0:00

In renegotiating this contract , you

0:02

probably got a lot of leverage , because they

0:04

probably don't want to lose you .

0:06

Being an African American , black , female

0:08

and being one of maybe

0:10

four in the city , that's some leverage

0:13

. And then you're not going to find another

0:15

primary care doctor that's more dedicated

0:17

to the health equity of the city , because

0:19

I trained in an urban setting and it's

0:22

hard to find people who are invested in

0:24

those communities . These are communities that look

0:26

like me trying to explain it to

0:28

corporate that you know I don't care what

0:30

your fair market value . You treat

0:33

me as I compare it to no number

0:35

you can give me . You have to see my

0:37

worth .

0:38

Folks , your exciting new medical

0:40

career it's just been hit with

0:42

a serious illness or injury that

0:44

stops you from earning a paycheck just when

0:46

you need it most . Check

0:48

out what Jamie Fleischer of Set For Life

0:50

Insurance set back on Episode 176

0:53

about having disability insurance

0:55

early in your career .

0:58

The real reason to get it early on is

1:00

really twofold . One is to protect

1:02

your insurability . So if you are healthy and you

1:04

can obtain the coverage , you also pre-approve

1:06

yourself to be able to buy more in the

1:08

future . So down the road , as your income

1:11

does increase , you don't have to answer

1:13

additional medical questions . All you have to do is show

1:15

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1:17

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1:19

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1:21

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1:23

. Check out setforlifeinsurancecom

1:27

. All

1:29

right , everyone was good . This is Dr Nei , as

1:31

well as Dr Renee . Hey , we

1:33

are here to have a little

1:36

bit of a Q&A conversation with

1:38

a longtime friend , a longtime

1:40

listener of the show . A lot

1:42

of times we don't get a chance to really interact

1:44

with folks who are listening or people

1:46

who just have questions about

1:48

just what to do with their career , what

1:51

to do with their lifestyle , and

1:53

we are always given advice . So this is a great

1:56

opportunity for us to kind of talk to

1:58

a listener , get their opinion or

2:00

, excuse me , get our opinion on what they

2:02

want to do with their life and we just kind of take it from there . So

2:04

, everybody , we're going to put the , the

2:07

number that you can text us if

2:09

you have questions and if you want to be on the show

2:12

and have a discussion like this . But we

2:14

have Dr Siobhan Suttles excuse

2:16

me family medicine doctor

2:18

who's here to talk about

2:20

locums , talk about investing

2:22

and probably a little bit more . Dr

2:25

Siobhan , you want to tell us a little bit about yourself , where

2:27

you're from , tell us what med school you went

2:29

to and where you're practicing at right

2:31

now .

2:31

Please , Well , thank you

2:34

, darko . I am

2:36

from the great city of Cleveland

2:38

, ohio . We're not

2:40

the mistake on the lake , ok

2:43

, but not since

2:45

2016 . Right

2:48

, don't go there , yeah

2:51

, but championship , yeah

2:54

. But yeah

2:56

, I am from Cleveland , ohio . I am a family

2:59

medicine physician and

3:02

I have a specialty in obesity weight management

3:04

. That's what I love to do , as

3:07

well as adolescent and women's health . So

3:10

those are my focuses , and I'm currently in

3:12

Akron , ohio , and

3:14

I went to Neal Yukon

3:16

, which is now known as Neo Med . It's

3:19

had a few name changes Since

3:21

I went there . I think every president has

3:23

named it something different , but that's where

3:26

I went to school and I did

3:28

my residency at the Ohio State

3:30

and

3:32

I am currently , like

3:34

I said , in Akron Awesome .

3:37

So you come with a lot of training , a

3:39

lot of you know . You've been your

3:41

board certified in that and

3:44

I think right now you're finding yourself in

3:46

a certain position

3:48

that you would like some that you

3:51

have some questions about . You want to just kind of jump right

3:53

into that .

3:54

Sure , I'm at 11

3:56

years out and I'm

3:58

at that point where you guys talk

4:00

a lot about burnout , where

4:03

it's a big cycle of , just you

4:05

know , hurting in patients and not really

4:07

giving them the quality of care that I

4:09

would want to give . But

4:12

insurance is dictating

4:14

how many patients to see and you

4:16

know companies are asking , you see , this many patients

4:19

. To make this kind of money and

4:21

to keep up with that kind of Workload

4:25

is getting a little mundane and

4:27

a little tiresome , that you know

4:29

. Getting up in the morning is a little bit harder Each

4:31

and each day . To go in and face that kind

4:34

of environment and the

4:36

turnover of the number of providers

4:38

that's there in having to reintroduce

4:41

yourself to new patients every day

4:43

, even if they have already established

4:45

with the company themselves . They're

4:47

new to you and so instead of

4:50

having two new patients per

4:52

session , you're left with 11 new

4:54

to provider patients because they've

4:56

had an abundance of physicians leaving

4:59

to go somewhere else because they

5:01

need to feed their families . I mean , you can't be

5:03

mad at people changing every

5:06

two to three . Contracts

5:08

are changed in the middle of a year and

5:11

then you are left to either stay

5:13

and accept what they don't give you or

5:15

find some other alternative , and

5:18

so I'm in the middle of contract renegotiation

5:20

and looking for some guidance on

5:23

, you know , making a different step , such

5:25

as locums .

5:27

So you are a hospital employee right now or

5:29

you work in a private practice , like you are one of the partners

5:32

, or it's hospital

5:34

based but it still feels like a private practice

5:36

.

5:37

So I worked for a large hospital who

5:40

has multiple clinics around the city , but

5:42

it's just it's just the two of us , and

5:45

then I also go to another office

5:47

where it's just me and another person as well , so

5:49

it's kind of like dividing time

5:51

, right .

5:53

Okay , and then this is fully staffed

5:55

clinics . So I'm talking about you have like

5:57

an MA or a couple of MAs , you

5:59

have someone who's to do an intake , you

6:02

have nurses .

6:03

Correct , okay , and

6:06

then fully staffed . Fully

6:08

staffed Most of the time . And

6:11

then the dynamics is I

6:13

see and serve the health

6:15

equity in the city , so like I

6:17

see the patients who nobody else really

6:20

wants to see , you know , whatever , because

6:22

of the high acuity of the patient

6:24

, and

6:26

so it's only me and one person that

6:28

sees a majority of those patients here and

6:31

so that's one clinic .

6:32

What does that mean ? What does that mean ? The health

6:34

equity ? What is the specific ?

