For the last couple of years I've been writing posts several months in advance and just autoscheduling them to run. Not this one. I wrote this one last Thursday while watching my son's hockey practice and updated it throughout the weekend. It's a real live glimpse into my own current, personal financial situation. In fact, I haven't yet told my wife what you are reading here, although I'm sure she'll hear about it before you do. No sense in spoiling her three day girls trip to Phoenix. She'll be back Sunday before this runs so I can tell her then.
You see, I've lost my ability to earn a living. As of today, I cannot see patients for money. How did this happen you may ask? Well, I'll let the letter itself do the explaining in a moment. But it isn't due to disability. It isn't because my group doesn't like me. Nor was our contract cancelled by the hospital. I haven't been accused of sexual harassment. I still have a license and I'm still board-certified. I haven't been sued or accused of practicing medicine poorly. So what was my great sin that has crushed my ability to earn a living? It was not surrendering my Virginia medical license 6 1/2 years ago when I moved away. Yup. I'm serious. It turns out when you leave a state, you shouldn't just let your license expire. You should actually surrender it. Or bad things can happen. And to me, they have. I bet many of you have done the same thing. In fact, this isn't even the first time I've done this. When I left Arizona after training I never surrendered my license, and that didn't seem to have any consequences. At any rate, check out the letter:
Dr. Giles, 290 feet above Upper Emerald Pool, Zion National Park
There you have it. Letter sent on 10/24, received 11/3, effective 11/7. It is spelled out succinctly: “Terminated from participation as a provider in the Medicaid program.” Now, very few of us would actually lose any sleep over not being able to be in the Medicaid program. They're less than 20% of our patient population and they're our worst payer anyway. However, our contracts with the hospital require us to maintain participation in Medicaid and Medicare. So working without being a Medicaid provider puts the whole group's contract at risk, and in a small democratic emergency medicine group, there is no higher priority than maintaining the contract. So what does that mean? It means I'm not working today and you're reading about job loss instead of college financial aid (don't worry, that post will run next week.)
This seems like a good time to pause and thank Dr. Ryan Giles, one of our nocturnists, for graciously covering my day shift today. Thanks Ryan! I'll go mountain biking in your honor.
At any rate, I go from working as normal on Sunday-seeing all comers, intubating, suturing, wrestling drunks etc, to being unemployed on Monday. That's the kind of power some government bureaucrat wields over my life, and possibly, over your life.
Not a very comforting thought, is it?
How Did this Happen?
So what happened? Somehow, my status in the “CMS PECOS system” is now revoked because I'm on the Virginia Medicare Sanctioned List for not surrendering my license. Now, I know you've never heard of the CMS PECOS system. You're a doctor, not a government bureaucrat. I certainly had never heard of this. It turns out that PECOS means Procurement, Enrollment, Chain, and Ownership System. Now you understand, right? Of course not. It's like I'm back in the military. Too many acronyms and even if you know what they stand for you still can't make any sense of it.
PECOS is the electronic portal through which physicians enroll in Medicare. They keep a database of doctors who have enrolled. And apparently, not surrendering my license years ago somehow transferred me onto the “sanctioned” list a couple of months ago. They sent a notice, and (despite what the letter says) they got a response and all the needed documentation was provided by our group's administrative staff. Then someone in the bureaucracy lost it. So they sent this letter, and I'm out of a job indefinitely. In fact, the worst case scenario is that I'm suspended from the program for a year. Our administrative staff thinks they'll be able to get this all sorted out within a week, but you really never know. They told me it was all taken care of a month ago too. I've got Tuesday through Thursday off (coming to see you folks at Baylor) so by the time I have another scheduled shift on Friday, I hope I'm good to go having had to only swap a single shift. But as of this writing, that's merely the best case scenario. I mean, this could be really bad. It's not like most other EM jobs in the United States isn't going to require me to be a Medicare/Medicaid provider. I can't just go find another job. In some ways, it would have been better to be fired. At least then I would have only had to wait a few months for licensing and credentialing.
