Questions from Readers – July

Occasionally I like to include a blog entry answering some of the most common questions I get from readers about locum tenens as a nurse practitioner. Feel free to comment any questions you have or email me at travelingNP.com@gmail.com.

  • Is there a limit to how many state licenses I can hold?

No, you can hold a nurse practitioner state license in all 50 states, D.C., and Puerto Rico if you want to. However, it can get costly when accumulating licenses. I recommend having about 5 active state licenses at any given time to increase your job options.

Also, the more state licenses you have, the longer it can take to acquire other state licenses or to complete credentialing. Depending on the state and site of work, they may need a verification from each of your active and inactive state licenses to support that you are a nurse practitioner in good standing. Some states may take several weeks to provide this information, which can delay credentialing or obtaining a new state license.

So, although there is no limit in the amount of state licenses you can hold at one time, just apply for licenses in moderation.

Flying Business Class to Europe for $50

Since becoming a traveling nurse practitioner and collecting points and miles, I avoid flying more than 4 hours at a time in economy. My international flights (unless going to the Caribbean) tend to be in business/first class. As many of you have noticed, I fly to Spain quite often. I wanted to share one of my favorite ways to book business class to Europe.

Off season, such as in the fall, winter, and early spring, you can find business class flights from the East Coast of the U.S. to Spain for only 42,500 miles and $50. These are flights through Iberia, which is Spain’s main airline carrier. To fly from Miami to Madrid on business class one way, off season, normally costs at least $1600.

I use points from my Chase or American Express credit cards and transfer them to British Airways. British Airways is a UK airline carrier that partners with Iberia. So, I can use the British Airways miles to book the Iberia flight. By using 42,500 miles, I only have to pay $50 out of pocket. Not bad for a flight that costs more than $1600. Even if you do not want to go to Spain, it is still a good deal to book this flight and then pay an extra $50-100 to go anywhere else in Europe (since traveling within Europe is relatively cheap).

If you are wondering where these points come from, check out my page on travel credit cards. You can easily get double the amount of points needed for this one-way ticket from just one sign up bonus.

That Time a Physician Asked me to Borrow Money

Earlier this year, one of my previous co-workers, a physician, called me out of the blue asking for a favor. I had known him for a few years, as we worked together on and off. I was surprised he called me because we didn’t socialize outside of work. He is about 20 years older than me, and normally preoccupied with his wife and children.

I figured it had to be an emergency so I answered the phone. He said he needed to borrow $65,000 to pay back a debt by the end of the week or he could face some jail time. I was in shock that he was calling me from all people with a request to borrow money. I figured he must be desperate. He told me a story about how his previous physician partner at the prior practice they co-owned had written some bad checks that they were both liable for. And if he didn’t come up with the money by the end of the week he could be going to prison.

I felt really bad for him because he is honestly the nicest guy. So sweet that if you were having a bad day, he would offer to see some of your patients for you. All of the patients and staff love him. So, I couldn’t imagine him going to prison.

His story about his partner doing bad things was believable, considering I am from Miami and there is medical fraud there all of the time. He said due to the problems with the previous practice, his credit is bad so he can’t take out a personal loan. He had been expecting to receive bonuses from his current position, but stated that he was given a difficult patient panel that prevented him from getting the bonuses so he could pay off the debt. He said his dad is selling his house so he could pay me back in 2 months.

I was at work and told him I would see what I could do and let him know later that day. Of course, I was not planning on lending him $65k – that’s just ridiculous. But I felt so bad for him I considered lending him something. I consulted with a few close friends and relatives about lending him the money, and they all told me “hell no”. They said it’s one thing if we were best friends, but you don’t lend a random co-worker a large sum of cash like that. I knew they were right, but I felt really bad about the situation.

I am glad I decided to google the doctor – because it turns out, he had already been arrested multiple times! From what I read, he had scammed previous physician partners from shared profits, several times. His first arrest was over a decade ago. I was in complete shock! I couldn’t believe he wasn’t who I thought he was.

Later that week, I found out he was arrested again, and let go from our job. I was surprised our employer hired him in the first place, since they do thorough background checks. But apparently, they thought it was a personal problem and didn’t think it would affect patient care. Our employer had even lent him $20k one time to help pay the debt. He was supposed to pay them back with the quarterly bonuses he received, but never did. He always told me he received $0 in bonuses, but that ended up being a lie as well.

He had asked the other physicians to borrow money over the years. Most said no. One did lend him money, and he paid him back. I am not sure what he does with all of the money from his salary, bonuses, and scams. Does he have a gambling problem? That would be the only explanation. I can’t believe someone that makes his income has absolutely nothing in savings. I remember when he started at my job he drove a minivan, and within a month he upgraded to a jaguar.

Most people think all doctors are rich. But this is just an example of how that can be far from the truth. Even when they try to portray wealth with a fancy car. One day, I was helping some of the staff open their 401ks at work. Since I am contracted through an agency, I wasn’t sure which company their employer used for the 401k. The Doctor walked by, so I asked him if he contributes to his 401k at work. I was surprised when he said “no”. I figured, ok he must be set then. Little did I know…

Anyways, it’s crazy how little you know people… Fortunately, my support system helped me make the best decision for myself. As a healthcare provider, we are always wanting to help people, but we have to make sure it’s not a detriment to ourselves.