6:37

Oh , you're a Medicare

6:40

part payers . You know

6:42

those who also , who don't have

6:44

access to care , so you know they may be on

6:46

some type of sliding skill assistance program

6:49

through the hospital and

6:51

are able to contract our services

6:53

there . And we're

6:55

in the underserved area of the city

6:57

, right across the street

6:59

from one of the biggest churches in the city , and

7:02

so we get a lot of care

7:04

from homeless . You know

7:06

people out of prison

7:08

or out of jail . You know they get

7:11

referred to us , especially

7:13

since my partner used to be one of the providers

7:15

at the jail here in the city . You

7:18

know they will sometimes come over to

7:20

our clinic once they were released , so we

7:22

see a lot of those patients who you know

7:24

otherwise wouldn't see a doctor .

7:27

And what's your schedule right now ?

7:29

I see patients starting from 7.40 in the morning

7:31

to around 4.30 in the afternoon 7.40

7:34

in the morning .

7:36

Are you really going home at 4.30 ?

7:38

No , if I go

7:40

home at 4.30 , you have to believe this

7:43

laptop is getting opened back up

7:45

anywhere between 8

7:47

in midnight , you know whatever

7:49

. And then , because we have the lack

7:51

of providers , I'm

7:53

on call weeks at a time

7:56

. So one week , then I'm off a week

7:58

, then I'm on call again for a week , and so

8:00

that's that interruption every

8:02

other week .

8:04

And when you say you're on call , this is home , like

8:06

this is called , directly from patients

8:08

, or is this like admitting patients into the hospital

8:10

?

8:11

No , it's triage

8:13

call . So I have a nurse in a mediary

8:16

, you know , so they get a call . They may need

8:18

a call for , you know , advice on

8:20

what to do about a patient , because you know everybody

8:22

gets sick after 11 o'clock at night .

8:24

Yes , they do .

8:26

And then at 11 o'clock at night . That's when it becomes a problem

8:28

, when they can't go to sleep . They

8:32

can't go to sleep , but I was already sleep

8:34

.

8:36

Right , you ain't had no problems , right

8:38

.

8:41

Oh yeah , so that sounds like a really busy . So

8:43

when you're on call , like we're

8:45

talking about , like on a Saturday and Sunday

8:47

, yeah holiday . Does

8:50

that interfere with because

8:52

you have a child , right ? How old is your child ?

8:55

My baby is six , just

8:57

turn six . Yeah

8:59

, very similar to our child .

9:00

Our child is almost six , I

9:03

think our kids are six months apart . Yeah , do you find that that

9:05

interferes in that at all ?

9:08

It interferes a great amount of time because I'm

9:10

a single parent . So

9:12

I moved home majorly because I

9:15

need help , you know , and just because

9:17

of this same schedule was what I

9:19

had in Charlotte , and anytime

9:21

I want to travel I got to fly my parents

9:23

in . You know , whatever , I

9:26

got a higher help to come in and help

9:28

, and so moving back home

9:30

was easier because my sister

9:32

is literally three minutes around the corner

9:34

for me . And she puts my

9:36

son on the bus in the morning for me and

9:38

get some off the bus in the afternoons . And

9:41

then , you know , those two nights a week

9:43

I want to go work out or at the gym . She

9:46

got to keep them later and I just feel like that's a

9:48

lot , even though there's family and they

9:50

don't require you to pay them , thank

9:52

God . You know it's still a lot

9:54

and as a mother you got that guilt feeling

9:56

. You know you feel guilty about not

9:59

being there for your kid in the morning

10:01

and you only there at night and so you

10:03

look like the monster . You always got to put me to

10:05

bed and wake me up and fight with

10:08

me in the morning , but throughout the day

10:10

we don't have . We have limited hours

10:12

Monday through Friday .

10:13

Right , Right . So

10:16

how like in terms of

10:18

your negotiation

10:20

with the hospital ? How far

10:23

I know , you said you're in the middle , but what does that mean ?

10:25

Like we're going back and forth

10:28

about what their expectations

10:30

are . At this point I feel

10:32

that you know I do the work of four other

10:34

providers because you just lost three

10:36

of them at one office . And one

10:38

particularly , might be out the door soon

10:41

and you want me to be the

10:43

lead over one particular

10:45

office . And then you call me back and say no , dr

10:47

Suttles , I need you to be the lead over two offices

10:50

now . And so I'm , like you , trying to

10:52

restructure your primary care

10:54

department and in

10:56

the meantime I'm left out here , naked

10:58

by myself , you know . And so there

11:01

is no room to schedule follow up visits , there's

11:03

no room to see anybody really acutely

11:06

, because you're trying to fit

11:08

in people's patients and I say

11:10

people's patients , other doctors , patients

11:12

who you haven't had an established relationship

11:15

with . You're trying to fit them in on your schedule and

11:17

still see the patients you established

11:19

a relationship with . And so there's nowhere

11:22

to put these people and you don't want

11:24

to hire anybody . I don't know if you guys

11:26

heard

11:28

, or it was on front page news here , of course

11:30

, but our hospital just got Bought

11:33

by a venture capitalists group . No

11:35

, from a nonprofit hospital

11:37

system to a non for

11:39

profit hospital system , starting

11:42

in probably January of 2025

11:44

. And so you got doctors who still

11:46

need to pay the student loan debt .

11:48

Yeah , they don't qualify . They

11:51

don't qualify for correct . What's

11:53

the name of that code ? The PSLF . Pslf

11:55

, now anymore , yeah .

11:56

Right . So imagine being in your ninth year

11:58

, right . In your ninth

12:01

year in this house , you know and

12:03

then you think about you know

12:05

restructuring . You can't hire

12:07

any new grads because they , like I , got

12:09

on this debt . And

12:12

so try to find somebody who wants

12:14

to come in and you've

12:16

got to stuff A nice package

12:18

. But here we are in the middle negotiations

12:20

and you trying to decrease your match

12:23

to my 401k . You trying to

12:25

remove CME money . You

12:27

want to pay me less to do more and

12:29

I'm just like nah , that don't work for me . And

12:32

also we're in contract . I

12:36

think we kind of know where this negotiation .

12:37

I think we kind of know where this negotiations are going . So

12:40

I mean , you kind of basically

12:42

described like how you feel about

12:44

it and how it's going . But but for

12:46

real , dr Suttle is like what's , what's

12:48

specifically ? Is your question to us ? What could we ? Because

12:51

I think I already know the answer .

12:54

I don't know how to exit

12:56

stage left Like what do

12:58

I do first , what do

13:00

I do second ? You know like

13:03

how do I set what

13:05

is my , I guess , a timeline

13:07

, because I know the timeline to submit

13:09

a resignation , but what's the timeline

13:12

I need to set up or

13:14

to explore what my options

13:16

are ? You know you got all these different locum

13:19

companies out here and some

13:21

of them be in my email , you know whatever , but

13:23

I don't know who to go with . And

13:26

already , with the restraint of being

13:28

a single mom , like I had explained earlier

13:30

, travel is looking

13:32

like something and I'm going to have to consider

13:35

, for the simple fact that I looked

13:37

at your list of the top 10

13:39

places that's looking for , you

13:41

know , family medicine , docs and stuff like

13:43

that , and the commitment they're looking for is

13:45

like two to six months , I'm like , no

13:47

, I need something a little bit shorter

13:50

, shorter but lucrative

13:52

.