The Financial Ramifications of Job Loss
Losing your job is generally considered a financial catastrophe. However, it is a catastrophe against which you cannot insure. My disability insurance doesn't cover this. My umbrella insurance doesn't cover this. You can't even buy insurance for crap like this. But I'm sure I'm not the only doc in this situation, and there are plenty of similar situations (bogus loss of privileges, unfounded allegations of impropriety etc). What can be done on the personal finance side when something like this happens? Well, let's discuss that.
The WCI Plan
First, let's recognize the elephant in the room and talk about why I'm really not all that worried about this. In fact, the first thing I thought when I realized I could be suspended for a year was about all the fun stuff I could do with a year off. Some of my partners and I have been talking about how to try to implement a sabbatical into our group anyway. But the elephant in the room is that medicine is just a well-paid hobby for me. We're not yet financially independent (because we spend too much), but we're not very far from it. Maybe 3 or 4 years. However, we have a side income that not only pays for our needs, but also all our wants, and also provides plenty of money to continue working toward our financial goals. And plenty to give away. So realistically, this isn't going to affect our lifestyle much at all, even if there is a year suspension involved. WCI has been too successful for that, and even if something dramatic happened to its income, we could almost surely still live on it without even tapping our emergency fund. In fact, it's possible that by being able to dedicate more time to WCI that we could make more without medicine than with it. Especially with all this great new material to write about (you have to admit, my financial life was becoming more boring by the year.) But let's talk for a minute about what we would theoretically do if there was no WCI income.
What To Do In The Event of Physician Job Loss
# 1 Figure Out Benefits
One of the worst parts for many people about job loss is they lose their benefits, like health insurance. Now, this isn't happening to me because # 1 I haven't actually lost my job, just the ability to work and # 2 I'm self-employed and buy my own benefits on the open market anyway. But in the event of a real job loss, it can be a big deal. If you lose your job, the main benefit to be worried about is probably health insurance. I mean, you don't have the cash to be funding retirement accounts anyway. You can COBRA your health insurance for a few months, which is perhaps the best deal in personal finance, since you don't have to buy it until you actually need it! Eventually, you can just buy health insurance on the open market/PPACA exchanges. In fact, if you've lost your income, you're probably going to be eligible for a pretty good tax subsidy on that. In this theoretical “no WCI” situation, I would buy my insurance this year through the exchange in hopes of getting a subsidy rather than just renewing my current policy.
# 2 Cut Spending Dramatically
The next thing that I would do in this theoretical situation is to cut spending dramatically. Any vacation not yet paid for would be cancelled. No more restaurants. We're currently shopping for a snowblower. Looks like we'd be shoveling for another Winter. No buying stuff from Amazon. We'd try to mostly avoid the grocery store and live off the food in the pantry and freezers, at least for a couple of months. We'd probably cancel Netflix, downgrade the cell phone plan, downgrade the internet plan, and turn the target temperature in the house down a bit. While many of the kids' Christmas presents are already purchased, we probably wouldn't purchase anything particularly expensive for each other. I suspect we could reduce our spending by about half.
# 3 Find a Job
In the event of job loss, one of the top priorities is getting a new job. Now I might not be able to work at a facility that sees Medicaid/Medicare patients, but there are lots of EDs out there that don't see them. Consider a VA hospital, a military hospital, an investor-owned Free Standing Emergency Department, or a foreign hospital. I'd probably call up blog sponsor CHG (CompHealth, Weatherby) and start the process to do some locums. (See the guest post this next Wednesday for more on locums.) I'd call up my friends working in the Air Force ED at Nellis AFB in Las Vegas and see if they could use some shifts covered. I'm sure they do (military EDs are always looking for contractors) and I wouldn't even need a new license. With fast track credentialing, I could probably be working shifts in a month. I'd probably also look into spending a year in New Zealand or Australia. That would be an adventure.