First Time Working as a 1099 Contractor

My first year working as a nurse practitioner, I worked for a primary care clinic as a 1099 contractor. I was paid hourly without benefits. The hourly rate was pretty high for a new grad since no benefits were provided. No taxes were deducted from my paychecks. 

At the same time, I was also working as a nursing instructor part-time. This was a W2 position, so my taxes were automatically taken out of my paychecks. 

Fast forward to the following year when it was time to file my income taxes. I figured since I was paying taxes on my W2 income, that I wouldn’t need to pay taxes on my 1099 income. I went to a CPA that was recommended and we worked on my taxes together. I was disappointed to find out, that although I had already paid ~$20k in taxes through my W2 position, I owed the IRS an additional $10k on my 1099 income. 

Since at that time I didn’t own a home, had no children, or any medical expenses, my CPA told me I didn’t qualify for any tax deductions. I cried that day out of disappointment and paid uncle Sam what I owed. 

Later on, I did my own research, and realized since I was a sole proprietor (same thing as a 1099 contractor), I could deduct a lot of my work-related expenses. This included the $5k I was paying per year for malpractice insurance, license renewal fees, uniform costs, my car lease, cost of tolls, continuing educations fees, cell phone bill, etc. 

I couldn’t believe my CPA didn’t recommend these deductions that I clearly qualified for! The following year, I did my taxes myself with my dad. I had the same 1099 NP job and the W2 instructor job. And guess what? By itemizing my deductions for my 1099 income, I didn’t have to pay the IRS additional taxes this time. Instead, I actually got a refund! 

It turns out, the sweet spot is working as a 1099 contractor and being able to deduct your expenses which will decrease your overall tax burden. Being a 1099 Traveling Nurse Practitioner is icing on the cake. In addition to the items you can deduct that I listed above, you can deduct all meal expenses while on assignment, travel costs, and anything “extra” that your agency does not cover.

It’s important to educate yourself on taxes for 1099 contractors prior to filing your taxes or even accepting a traveling nurse practitioner contract. The tax code in the USA benefits self-employed individuals, but unfortunately, tax “loopholes” aren’t always obvious. So do your research or you too will have the burden of paying too much in income tax.

My Top 4 Most Read Blog Posts

If you are new to the site and not sure where to start, maybe check out these popular posts below. After blogging for 8 years now, these seem to be to most commonly read blog articles. Surprisingly, people have been very interested to learn about recent legislation in California that prevents nurse practitioners from working there as a 1099 contractor. Not surprisingly, maintaining multiple state licenses is the second most read post. It may be time for me to update by 3rd most popular post which is about being paid as a W2 employee vs 1099 contractor. And #4 is a good eye opener for nurse practitioners new to locum tenens.

#1 California AB5 Bill

#2 Maintaining Multiple State Licenses

#3 W2 vs 1099 Pay

#4 The Difference Between a Travel NP and a Travel RN

Finishing in Jacksonville

My 3-month assignment in Jacksonville, FL has come to an end. I had a great experience and wouldn’t mind returning there in the future. The staff is so sweet and fun there, I will surely miss everyone. The owners of the company came to visit the clinic in March. I hadn’t seen them in years but they were very kind as always. They hugged me as if I am family and thanked me for continuing to help over the years. They joked that every clinic leader thinks they can convince me to stay permanently but they always bet that I will continue being a free spirit. 

Each week, the clinic has a “VIP of the week” for an employee that goes above and beyond. My last week they announced me as the “VIP of the week”. They acknowledged me and how appreciative they were of me every day during our morning huddle that week. Some of the employees said they are truly in aww of me and feel inspired. 

Since it is a pretty new clinic (open for only about one year-ish), the staff said they learned so much from me, and how things should be done. A lot of them individually said they would miss me so much and didn’t want me to leave. It made me feel good that I can make such an impact on people in just a mere 3 months. 

They treated me to lunch on my last day, and surprised me with a cake, balloons, and cute card. One of the staff made me a Cuban flan and another one even gave me a $50 gift card which I thought was so sweet. Even the patients were so kind, they brought me donuts, cakes, and cards on my last week as well. 

Interestingly, I was asked to help again in Bradenton when I finished my assignment in Jacksonville. I told them no, that I had just worked in the best place ever and could never go back there until the work culture improved. 

Side note, I caught up with a handful of friends from college during my time in Jacksonville, which was awesome! This is one of my favorite parts of being a traveling nurse practitioner. I get to see people I know but haven’t seen in years. 

Finding balance and the right travel assignment as a nurse practitioner, with Sophia Khawly, NP

I wanted to share my very first podcast interview with you guys! It was done with LocumStory.com. It’s brief, less than 15 minutes long, so you can listen quickly on your way to work. I talk about why being a traveling nurse practitioner is the best life and tips on how to get started.

You can listen to it via the link below or though spotify.