13:53

Right , yeah , so

13:56

that's a deep question , but I think

13:58

it's a problem or a question that a lot of people

14:00

have , which is can

14:03

I summarize ?

14:04

Oh yeah .

14:05

I don't want to resign with my hospital , but

14:08

I'm not sure exactly how to take

14:10

the next steps to make sure that I don't have to resign

14:12

with my hospital while I'm trying to figure

14:14

it out , right , basically . So , should

14:17

I resign with my hospital while I'm figuring out

14:19

or should I just , you know , just

14:21

be quiet and figure

14:23

it out ? Because I think a lot of people are like bouncing is

14:25

not an exact , is not an option , right , unless

14:28

you have a plan Right . So it's either

14:30

resign with the hospital under

14:32

the full terms or and you have really

14:34

good , you being from Akron and you

14:36

being from Cleveland you got LeBron James there , who

14:38

knows how to sign a one year contract

14:40

On the low right . Excuse

14:42

me on the right , you'll sign a one year contract

14:45

, over and over , and over , and over and over again to keep

14:47

companies to

14:49

keep the Cleveland Cavaliers making sure that they have

14:51

talent around them , right , right . So

14:53

my question to you is one

14:56

can you just bounce right

14:58

, just be like I'm out ? Do you have enough in your

15:00

savings ? Do you have enough of

15:02

that to just be like , yeah , I'm not working until I

15:04

figure out something better ?

15:06

Yeah , I have an emergency fund . I

15:09

really don't want to tap into it , but

15:11

I mean , if push came to show

15:14

, yeah , I mean soon . As we were going through

15:16

these negotiations , I reached out to my finance

15:18

person and said , hey , do I have

15:20

to sit still or can I , you know

15:22

, for the next six months , you

15:24

know , sit at home and figure it out

15:27

? And he told me it's pretty much up to

15:29

me , but you know , you sit at

15:31

home for six months . That's six months . I'm putting myself

15:33

backwards . This that afford

15:35

, but yeah , I could

15:37

just bounce being

15:40

short . I mean the answer to that , I could

15:42

.

15:43

So yeah , because that's that's always one thing that

15:45

you want to think about right is whether or not

15:47

you have the financial ability

15:49

to be able to pivot when

15:51

you want to pivot . So that's , I

15:54

think that's first things first . The

15:57

other thing is , you know you talked

15:59

about doing low comes

16:01

. One of the things that you could do

16:03

is you could do the smooth transition

16:06

right where you

16:08

work OK , but

16:10

you do low comes on the side . Now

16:13

I know , as a single mom

16:15

, you're already busy . That's

16:17

going to be tough . So

16:19

I guess my question is

16:21

before we get on to the

16:23

move and trend you're , before we

16:25

get into the work in transition , my

16:28

question is in renegotiating

16:30

this contract , it sounds like you have a

16:32

little bit of leverage if people

16:34

are , you know , chucking

16:37

the deuces left and right and

16:39

so while we joke about that one year

16:42

contract or whatever , the

16:44

reality is you probably

16:46

got a lot of leverage because they probably don't want

16:48

to lose you . So

16:50

what , what do you think you

16:52

could do in order to leverage , kind

16:55

of , you know , your ability

16:57

to be able to take advantage of the situation

17:00

that you have at work and move that

17:02

into something that you could

17:04

do , you know , while

17:06

you transition into low comes ?

17:09

Well being African American , black

17:12

, female and being

17:14

one of maybe four in the city

17:17

, that's some leverage

17:19

that you know here . And

17:22

then you're not going to find another primary care doctor

17:24

that's more dedicated

17:27

to the health equity of the

17:29

city . Because I trained in

17:31

the urban setting , you know I , you know was a national health service

17:35

scholar , you know . So my first couple of years out in

17:37

practice

17:39

were in these underserved areas . So

17:41

I'm dedicated to the patient , you know . Whatever , and

17:43

it's hard to find people who are invested

17:46

in those communities , you know , and these are communities

17:48

that look like me . And

17:51

so you know , trying to explain it to corporate

17:53

, that you know I

17:56

don't care what your fair market value you bring

17:58

me , as I compare to no number you

18:00

can give me , you know whatever

18:03

. I was comfortable with what you were supplying

18:05

me before and

18:09

I'm not looking to make any downward

18:12

move in my , in my salary , you know whatever . And

18:15

that's where we are currently Like

18:18

you have to see my worth , and I have patients that

18:20

would stand 10 toes down , like she need

18:22

to stay , you know whatever

18:24

, and so who I need to contact

18:26

? You know whatever kind of thing . So

18:29

I think I have some leverage there . And then the

18:31

fact that they keep adding

18:33

more responsibilities that come at a price . You

18:38

can buy my loyalty for it one year at this fair market price for me , and if

18:41

that's a no , are you negotiating yourself

18:43

for ?

18:44

it . That's a no . Are you negotiating yourself

18:46

or do you have a lawyer ?

18:48

Myself . You suggest I get

18:50

a lawyer .

18:52

Um , in my opinion , um , I think

18:54

that you can do it yourself if you have a lot

18:56

of experience , um , if you have

18:58

some training , um , and definitely

19:01

if you can learn to keep the emotion

19:03

out of the back and

19:05

forth , right Like you can be extremely

19:07

, um , just like they , transactional

19:09

, if you can be very transactional about your skills

19:12

and what you do and what it would

19:14

mean to the hospital with you there and

19:16

what it would mean to the hospital without you there

19:19

, without bringing emotion , then , yeah , if

19:21

you feel comfortable having that type of conversation

19:23

, go for it .

19:24

Motion out of the email responses .

