Read time: 3.5 minutes
So you’ve decided to value your time and your sanity appropriately – you’re set on starting on the path as independent contract physician or nurse.
Great!
You might even have the first assignment locked down, your credentialing ongoing, and given notice at your current employer for your pending departure.
Even better!
You’ve got all your ducks in a row.
So what could possibly go wrong?
A lot.
My first lesson in contracting
I thought I had it all planned out:
- agreement with client signed
- talked with my direct supervisor multiple times
- credentialing started > 100 days from planned start and completed > 60 days prior
- gave notice to my former employer >100 days before my planned last day
- I even had great communication via my staffing agency throughout
Then, 6 days before my start date, I received an email asking for some documents that I had already sent 2 months earlier.
So I forwarded that old email.
The very next day, I received a new request for more information about a pending malpractice case.
Thirty minutes later, I received another email announcing that my file was complete. They were happy to inform me that my case would be presented at the credentialing meeting 3 weeks away.
So much for having everything planned out.
In total, my tentative start date would be pushed back almost 4 weeks, costing me approximately $40,000 in lost earnings.
I talked to my reps at the agency as soon as I read the email: how is this happening?
Even my clinical supervisor, couldn’t understand the delay. He was desperate for me to start because of their staffing challenges!
The bottom line was that these things happen:
- The people in that hospital credentialing office clearly didn’t review my file for 2 months. They then scrambled to complete my file the month of the credentialing meeting.
- They probably always planned on presenting me during this month and not the previous month so that I could start on time.
- No one cares that the clinical department at the hospital is in desperate need of someone to start helping out the group and the patients.
In the end, there was nothing I could do to change things. I enjoyed those unexpected weeks off and moved on.
Control what you can control
Being in business for yourself doesn’t mean that you don’t or won’t need to rely on anyone else.
I wish that were true (see above).
What it does mean is that you have to be responsible for everything.
Luckily, if you are using an agency to place you at the job, then they have some skin in the game. The sooner you start getting paid for your work, the sooner that they start getting paid as well.
Being an independent contractor as a physician or a nurse means you have to start thinking like a business.
Because you are, in fact, your own business.
Basic business principles for the self-employed clinician contractor
Two terrific resources written for physicians and healthcare professionals by physicians:
– a very popular personal finance blog that touches on every conceivable interaction between healthcare professionals and money.
– a terrific blog written by an interventional radiology colleague who focuses on personal finance, entrepreneurship, and practice management through the lens of a mid-career IR doctor.
I’ve linked to their respective seminal articles outlining their basic principles for financial well-being.
Let’s look at the commonalities:
- Create and follow a business plan
- Save money
- Live within your means
- Diversify your income streams
- Insure against catastrophes
- Be patient
- Minimize risks
Whether you are Buffett and Munger or a first year attending, the principles are the same.
In my scenario, I was lucky that I had a few things going for me from this list without having a clear plan or method.
I got off easy: I only missed out on 3 weeks of work, I had plenty of money saved, my wife and I have no debt, and, most importantly, I was naive.
In retrospect things could have been much worse.
The entire job could have disappeared. If that had happened, I would have had to start the whole process over again somewhere else, starting the 90+ day credentialing process all over again.
The emotional and financial stress would have been much more severe.
So what am I doing now to change things?
Simple. I am checking off the other points on the list:
- Creating a written plan (still working on it, I know)
- I’m credentialing at a 2nd job to diversify my income streams
- My wife and I are applying for laddered term life insurance policies
Summary
Don’t expect to get lucky just because I or someone you know has been – I have plenty of colleague horror stories left to tell in future newsletters.
Control what you can control.
Get your proverbial ducks in a row.
Use resources like the White Coat Investor and LineMonkeyMD.com to gain knowledge.
But don’t stop there: put that knowledge into practice to protect yourself, your family, and your business.
I hope this encourages you to put yourself in a situation to succeed.
Thank you for reading and I’ll see you next week.
Whenever you’re ready, here are 2 ways I can help:
1) Let’s talk through what choosing your own path through medicine looks like: https://calendly.com/tonyvullo/20min
2) Free Articles and Resources to Help You Reclaim Your Time and Autonomy: www.tonyvullo.com
Help Patients. Work Less.
Do More of Everything Else.
