
York because the tax is too damnhigh.
Let me go to Texas, wherethere'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 andcan't front.
Like living in New York city isdope, right, like being able to
get on a train or it's justbeing in New York is just a
different vibe.
So I would say this um, I wouldmake sure that you figure out a
(06:07):
way to start your business andmaintain your business in the
most tax efficient way, as wellas the most time saving way that
you can do that, right, I don'tknow if, okay, if you work, if
you live in New York City, butyou have an LLC that's created
in Delaware or in Pennsylvaniaor anywhere else outside of New
(06:28):
York City, if that's going tosave you in taxes, that's really
a question that we should bepresenting to our CPA and we'll
probably I'm going to submitthat to our CPA and ask what
they think about that and I'llget back to you on that.
I don't know about that, butjust 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 NewYork city and you get a locum's
job and you're working in NewYork city but your company is in
(06:49):
, let's say, pennsylvania.
Well, the fact that yourcompany's in Pennsylvania,
you're going to have to paystate taxes to Pennsylvania
anyway.
Right, and let me listen thefact that your address, your
home address, is in New York.
I'm assuming that if you do anLLC, you're going to want your
locums company to pay your LLC,and then you're going to want
(07:11):
your LLC to pay you.
Well, guess what, when your LLCpays you, they're going to pay
you according to where youraddress is, which is New York
city, and New York city taxesare high.
That's just how it is Right.
So, um, there's just a lot ofways that you can get around it.
The question is do you want todeal with that?
I don't know.
(07:31):
I don't know if it's worth it,you know.
So sometimes what people do isthey just they work a little bit
harder to bring in a little bitcash 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 wedid, you know I started off my
LLC in New Jersey.
I started off my LLC in NewJersey, and I just started off
in New Jersey because, after Ifinished fellowship, I started
(07:54):
working locums and I was livingwith my parents and I was
helping them pay their bills andeverything, and I would live in
one of the bedrooms and then Iwould just be gone for several
weeks, come back home and helppay their bills and do all the
things that I wanted to do.
So I started an LLC in NewJersey, 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 inMinnesota, wisconsin, idaho and
(08:20):
some other state I can'tremember, but I would do like a
four-state, like I had afour-state cycle.
I'd just go around and I'd comeback to Jersey chill out for a
week or so or what have you do?
Barbecue, whatever.
Help dad with you know allthose different things that we
(08:41):
needed to do.
It was really great times whenit came time for taxes.
You know I do have to let youknow that we had to file four
different tax returns with allthe different states that we're
at.
So we still had to do all that.
My lawyer or, excuse me, my CPAhad to, you know, help me
manage all of those differentthings and that, being my first
year out of fellowship, thatwould have been really difficult
for me to do by myself.
So I feel really good that Ihad a CPA, but that's just
(09:01):
something to consider that it'sgoing to be tough, you know, to
you know, really coordinateeverything 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 goingto have to end up paying state
taxes because you live there andif you have your business in
another state, you're going tohave to pay taxes just to have
(09:23):
your company in that state also.
So my advice is just talk to a.
We'll see if we can find a CPAabout that.
Speaker 2 (09:32):
Yeah, the other thing
I was going to say is, you know
, just keeping up with what isgoing on in that state, right?
Because you don't live there.
So now you have to keep tabs onwhat'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 thatdon't have income tax now will
(09:55):
continue in that particularstate.
So just using you know, justusing that state, whichever
state that you decide because itdoesn't have income tax, may
(10:15):
not necessarily be enough, right.
You may need to know a littlebit more about what's going on
and just how you potentiallymight be affected, which becomes
difficult because you live inone state and now you're like,
are you really going to keeptabs?
So I think that's reallyimportant, because not all
states, obviously, are createdequal that's the only thing that
(10:37):
I would add there, and I mean I.
Speaker 1 (10:40):
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 becomelike you.
You've been doing that for medschool and you did that probably
for residency.
Right, you had to go someplaceto go fit in, got into a med
school, you decided to go there,you had to move.
It may not have been in thearea that you wanted to be,
(11:01):
residency, I'm not sure.
Well, I guess your residency isin New York, possibly.
But for me it's like, once youbecome an attending, just choose
the place that you want to live.
That's what I would do, unlessit's some type of extenuating
circumstances.
Now, for us, we didn't livewhere we wanted to live.
Initially, we lived in centralPennsylvania because we had
almost, you know, $700,000 instudent loan debt.
(11:22):
So we knew living in New Jerseyor living in New York like a
significant portion of our moneywas going to go towards paying
off, you know, going towardshousing, living expenses and
living expenses.
Yeah, and yeah, to be honestwith you, we didn't want to work
in New York.
Speaker 2 (11:38):
Yeah, I didn't want
to work in New York.
Yeah, I didn't want to work inJersey.
Yeah, I didn't want to work inNew York.
I still don't want to work inNew York.
I'm like you know?
Speaker 1 (11:42):
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.
Speaker 2 (11:48):
Being a patient in a
New York City hospital has made
me not want to be a doctor, butyeah.
But thank you for submittingthat question, Mona.
I hope the answer was at leastsomewhat helpful.
At the very least, I would saygo and talk with the CPA, see if
(12:09):
it's worth it.
Talk with other people maybewho are doing what you're
considering doing and see howit's working for them them.
But I wouldn't just make thatdecision 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 dothat right, Because there's
never just kind of a one reasonto do something right.
(12:31):
You want to weigh your pros andcons, so that's, that's what I
would do.
Speaker 1 (12:35):
And I would say, mona
, like, the best way to get
around this at this point rightnow is um, like, instead of like
focusing.
Like I said, you still got totalk to a CPA.
They can give you the bestadvice.
You are a tax lawyer.
They can give you the bestadvice, but I think, from our
standpoint, I think the bestadvice right now is um, don't
(12:56):
worry about chasing a taxfriendly States like.
Focus on things like maximizingbusiness deductions.
Right, with your LLC, makingsure that, you know, in your
apartment is there a spot that'sdeliberately, deliberately
that's going to be there fordoing your business right, doing
notes, you know, billing thehospital, taking phone calls for
your, for your work?
Right, you need a home office,because you can get a rather
(13:18):
nice deduction which decreasesyour tax burden by having a home
office.
Right, and that's based off ofthe square footage of your house
.
That's something to consider.
Make sure that you get, like, aretirement plan right, I'm
talking about a SEP IRA or evena solo 401k.
We've talked about that onplenty of episodes.
Right, that also reduces yourtaxable income and you want to
(13:41):
try to maximize that right.
Right, then, what else?
Your health insurance, oh yeah,health insurance, like those
are things that you can do toreally like control that you
know of, to really decrease yourtax burden.
And I think hiring a CPA isalways like hiring an expert to
walk you through this process,who can teach you through this
(14:02):
process, is super important,very, very important.
Speaker 2 (14:05):
Yeah.
Speaker 1 (14:06):
Wish you luck.
Wish you luck, Mona Greatquestion.
Speaker 2 (14:10):
All right, so our
next question is for Mona again,
and we are going to be talkingabout whether or not she should
share her CV with the Logan'scompany at which point she
should do it.
So make sure you guys move onto the next segment of the
podcast so that we can answerthat question.
Speaker 1 (14:31):
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 andclick the next button on your
favorite podcast app Listen.
That's next for more banterbetween me and Dr Rene.
That's next for more topics.
That's next for more segmentsListen.
Did you hit next yet?
Go ahead and click next.
Hit it Next Peace.