19:27

I can't do that I can't do

19:29

that . I use caps locks for everything . You

19:34

know I will , you know I will , I will put paint

19:36

on their car , like I just . So for me , I

19:39

just get a lawyer so I can handle all that

19:41

stuff , because I , for me , it's just , it's really

19:43

hard for me to , yeah , like

19:45

it's hard for me to be transactional about what I do , because what I

19:47

do on a daily basis is very

19:49

high intensity you know what I'm saying and

19:52

for me to kind of just say , hey , like you know

19:54

, a trauma surgeon is worth this versus this . There's

19:56

this . This quantification is hard , you

19:58

know . So that's often me . I always get a

20:00

lawyer , because after a while I get bored . And when I get

20:02

bored and I start to get frustrated but

20:04

we're different , we're different , Um

20:07

, so if you feel like you need a lawyer who

20:09

can kind of talk about things

20:11

in a very transactional process and you can't

20:13

, then go ahead and do that , right , because right

20:15

now , lawyers who can negotiate for

20:17

yourself we had one on our show about a year and a half

20:19

ago . You know , the average cost , I think

20:21

realistically , is anywhere between like 500

20:24

to maybe like $3,000

20:26

, possibly depending on how long it takes

20:28

Right , but sometimes it doesn't

20:30

mean that you can't at least get a

20:33

lawyer to at least review the contract

20:35

Right . The final yeah , at least give you advice

20:37

on a contract . Like , maybe

20:40

I would ask for a and then I

20:42

would let B slide so that C

20:44

can come through and look nicer . You know

20:46

something like that so that you know that you

20:48

know in a negotiation you can't get everything Right

20:50

, but maybe you can get 50% of

20:52

what you need and go from there .

20:54

Yeah , and also you know to look

20:57

at the language right , because

20:59

just when you think everything has been negotiated

21:01

and everything is , you know , fine

21:04

, and you've gotten everything that you wanted , the

21:06

question is about the language and

21:08

how the interpretation of what

21:10

is written in the contract will

21:13

be Right . So if it

21:15

can be interpreted one way versus another

21:17

way , you need it to be rock solid , like

21:19

this thing cannot be interpreted any other

21:22

way but this way that you want

21:24

it to be .

21:24

Like what does fully staff mean to Right , exactly

21:27

, exactly .

21:30

So things like that , things that are very ambiguous

21:32

, even though you might have an

21:34

idea of what that means , but

21:36

it's actually ambiguous . So

21:39

at least for the final contract , I would say

21:41

I would suggest getting someone

21:43

to take a look at it . But I'm kind of like you I

21:47

like to negotiate on my own

21:49

, primarily , and then hand off , okay .

21:53

So what do you need to come back , you

21:55

know , for another , however long , one

21:58

year , three years . What is it that you're going to need

22:00

for them to do ?

22:03

I hear some more physicians . What

22:07

if they can't do that ?

22:09

What if they ? Said they can't guarantee that in a year .

22:12

So one of the things that we are

22:14

I think we're finally solid on is

22:16

I don't

22:18

want to do production , I don't want to do

22:20

work RBU , I don't want to be able

22:23

to a certain number A

22:26

patient work that I have to do . So

22:29

I need a salary , and

22:31

I need a salary with a floor work

22:33

RBU that I

22:35

need to meet , and

22:37

then I need to know what my payout will be when

22:39

I see the work RBU you're going to

22:41

set .

22:42

And so we're working those

22:44

numbers out . Do you want a salary

22:46

guarantee or do you still want RBU's

22:48

in your calculations ?

22:51

I want them to run concurrently together . So

22:53

this is what you're going to pay me as my salary , as

22:56

long as I meet this floor of

22:59

your RBU .

23:01

So you don't have that right now

23:03

, no , how's

23:06

it ? Structured right now . When you first started

23:08

working with them , did you have

23:10

a guarantee salary at all for a couple of years , and

23:12

then they took it away . Correct the

23:16

thing is we got some young people listening

23:18

and they don't understand how Right

23:20

.

23:20

So because of my experience

23:23

, I started off

23:25

let's say the tiers was one through five

23:27

. Because of my experience , I started

23:29

at a tier four , and so

23:31

I got that guarantee for two years

23:34

. The second year was the measure

23:36

year . That was the year to measure how

23:39

well I did , you know whatever . And so now

23:41

this year is well , hey , Dr

23:43

Suttles , you didn't meet that measure , so we're

23:45

going to drop you from a tier four to a tier two

23:47

no , you're not . Right

23:50

, because

23:53

one you can't show me any evidence

23:55

of a provider who came in this environment

23:58

and met your current work

24:01

RBU . You can't even show me how to

24:03

do it , you know whatever . And so

24:05

therefore , it tells me that you hired me knowing

24:07

that I wouldn't meet that expectation

24:10

, and so you always plan to pay

24:12

me less to do more , and

24:14

so we're going to renegotiate that

24:16

.

24:17

Right . No matter

24:19

where you are in your career , you've seen patients your age or

24:21

younger get seriously injured , have

24:24

a long term illness or even have a mental

24:26

health issue that affects their ability to work . Now

24:29

what if that was you ? No , for

24:31

real . What if that was you without disability

24:33

insurance ? How are you going to replace your paycheck ? In

24:36

episode 176 , jamie Fleissner

24:39

of Cephalife Insurance explains why

24:41

the best time to buy disability insurance is

24:43

during your residency .

24:45

Most people , most physicians , acquire

24:47

their disability policies during residency

24:49

, and there's several reasons . First of all , when

24:51

you're younger , you're able to obtain the

24:54

insurance because they ask you a whole host of

24:56

medical history and so you

24:58

usually don't get healthier over time . Usually

25:00

you get less healthy over time , so when you're healthy

25:02

, it's easier to acquire the coverage

25:05

. Number two it's also less expensive because

25:07

it's based on your age and your health . You're

25:09

not getting younger or healthier over time

25:11

, so you're at the ideal time . The earlier you get it

25:13

and the younger you are , the less expensive

25:15

it's going to be .

25:17

So , whether you're a resident or you're an attending , it's

25:19

never too late to protect your income . Renee

25:22

and I , we use Cephalife Insurance to find a

25:24

disability policy that fit our needs

25:26

and budget . So what are you waiting

25:28

for ? Check out CephalifeInsurancecom

25:31

Once again . That's CephalifeInsurancecom

25:35

. So

25:37

everybody who's listening ? So RVU

25:39

, basically , is a way to quantify

25:42

.

25:42

Relative Value .

25:43

Unit . Yeah , it's a way to quantify

25:45

what doctors do , right . Like if you

25:47

see patients in clinic , that

25:49

is assigned an RVU , right

25:51

? If you do gallbladder surgery

25:54

, that's an RVU , and

25:56

it's basically a way to quantify

25:58

how much work you do

26:00

. How much work you do , and

26:03

it makes sure that the gallbladder that is

26:05

done in Denver or a gallbladder that is done

26:07

in Ohio is basically the same price

26:09

as a gallbladder that is done in Jersey or

26:11

in Florida . And

26:14

what we find out , though , is that if

26:16

you see a patient who , for example , in family

26:18

medicine , I'm sure like the RVUs for seeing a patient for a high blood pressure

26:21

check is not the same as an RVU for a high blood pressure check . It's

26:23

not the same as an RVU for someone who

26:25

may have something more

26:28

complex or a combination of things .

26:30

Just a heart failure diet .