# 4 Tap the Emergency Fund
This sort of thing is exactly what emergency funds are for. We have gradually expanded our emergency fund over the last few years to a full 6 months worth of expenses. And that's expenses at our current lifestyle (okay, maybe without the most expensive vacations.) If we cut back, we might be able to stretch that money out for 9 months. That alone would get us through most of the year suspension.
# 5 Save Up Cash
We are in the process of paying off a mortgage. We owe about $138K and have a taxable account ear-marked for this debt of about $150K. Without a reliable income, we would have a bit more of a difficult choice. While it would be nice to drop $2500 a month off our fixed expenses (the P&I of that mortgage,) the money would probably be more useful as a secondary emergency fund. Now we've got a 2 1/2 year emergency fund instead.
# 6 Readjust Savings Goals
In addition to our emergency fund, we also have some savings for other goals in our savings account. This might be for the next vacation, the next car, annual insurance payments that are months away, funding the defined benefit plan in a few months etc. That can all be redirected to the emergency fund. That's probably another six months of expenses.
# 7 Sell Stuff
We could sell the boat and live off the proceeds for 6-9 months. We could downgrade our two Sequoias to a single beater and have a similar amount of money. This would also have the effect of reducing fixed costs. Since it is November, it might be tougher to sell the boat, but the cars would go fast, and for the right price, you can sell just about anything quickly. Our emergency fund is now worth 4-5 years of expenses.
# 8 Tap the Savings
Many who find themselves unemployed stay that way for some time. They burn right through their emergency fund and start into their savings. Unfortunately for most people, they don't have much savings. Fortunately for us, we have a lot of savings. In fact, even paying taxes and penalties for retirement account withdrawals, I think we could probably live our current lifestyle for at least a decade, maybe two. We're not that far from financial independence at which point our stash would last indefinitely.
# 9 Alternative Sources of Income
WCI isn't our only alternative source of income. We have the interest, dividends, and capital gains distributions from that taxable investing account and our savings account. We own some real estate as well that kicks off income. Other docs who lose jobs may also have another side business, a spouse's job, or a military pension. That income can really shield you from the loss of the primary income.
# 10 Send the Spouse to Work
My wife is a certified teacher. I think she could be employed and earning money within a couple of weeks of starting to look for a job. There is always a teacher shortage around here. I think she'd probably enjoy going back to work, at least for a few months or a year. In fact, we could make it a race to see who could get a job first with the other person being the stay at home parent. Of course, then we might both drag our feet in hopes of getting to stay at home.
# 11 Deal With The Identity Crisis
This might be one of the hardest aspects for some docs. All of a sudden something that you've spent a great deal of time and effort learning how to do is taken away from you. For most docs, at least part of our identity is wrapped up in being a doctor. To have that ripped away with just a few days notice can be very difficult. I would go mountain biking a lot to console myself.
The worst part about this potential one year suspension is leaving my partners hanging high and dry. While I did recently cut back from 16 shifts to 12, that's still 12 shifts a month to be covered by 17 docs. Undoable? No. Annoying? Absolutely. And worse than a maternity leave or injury since it will last a full year and no cute baby pictures come out of it. At least they won't have to go through the trouble to hire, since by the time they got someone I'll be almost back due to the long physician hiring cycle.
[Update prior to publication: They got me off the “Virginia Medicare Sanction List” 30 minutes before this post ran, so I'll be working my scheduled shift on Monday after all. Oh well. It was interesting to think about losing my job for a couple of days and I'm going to run the post anyway.]
What do you think? Have you or someone you know lost income for something like this? How did it turn out? What was the worst part of it? How did you/they weather the storm financially? What would your plan be in the event of a sudden job loss you couldn't insure against? Do you feel like beefing up your emergency fund after reading this post? Comment below!
Thanks for the candid post. I am sure it was tough to write at the time but I am relieved to hear you are back on the ‘job treadmill’.