26:31

I was just thinking congestive heart failure

26:34

you see stage three

26:36

and had a blood clot . Right and

26:38

they take a lot of time .

26:39

They take a lot of time

26:42

. I

26:44

don't know how many patients , how many of those , you can fit in your schedule . You probably

26:46

double booked , triple booked , you know

26:48

. So it really affects your ability

26:50

to provide

26:53

a stable income for yourself , because

26:55

what we end up finding is that RVUs , that relative

26:57

value unit , really it values

26:59

procedures more so than clinic visits

27:02

. Is that safe to say ?

27:04

It is safe to say .

27:07

So for someone like you who is mainly , at

27:09

this point , clinic based , you know it puts

27:11

you at a disadvantage and I think for

27:13

the folks who are listening , what ends up happening is if

27:15

you're going to go to a hospital that's going to focus on RVUs

27:18

, usually what they do is they provide a salary

27:20

for you for the first two years or three years , like

27:22

inductive subtles example

27:24

. It's guaranteed , like they're going to pay you 200K

27:27

, no matter what , and then in between

27:29

one of those years , like your second year or third

27:31

year , they're looking at all the procedures

27:34

you're doing . They're looking at all the clinic visits that you do . And

27:36

then what they do is year four , when you

27:38

resign with them or whenever it's time to

27:41

renegotiate or

27:43

you may not even have to renegotiate that

27:45

next year is going to be based off

27:47

of how much you make , is going to be based off of

27:49

what you did the year before . There's no longer

27:51

a salary guarantee , right ? So

27:54

if let's say , for example , the people

27:56

don't come to the clinic anymore , you're not getting the

27:58

referrals that you need anymore , or whatever

28:01

it may be Patients .

28:02

don't come today visit .

28:03

Right , exactly .

28:07

And especially when you have a patient population

28:09

that is more vulnerable . I

28:11

mean , you know , yeah

28:14

.

28:15

Oh , absolutely , and you can even

28:17

change in a bus route Right Checking

28:19

a bus route . Yeah , you can't triple

28:21

book because then that's the day everybody show up , right

28:24

.

28:24

Then they made it .

28:25

Yep , you want to imagine patient satisfaction

28:28

, right yeah .

28:31

So you , you want it so that you're

28:33

getting a floor , a guaranteed

28:35

, guaranteed salary , which is a certain amount , and

28:38

then if you go above

28:41

and above , if you go above a certain amount

28:43

of RV use , then you'll get that as a bonus

28:45

, which is not a big ass . Actually

28:47

, a lot of people have that . So

28:49

those who are listening , I hope you're only like why

28:51

she asked about nope , that happens a lot guys , yeah

28:54

Well especially when you're doing the work of 10 men .

28:55

You know what I'm saying . It's

28:58

like , you know , at some point

29:00

they , you know , at

29:02

some point they have to realize that you

29:04

do have that leverage , because

29:06

they don't have the number of providers , and

29:09

, no matter how much they want to double

29:11

and triple book you , it is never going

29:13

to actually equate to

29:15

the number of patients that

29:17

they would see if they have the

29:19

number of providers that they actually had , which

29:22

it sounds like they are not really doing a good job at keeping providers . For

29:26

me , I think that's actually the leverage that you

29:28

have is that they

29:30

don't have the number of providers

29:33

that they need and that you are

29:35

providing , you know , a

29:37

service , especially when

29:39

you describe that you're seeing a patient

29:41

population that a lot of doctors might be running

29:44

from . If

29:46

I were you , though , I would never bank

29:49

on doing

29:52

a negotiation based on

29:54

something that they

29:56

will externally promise

29:58

ie , we will get more

30:00

providers . They

30:02

cannot guarantee you

30:04

that . That

30:08

is a big conditional , because

30:10

it has . It's going to be an if

30:12

, not necessarily a when

30:14

. So

30:20

when you negotiate on something that you know that

30:22

you can control , that you can set the boundary

30:24

on . So I do like

30:26

the . You know , I want my

30:28

salary , I want my base salary . Is

30:31

that your biggest pain point ?

30:33

Is that the biggest thing for you ?

30:35

The biggest thing , yes , and then I mean just the

30:37

demand like more work

30:39

, like they want me to take over two offices . This

30:42

is like you know . You want to grow in a

30:44

company . You want to be able to see yourself like

30:46

, hey , maybe one day not necessarily being

30:48

in patient care doing something

30:50

a little bit more administrative . So I'm trying to get

30:53

my feet wet a little bit , but I can't be

30:55

pushed into it , you know whatever , and

30:57

still expect to do this

31:00

job . And , like you know , one of the biggest things

31:02

for me is that most of the administrators

31:05

here are physicians

31:08

, right , but none of them

31:10

carry a patient load , not even

31:12

a half a day a week , right , you know whatever

31:15

. So if you want to help the system

31:17

, you

31:19

know , instead of sitting behind a desk , see some patients

31:21

If patients is how we going to get our money you

31:24

know Right .

31:25

That always makes me nervous when you have doctors

31:27

who are . I mean , either way , anybody in the C-suite

31:29

makes me nervous , but I think doctors in the C-suite

31:31

make me nervous because it's like , well , what

31:33

exactly are you here to do ? Are you here to make

31:35

it easier for the administrators

31:38

to understand the plight of doctors , or are

31:40

you just here to basically be a nice

31:42

face to the demands

31:44

of what the C-suite wants doctors to do ? You

31:46

know what I mean . That's what I get nervous about .

31:48

I think , honestly , C-suite

31:51

doctors I think for the most part , if

31:54

I were thinking about C-suite , I would literally

31:56

just be thinking how can I get

31:58

my schedule in such a way

32:00

that I don't have this workload ? If

32:03

I can do something great , then

32:07

I'll do it . But

32:10

is it 100%

32:12

that I'm going to do something great

32:14

for this community ? Probably

32:17

not , because I'm in this big conglomerate

32:19

. I'm in this . I'm just a cog in a wheel . So

32:21

I'll do what I can . But

32:23

right now , the priority is I got

32:25

to get my time back and I think that's probably

32:28

a majority of administrative

32:30

physicians , you know , and no shade

32:32

to them because they probably

32:34

did it because they were burnt out from

32:37

seeing so many patients and they

32:39

probably feel like , yeah , I'm not

32:41

, I'm just a cog in a wheel . This is not necessarily

32:44

going to change , but I've got to do

32:46

something to change my own life for

32:48

myself and for my children . You know

32:50

, like you mentioned , you're a single mom

32:52

and , yes , you become the monster of wake

32:55

up when the child doesn't want to wake up in the morning

32:57

and go to sleep , when he doesn't want to go to sleep

32:59

, and it's like you know , is that

33:01

the only interaction that you're going to have with this

33:03

kid ? Correct you

33:05

know .

33:07

In my opinion , I would you know if negotiations

33:10

don't go the way how you really want it to

33:12

go . I

33:14

think what I would be thinking to do is man

33:17

, because relying on your savings

33:20

, that's a big deal , right , like

33:25

that's a 180 degree turn , right there . That's

33:27

extremely drastic . But if you're willing to do

33:29

it and you're ready to do it , go ahead

33:31

. What I was thinking is just maybe

33:33

considering seeing how far you can get

33:35

with negotiations and then just deciding

33:38

. You know what this is going to be either one year or

33:40

two year type thing and during that

33:42

time you're saving up , you're getting

33:44

your ducks in a row , you're speaking to family

33:46

and you're just saying , hey , guys like oh

33:48

, and also you're looking at other options , whether

33:51

that's going to a competing

33:54

hospital or considering

33:56

locums , or maybe considering urgent

33:58

care If that's not like restricted from you

34:00

when you leave your hospital , and so forth

34:02

. But I , during those telemedicine

34:05

, telemedicine right , you

34:09

know those one year to two years . Those

34:11

are the things that I would be doing to

34:13

really like get yourself ready

34:15

to transition out of

34:17

this situation , because it doesn't seem like it's a situation

34:20

that's going to end positively . Because

34:22

, yes , let's say you do get the salary guarantee and

34:25

yes , let's say you do get the RVUs

34:27

that you want , like the things that are

34:29

also just important to you , ie spending

34:31

time with your children , not being on call

34:33

or seeing so many hella patients

34:35

. I don't know if that's really going to change .

34:38

I agree , I don't think that part will change , especially

34:40

if they bend on that particular area

34:43

. You know they're like . Ok , we're going to give you

34:45

this Suttles , but we still need you

34:47

to produce what you already been

34:49

doing , which is saying hella

34:51

patients , you know whatever . So

34:54

I mean , one other thing that I

34:56

wanted to negotiate in that too , was some

34:58

protected time . I already get a couple

35:00

of hours of protected time per week

35:02

, but because you're asking

35:05

me to take on more administrative role

35:07

, I need a little bit more protected

35:09

time . And so that's you know

35:11

paperwork coming in from four other doctors

35:13

plus your cell . You know , that's the part of

35:16

my job I hate to . Renee , I heard you say

35:18

I hate the paperwork .

35:19

Oh , I hate paperwork . Don't like

35:21

it at all .

35:23

You know FMLA paperwork , you

35:25

know yeah , it takes a long time .

35:27

Family medicine , I see .

35:27

So , yeah , yeah , you get a lot

35:30

of FMLA for that .

35:32

Oh , the older you are , people like I don't want to come

35:34

get my trash can out the backyard

35:36

. Can you sign this form to

35:38

tell them they got to come to my backyard ? I'm

35:41

like doctor , do it ?

35:42

Or get a handicap , or help me get a handicap

35:44

. Yeah , all of these things

35:47

that , yeah , they take time .

35:48

I'll tell you that in residency you fill out

35:50

paperwork to keep people lights on , to

35:52

keep the gas from getting disconnected for

35:55

them coming to get your garbage gas A

35:57

support dog , A support dog . No

35:59

forgiveness because you're disabled

36:02

.

36:03

Yes , all kinds of stuff , yeah

36:05

, so you know the way how I look

36:07

at it is , you know , locums

36:09

. The

36:12

way I look at it is how uncomfortable do you want

36:14

to get ? Right , because

36:16

for locums , I do think that there

36:18

are opportunities for you to find opportunities

36:22

. Possibly they're closer to you , right ? I

36:24

think that's an especially where you are . There's opportunities

36:26

to be locums there . You'd be surprised

36:29

you leaving . You might be able to do locums

36:31

at your facility . I was thinking the same

36:33

thing . It's like you know what y'all can't have

36:35

me this way . You don't have to have to have me the other way , right

36:37

? That's one thing to

36:39

consider . Also , don't

36:42

sleep on like private practices that are in

36:44

the area that need some coverage on

36:46

weekends or may need coverage when

36:48

people take time off Yep , right

36:50

. And also

36:53

don't sleep on like other competing

36:55

hospitals that just need locums coverage , you

36:57

know , for their practices either

36:59

during a week or during the weekends and

37:01

so forth . It just depends on

37:03

you know . And obviously you know there's family practice

37:06

opportunities where you have to travel

37:08

, right , but that's going to be difficult . You

37:10

know , with a six year old , you know that's going to be really

37:12

difficult and that's why I say it depends on how

37:15

uncomfortable you want to get , but

37:17

I think you can do it , maybe

37:19

not far away , but I do think you can find these

37:21

local places that are willing to contract

37:24

with you , maybe even just running an urgent care

37:26

, you know .

37:30

Yeah , I was going to say , but you also

37:32

, dr Suttles

37:35

. First of all , full disclosure . I

37:37

used to live with Dr Suttles for like

37:39

a month .

37:41

Yes , I was living with someone .

37:43

It was living .

37:44

It was living .

37:45

We had a good time . Ok

37:48

, we had a good time . What ? This was October 2005

37:50

. Oh yeah , I think it was

37:53

October . No , no Black and White TV

37:55

, but EET was still

37:57

having videos , right . But

38:00

when I was a fourth year , I

38:02

rotated at Akron Children's

38:05

in their Children's ER

38:08

and lived

38:10

with Dr Suttles . Didn't know anything

38:12

about me , I didn't know anything about her

38:14

and I think there was at

38:17

one point when I quick

38:19

story , when I came

38:21

in , I think that evening she

38:23

set me up in a second room

38:25

and I got up before her and

38:29

I went to my rotation and

38:31

she I come back . And

38:33

when I come back she says to me girl

38:35

, I thought you was crazy

38:37

, I was like what happened ? She's like I

38:39

went into the room I didn't see anything

38:42

. No luggage , no , nothing . She

38:45

thought I had left , but what actually

38:47

happened was I had put all my

38:49

stuff away in a closet . But

38:52

she thought I was insane and just

38:54

like up and left , right

38:56

and I was like what is going on , but

39:00

I digress

39:02

, I digress . Those are good times , but

39:06

you do have a little something

39:09

on the side that you are

39:11

doing . So tell us a little

39:13

bit about that and if

39:15

that is an option to

39:17

be able to expand that

39:19

, to be able to kind of

39:21

meet the goals that you're trying

39:23

to meet right now . Right , because while

39:26

Locom certainly is

39:28

an option for you , entrepreneurship

39:31

Right Looks

39:33

different ways . Right , so

39:35

tell us about what you're doing , the name of your company

39:38

and what it's all about

39:40

, and like how you envision that growing

39:42

potentially .