30 years ago my engineer husband worked diligently & tirelessly to ensure our investments (generating passive income) would eventually eclipse our combined incomes. He spent a lot of free time & sweat equity to build what was to become a financial wall to ensure we would never need a JOB to survive. He has since convinced our 3 children to follow suit.
I enjoy your posts but this one hit home.
My condolences on being removed from the Virginia sanctions list. I think you were looking forward to taking a year sabbatical!
Thanks for sharing and turning this lemon into lemonade. Back before I retired and found out In retirement that I just don’t care enough to wage a fight, I thought that I might spend some of my retired time battling the archaic, arbitrary state by state medical licensing system. This reveals another ludicrous feature of this idiotic money grabbing series of fifty fiefdoms.
You could hold a license in 49 of 50 states and if you moved to the 50th, the 50th state would require the exact same documentation for licensure as if you had no other state license. Some states charge nominal fees, other charge many multiples of those fees. When I moved from the east to Missouri, I remember my licenses in NY, PA, NJ, DE had no meaning. I remember having to show proof of passing one of the two national license exams (and pay for them to send the proof)– but what surprised me is I also had to pay for the other license company to send proof that I did not ever pass or take their exam! (One of the few instances in a scientific field where you have to prove a negative.).
But on a more basic level what are we saying by cordoning off medicine on a state by state basis? Is there really supposed to be any difference between doctor’s practices on one side of State Line Avenue vs another? (i’m thinking of Missouri and Kansas border, but there are many states where communities straddle arbitrary state lines.) These communities put the lie to the notion that State Licensing Boards can or should maintain medical standards. If there is no difference why do we require separate State licensing? If there is a difference, why? If one State has “better” care than another, shouldn’t the inferior state be DEMANDING it be brought up to the higher level? As far as the state should be involved in medicine, shouldn’t it be based on scientific evidence? And isn’t science applicable in all States equally? And if we have a national database of practitioners to keep track of bad doctors, why do we need separate state boards?
Well, this is doesn’t affect me enough to care beyond typing up this little rant. For the young docs out there trying to find jobs, maybe too many other things occupy your attention. But somebody needs to change this stupid system which hinders mobility of the physician workforce and drives up costs and barriers to providing medical care throughout the land.
Very appropriate , there is a new program coming up for reciprocity licensing called “Medical licensure compact program” with 16 states having joined it already. I am definitely signing up when it opens.
I agree that licensing is ridiculous. I practice Emergency and Telemedicine and cover a 5 state service area – plus I’m medical director of a flight program. Keeping up with my licenses is a ridiculous part time job – and each state is so particular, even going so far as to require specific CME from me, individual fingerprinting, etc, even for just Telemedicine.
I think I remember reading that in TX only a very small percentage of the money generated from licensing fees goes to administering the Texas Medical Board. Most of the money just gets added to the general funds pool with all state’s other revenue sources. So licensing is really just an extra tax on being a physician in that state.
I think you may be right. I head that our state just waived license fees as the fund was getting to large and they are afraid the state will sweep it into the general fund and we will lose it all.
And that’s the spelling you get when I’m writing between patients….
I liked your comment Marianne. I am also trying to convince my children about the concept of a financial wall. Would your family members build such a wall with the basic index funds as recommended here or is ongoing sweat equity still needed due to the low growth environment especially for young people just getting into investment when values are high.
Timing the market is a losing game but so is starting to invest at all time highs- it feels more like “playing to lose”.
Thank You
My husband always concentrated on properties & invested heavily even during the days of 18% interest.
He has dabbled in the Index ETF realm but the returns on Real Estate have been exceptional.
It’s interesting when we take our dog in for a checkup we spend 15 mins on the dog examination & 20 mins with our Vet discussing commercial investments he has recently made.
Many years ago a colleague of mine told me he made more from his car wash properties than he made from his practice.
I’ve heard many, many similar accounts. There is no doubt that many people have become wealthy by owning real estate and other small businesses.