39:45

So I have a little side hustle . It's

39:48

called the Lux MD , l-u-x-e

39:51

, the Lux MD

39:53

, and it's more so aesthetics and

39:56

obesity , weight management kind of med spy

39:58

feel . It's

40:00

pretty much seeing patients who

40:02

are self-pay , you know , no

40:04

insurance base or anything like cash based business

40:06

, who are looking to

40:08

feel good from the you know , inside

40:10

out , you know , and outside in you know whatever

40:13

. So , just

40:15

doing that , I did a little bit in

40:17

North Carolina when I was there , had

40:19

a nurse that was working alongside

40:22

with me , and so since I

40:24

moved here , I'm currently

40:26

looking to hire like a nurse practitioner

40:29

to kind of do more of the lead work

40:31

. A lot of the time is during the week and

40:33

I can do some consults maybe

40:35

two days a week and offer

40:37

some other services as I roll out stuff

40:39

. So I'm looking to

40:42

make that full time . But

40:44

that's a dream , you know . So

40:46

trying to work that in some kind

40:48

of way . So those are where my weekends

40:50

are currently like stuff like

40:52

that .

40:53

So you actually are practicing this

40:55

already .

40:55

Yeah , oh , wow , okay

40:58

, this is up and running and that's kind

41:00

of a big deal actually . Yeah , I was thinking

41:02

about that because I was thinking

41:04

that you're I mean , you're essentially

41:06

almost like a concierge type

41:09

, right ? I mean that's

41:11

one of the things that I think you

41:14

should certainly consider , especially

41:17

if locums becomes something that's

41:19

a little more cumbersome for you

41:21

. Right , you know me and I love

41:23

ourselves some locums , but you

41:26

know it doesn't necessarily work for

41:28

everyone , and I think with something

41:31

like the Lux MD , that's

41:34

something that you could potentially build

41:36

out , get clientele . If

41:38

you listen to episode what

41:40

is it ? Number two with Dre , number

41:42

two or three with

41:46

Dr Dre on Burge ? He talks about how

41:48

he built a concierge

41:50

practice where he literally

41:52

has I don't know eight patients or

41:54

something per year and

41:57

they pay like a premium price to

41:59

have access to them . Also , brooke

42:01

Shillay .

42:04

She had a psychiatry practice

42:06

that she built while in residency Right

42:08

and she was able to hire different

42:10

doctors Her attendings To work that job

42:13

. I think

42:15

that stuff is , I think , what you're

42:17

doing with Lux MD . The Lux

42:19

MD , please . You've

42:21

already trademarked that right .

42:23

Yes , she did because I looked it up .

42:25

Okay , good , good , it's not because

42:27

I didn't know .

42:27

I see somebody else trying to

42:30

register right .

42:31

Just to clarify .

42:32

It is .

42:33

Okay , good , because there's R and then there's okay

42:35

, good .

42:36

So the most important thing is you

42:38

got to have time to work on that .

42:41

Right .

42:41

And the way in which you're working right now , like it's going

42:43

to be tough , and that

42:46

goes back to what I was saying . Like maybe

42:48

just go back to him and say , look , give me

42:50

the salary , give me this , find , like the big

42:52

things , and just say , look , I'm going to do this

42:54

for a year and then I'm a bankroll . Or

42:56

give my business , the Lux MD , the

42:59

, the ref , the runway that it

43:01

needs to really get off its feet . Yeah

43:04

, because , like I said , if you're , if you just go cold

43:06

turkey , you know , and

43:08

you're paying for your re , you're paying for , you know

43:10

, your home or , excuse me , you're paying for your home

43:13

or you're paying for all of those different

43:15

things . You know you're not going

43:17

to have the re , the runway , to really do what you want

43:19

to do with the Lux MD Right , whereas if you're

43:21

working just for maybe

43:23

a year . You're giving yourself a finite time

43:25

. You're bringing in revenue . You

43:27

got what . You got what you wanted , which was the salary

43:29

guarantee , and , yes , they're making you work , but

43:31

look , they've already making you work and you're already

43:33

doing this on the weekend . So you give yourself a timeline

43:36

after a year . You're bouncing , you

43:39

know . The question I also had , too

43:41

is in your current practice style

43:43

, is the hospital doing a good job with advertising

43:46

Like is your billboard up there ? Are

43:48

they still doing that type of stuff or no ?

43:51

Oh , they know who I am . Okay

43:53

, yeah they did , they did . I think

43:55

they did an excellent job with marketing for me

43:57

Okay . I mean I've had a lot

43:59

of other doctors say they didn't do half things

44:01

they did for you , for me , so

44:04

I think they have done a great job with

44:06

that . Well

44:08

, I get a lot of my patients word of mouth , though , honestly

44:11

.

44:12

Right , I mean but , again , I think that's

44:14

part of the leverage , right Is that you're a black

44:16

female physician is not too many in

44:19

your , you know , in your area and

44:22

so , yeah , like considering

44:25

the population of Akron , ohio , right

44:28

, I mean , you know

44:31

you're a hot commodity , that's

44:33

leverage . That is

44:35

leverage . Um , you know , pick

44:37

a salary , pick a big

44:39

salary .

44:41

And you know , be careful , though , with these companies

44:43

, though , when they go for profit . See , the whole

44:45

thing is , when they go for profit , like

44:48

they have to guarantee a certain amount

44:50

of to their shareholders , certain amount

44:52

of , certain amount of

44:54

return to their shareholders . So a lot of them

44:56

will just like they'll hold the fork right

44:59

Because they're like , well , no matter , we still got to bring

45:01

in a certain type of revenue . So just be prepared

45:03

for like a really hard negotiations .

45:06

Yeah , but I mean

45:09

, one of the other things that we didn't talk about

45:11

also is kind of

45:13

you know , we talked about career moves

45:15

but we didn't talk about investing yet , and

45:18

I know that you had some questions about

45:20

investing . Are you currently investing ? You said

45:22

you had a financial planner

45:25

that you're working with .

45:27

I need to invest in book for dummies

45:29

, like I need to be broken down , broken

45:31

down , like . So , if you can like

45:33

, email me some things I should read

45:35

. You know , I know we're running out of time , but

45:37

we can be some literature to

45:40

look over . You know whatever . If we need

45:42

another you know Q&A I'm

45:44

more than happy to come on and tell you what I did

45:47

, how it worked for me , but

45:49

I really would love to

45:51

just like take this money

45:53

and flip it real fast , you know feel

45:56

like I want to you know , I'm not a day

45:58

trader , you know , but I've been put , some put

46:00

in and some . You know , whatever I need to

46:02

do to pay

46:04

my son's tuition legally

46:07

.

46:09

Or illegally , but that's good though . Okay , then

46:11

Without going to Onlyfans .

46:16

I think we're gonna you took it then , you got to put that

46:18

as you got pretty free .