Congrats……or sorry;)
Great article.
Would like to see you expand on #1, health insurance. My current gold plan ($800/month for family of 5) is going to cost $2000/month starting 2017.
Any advice for health insurance?
I’ve shopped individual insurance sites, government, and ehealthinsurance.com
Thanks
Why not just use a health insurance broker? If you’re a high income professional, you’re probably not getting a subsidy anyway.
Ours will also be almost $2K month/family. Dr Husband has always been afraid to go outside the group for health insurance (something about not being able to sign up again if needed?) I have no idea how it (using a health insurance broker) works, but all the insurance we pay combined, I’m sure, is devastating to working towards financial freedom.
My county has exactly ONE plan available – Anthem BCBS HMO – that’s it. Everyone else has pulled out. I can’t buy a different plan even if I wanted to. It’s going to be $1700 a month. In 2012 I paid $693/mo.
If I add a group plan then I would have to offer to all employees too and we can’t/don’t want to.
Seriously considering Christian Health Sharing except I can deduct the current premiums and contribute to HSA and my wife and kids are heavy health care users (we have gone above the max deductible every year for the last 5 years), so I’m uncomfortable switching.
^^ If you lost your job, you would be free to move somewhere else, where the health insurance environment was better.
Hi WCI
I have an expired NY license from 2012 – should I be worried? Anything I can do now to avoid a similar situation.
Dunno if it would do any good to call them up and ask them to change it from expired to surrendered. You could try.
Similar question….Although I never had an official license during training a “physician in Training” license….I never renewed it but do I need to call that state and get rid of it somehow?
Thanks,
I don’t think so. I didn’t surrender my AZ “PIT” license nor my regular AZ license when I left and nothing came of it. Not sure why this happened now other than some crazy bureaucratic rule somewhere.
List of things that take away my ability to provide for my family AND against which there is no insurance:
1. Prison (wrongfully or rightly accused)
2. Loosing my medical license
3. Revoked status in the CMS PECOS system
Anything else anyone can think of or has experienced?
Burn out
4. Sexual harassment claim
5. “Disruptive Physician Behavior” accusation (this to me is the scariest)
6. Mental health or substance abuse issue (limited coverage/insurance)
I guess you can file it all under #2.
Do pharma companies and the like require a license? Im sure you could find some work without a license albeit perhaps lower paying.
Being sued for sexual harassment or discrimination.
Oh wow. It is scary to think about how someone’s livelihood can hinge on someone else’s bureaucratic mistake. And this can lead to stress, fights, divorce, depression, etc. It really drives home the benefit of a backup plan (or 10).
I’m so glad it all worked out for you quickly. That deserves a planned week off for a celebration soon!
You essentially self insured against this government overreach and incompetence with your business income. With burn out rates as high as they are today and for those without a secondary business income, self-insuring with passive income outside of medicine is increasingly more important.
If savings and emergency fund were more of an issue, what do you think about a HELOC?
Two things about a HELOC that I don’t like as an emergency fund:
# 1 It isn’t totally under your control. The bank can get rid of it at any time and is probably most likely to do so at a time when your job (and maybe your investments too) is most in peril
# 2 A HELOC is borrowing. One major point of an emergency fund is to avoid borrowing to me. I mean, I guess having emergency credit is better than nothing, but it’s not quite the same as money in the bank.
Uh-Oh. I also have an expired Virginia license from my military time (never moonlighted, so only for military purposes). I let it lapse based on advice from my attendings during residency. Any advice for someone in nearly the exact situation as you for preventative steps?
I’d call the Virginia license folks and ask if I were you.
I already called the Virgina Medical Board this morning to inquire as I left Virginia a few years ago and also just let my license expire in April. The lady looked up my license told me not to worry about it as long as you expire in good standing with no actions pending nothing should happen. I mentioned WCI’s situation and she had no idea why this would have happened to him. She told me that I could reapply to have it reinstated and then immediately make it inactive, but they have no formal surrender process, and even she noted that would be a waste of money.
See also mentioned that she had already had 8 other phone calls from physicians with expired licenses asking the same question this morning. We are not a lone.
Glad to hear it may be a little more rare than I feared. Now I really feel singled out!
I have an expired Ohio license…better check on it, not that I take medicare or it matters where I work but certainly something to get crossed off the list of possible future problems. Didnt know you had to surrender expired licenses, as that seems redundant.
One thing I think you failed to mention is that most physicians are well educated and highly motivated individuals. Although you already have a job as WCI, I believe most would be able to find work of some sort. They may not be as well compensated for their work, but they would be able to do something else. I would probably go work restoration/construction. I did it in college and really liked the work. I wouldn’t get paid nearly as well, but it would be enjoyable and would help pay the bills. Plus it is completely different than the bureaucracy of medicine and working inside in an office all day.
The scary thing is there are many little bureaucratic things like this then can really screw up your livelihood. For example I live in a rural area, without a car there is no way I could get to work. If a beauracratic snafu cost me to lose my license even for a short period would it cost my job? Possibly. Yet another good reason to plan for tomorrow and shoot for financial independence even if your not going for early retirement.
I once had two traffic violations / 12 months. My state removes licenses at 3 per 12 months. I drove very carefully after that. Without a drivers license, I’m unemployable.
You could always live close to the hospital. I rode my bike to work this morning. It was 31 degrees, but my car is getting new brakes. No car, no big deal.
Which state is this, if you don’t mind me asking?
People will think I am crazy, but my emergency fund, in cash and equivalents, will cover my family for four years (!) at $10k/month…and that assumes my wife and I both simultaneously lose our jobs. People may opine that I am leaving a lot of potential growth on the table, but I am more worried about something crazy happening (like in the OP, hospital blowing up, losing contract, etc.) than I am about not having enough at age 87 1/2 or whatever.
I too have a couple of state licenses that I have left behind, perhaps with improper closure. Maybe I should up the emergency fund a little more. 😉
Question for WCI: Why couldn’t you use the “substantially equal payments” exception to avoid paying a penalty for early withdrawals from a tax-deferred plan? There’s the “risk” to getting a job again and not being able to contribute to said plan until the payments ran their course, but that risk is much better than a 10% penalty in my book.
I’d certainly do what I could to avoid the penalty in that sort of situation, and SEPP could be part of the solution. There are other exceptions as well.
I think a bigger risk to your license is getting reported to the board for substance abuse or other mental health problems. They have a duty to protect the public from impaired providers so once you’re reported, you could easily be out of work for months until you get evaluated and cleared to return to work (or have recommended treatment). It drives home how important it is to keep a balance.
I was appalled and very angry at first and still unhappy that the state could do this with so little notice. Loosing your talents for a year would hurt society and perhaps dull your talent. How about practice for cash only as an alternative?
As an emergency doc? Not really a viable option outside of maybe a free-standing ED.
“You can’t even buy insurance for crap like this.” — You can’t buy an actual policy, but financial independence can be all the insurance you need. Also, side income and the other backup plans you mention act as a form of insurance.
I’m sorry to hear about the swift resolution. You could have had a really nice time with that freedom, even if it were only a day of mountain biking. The year in NZ or AUS would be even better, and that’s exactly what I’m planning to do in about 20 short months.
I was never keen on early retirement until I realized I had enough to easily afford it. Faced with the real possibility of living exactly the way I want, the workdays seem less enjoyable. I was expecting the opposite effect — appreciating the workday more because I’m not reliant on the pay, but instead I find the negative aspects more magnified. I don’t need to put up with the nonsense… there’s still enough gratifying experience to keep me around for a couple years, but if I got a cease and desist practicing letter tomorrow, it wouldn’t break my heart.