46:21

Make it work , baby , make it work

46:23

my red lips .

46:26

There you go . You want to hear

46:28

.

46:31

Asma , yes , asmr .

46:32

Yeah , clicking on stuff

46:35

.

46:36

Like why you're , why you quadruple

46:38

book now Everybody

46:41

coming in like , huh right , you can't

46:44

afford my copay , but you can afford Onlyfans

46:46

.

46:46

Interesting Right , that'd be a whole

46:48

episode . How quick medicine and .

46:51

Onlyfans With your feet

46:53

, with my feet , stepping on

46:56

cans .

47:03

So that's not where I thought this show was gonna go . Hey

47:05

, it's a welcome change . I will

47:08

take it . We'll take it . We'll take it . Onlyfans

47:10

we should do an episode on that . How many doctors are doing

47:12

Onlyfans ? If you are a doctor and you have an Onlyfans

47:14

account , come in and write us out . Write us on this

47:16

show . We'll catch you up in the show . Yo , alfred , put

47:18

the text number on there . Let us know if you're Onlyfans

47:21

, doc Boom , there you go

47:23

. But

47:27

Dr Siobhan , dr Siobhan we should have you come back and talk

47:29

about the investing component , because I think

47:31

it's really interesting , because if you have a financial

47:34

planner , do you know

47:36

what the plan is ? Do you

47:38

know what you're invested in ? Do

47:40

you have access to see it ? Do you know how he

47:42

or she gets paid ? Those are things that

47:44

I think we can work out in another episode , because I'll

47:47

be really honest with you In terms of flipping quickly

47:50

and I know you're just joking with how quickly

47:52

but we are long-term investors

47:54

, so when we buy , we buy and we

47:57

hold and we are investing for the long term . Now

47:59

, when we get real estate , that's a little bit different

48:02

, and so forth . But it'll be super

48:04

interesting to get you on to talk about that and

48:06

see what your approach is and see what your numbers show

48:08

and give advice on that when we have

48:10

you back on the show .

48:12

That sounds great .

48:14

Yeah , Well

48:16

, hopefully from

48:19

this talk you got a

48:21

few options on what you can

48:23

do .

48:23

Take some notes .

48:25

Yeah , take some notes . And then we have our

48:28

attorney . I will text you

48:30

his information

48:32

. We've been working with him what

48:35

, oh gosh over 10 years

48:37

. Yeah , well , over 10 years and

48:40

so he's done our when we were

48:42

permanently employed . He's done those contracts

48:44

for us . He's done our Loeweums contracts

48:46

for us and he's really good , very thorough

48:48

, and loves

48:51

to call people if he needs to be

48:53

able to be like , yeah , we're going to do this

48:55

this way , and so

48:57

he's very effective . So

49:00

I will text you his information tonight

49:02

.

49:03

But yeah , but let's just revise or excuse me

49:05

, this review real quick what we talked about . So most

49:08

important things are number one , you have a healthy emergency

49:11

fund . Doesn't have to be salary

49:13

, it just needs to be whatever the house

49:15

expenses are and some

49:17

other expenses that you need , like food and other

49:20

things like that . Number two is

49:22

you're negotiating on your own and you feel comfortable

49:24

doing that . But no , just like

49:27

Renee had just mentioned , there are lawyers out there

49:29

who I think are well worth their

49:31

weight in gold in terms of being able to give you

49:33

a different opinion or maybe

49:35

even kind of take the emotion out of things

49:38

. If you feel like you're getting emotional with it , I

49:40

do . I'm not saying you are , but I would . And

49:43

then three is considering

49:46

fighting for what's really important

49:48

for you , which is having the salary

49:51

bottom guaranteed and

49:53

then having the RVU's be working concurrently

49:55

, and then realizing that you may

49:57

not be able to get everything and putting yourself

49:59

on a timeline , because you can put up with for

50:02

a life if you give yourself a year or two

50:04

years , right , like we've been through

50:06

it . Right , like you can put up with stuff for

50:09

like a year or two if you know what the ultimate end

50:11

goal is . And then number four , I think

50:13

, also is considering locums opportunities

50:15

that are local to you right

50:18

, local to other hospitals , local with

50:20

other private practices , or maybe

50:22

even when you walk away from this hospital

50:24

, coming back and saying you know what ? I'll

50:26

come back and I'll be a locums doctor for

50:29

you know , for as long as it takes

50:31

for you to hire fans rate would be

50:33

, you know , only fans divided by 365

50:36

.

50:36

Right .

50:36

It's my daily rate .

50:38

It's a daily increase .

50:40

It's my daily rate , that's your daily rate .

50:42

I'm not budging there you go , then

50:45

why don't you ?

50:46

sponsor our show With your only fans . Feet

50:49

, only feet . Okay

50:51

, right .

50:53

And then number five is , you

50:56

know , I think number four . What was number five ? I don't know .

51:00

We covered a lot oh

51:02

this one .

51:03

Oh , yeah , yeah . Number five is your entrepreneurial

51:06

endeavor , which you're already in the midst

51:08

of anyway , is not only

51:10

just keeping yourself ready to go

51:12

to do locums at other places , but

51:14

also using this year or two

51:16

to kind of give your business

51:18

the Luxemd , the runway that it

51:20

needs for you to really just say you

51:22

know what , for a year , we

51:25

just going to make it happen and we're not going to

51:27

worry about working anywhere else . This

51:29

is what I do , and give you the time and the opportunity

51:32

to do the administrative and marketing things that you

51:34

need to grow the business Right . You got a lot of options

51:36

. Invest in myself .

51:37

Yeah , absolutely , absolutely

51:40

. Well , I got my list , you

51:43

got your list .

51:44

But we're going to have you back on the show . We're going to talk about investing

51:46

because I think that's another component that you

51:48

know you got to make sure long term is working for you as

51:50

well as for your son .

51:51

Right , right , cause we oh

51:54

, oh , yeah , we oh oh , young

51:57

babies .

51:58

Yalla old , I'm wise , so

52:00

I feel like I'm getting better

52:02

like a fine wine .

52:05

Yeah , I got to go back and watch your episode about them

52:07

, red flags

52:09

.

52:09

Thank you , look

52:12

at his face .

52:13

Look at his face . None of the red flags were on me , oh

52:16

okay . Well , that's another show , y'all yeah .

52:19

Let's end this show right here . It's October

52:21

2005 .

52:22

Okay , let's end this show right now , guys

52:25

, because that's another topic that we ain't going to be doing

52:27

. All right , hey y'all this is . Dr

52:29

Me .

52:30

Dr Renee and Dr Spuddle

52:33

.

52:33

Thanks for having me , guys , yeah .

52:35

Yeah , all right , y'all , we'll catch you on another episode , y'all Peace

52:37

.