That reminds me; I used to have 10 state licenses. I believe I let the licensing states know I would be surrendering or going inactive, and was generally told to simply ignore the renewal reminder. For better or worse, I could find myself in your shoes at any time. I’ll keep my fingers crossed. 🙂
Best,
-PoF
PoF,
Are you thinking of changes plans and calling it quits sooner?
Have you considered just doing some locums for a few years so that you can go part time?
My tentative plan is to be done with the full-time job when I become fully vested in my 401(k) employer contributions in the summer of 2018, and take a locums position with my family in New Zealand or Australia, with a strong preference for a position without call. We’ll enroll our boys in school there and see what life is like on the other side of the world!
After that, we’ll see where things stand. More locums is always an option.
Best,
-PoF
Wow! Thought this would be just a gimmicky title.
Virginia is the worst. Besides Virginia being terrible, I have to say, the most bewildering aspect of this post is that you would cancel Netflix. 😉 I mean, really, to save like $9.00 a month? I would get rid of internet altogether before I dumped netflix.
Glad things worked out for you in the end!
We take FIXED expenses very seriously, no matter how small. But yea, if I was out of work, I’d probably cancel Netflix. I barely use it anyway. And yea, we’d toss the Cable TV too, but not the internet. Not sure how we ever lived without that.
If you get rid of the cable, you’ll use Netflix quite a lot more 🙂 Networks come over-the-air in HD, so you get most sports except ESPN. Netflix and an Amazon Prime account which you might already have anyway + antenna and I never feel like I’m missing out.
Just don’t add too many streaming services. Some folks dump cable but have four or five other subscriptions which add up to the same price as cable.
Has there been a post on cord-cutting? Saving another $2k, $3k a year adds up, even for physicians 😉
Buy a $90 ROKU and an indoor antenna. If you have amazon prime you already have access to their streaming service. I got rid of cable and switched to roku years ago.
If you have a smart TV you already have the icons in place.
When I called ATT to cancel cable the rep asked what I was going to do for TV I just said ROKU. She did not say a word. That was over 5 years ago.
An antenna gets you the major network stations.
Subscribe to netflix and you are all set.
In all honesty, I don’t think I would mind a 1-3 month lay off. I have a lapsed license from another state as well. Keeping my fingers crossed also.
WCI, you made me think about our living expenses. We have a 6 month emergency fund which can easily go for 1 year if we stopped travel and cut eating out completely. Also have a home remodel fund that would be good for another 1-2 years depending on how may expenses we want to cut. Plus our taxes would be lower for the year ad therefor would receive a refund supplying a few more months. Basically we can live comfortably for 1.5-3 years without earning a single penny, selling our index funds, or collecting dividends. I like that. Thanks for making me think about it.
Suggest you would definitely hire the most-experienced attorney in these practice areas (get a referral) – and get an expedited “hearing” from your Dept of Heath and/or Medicare division. You can’t simply sit and wait on these bread-and-butter — more so, if your high-income depends on it!
Sure you may be doing this already – in addition to public shaming this process/dept 🙂
Now – any lawyer or Black-coat-Investor in the house !? 🙂
Black coat investor, took me a minute, but love it!
I noticed you referenced Baylor (assume Texas medical center) – are you doing some sort of open seminar or inspirational class for the medical community?
Baylor University Medical Center in Dallas on the 8th and 9th (parted ways with Baylor College of Medicine in Houston since the 40s)
I wish I could invite anyone, but I think this event is just for those who are there. They pay the bills and buy the food so they get to set the rules.
That’s a shocker. I have allowed three different state licenses to expire over the years, but have never encountered a problem. I then obtained licenses in two of those three states at later dates (none in Virginia) without incident.
The Virginia Medical Board representative told Tex, M.D. (above) that this should not have happened to Dr Dahle. It would be very helpful to know what caused the problem (in order to avoid it).
Not to minimize how much I appreciate this article, but do you seriously have your Christmas shopping almost completed?!?!
Honestly, thank you though for another great post.
I take zero credit for that, but I wouldn’t be surprised to learn “we’re” half done at least.