Strategies to Increase Income

It’s no secret that money is important. It’s not everything, but it sure plays a major role in most aspects of life. I shamelessly admit choosing to become a CRNA was as much about the money factor as it was social impact.

Money is not the root of all evil. Just like guns and knives are not the root of all violence. Immoral, malicious, evil souls are at the root of all evil. Don’t lump money into that pool.

It’s okay to admit financial compensation plays a role in decision making. Says the guy who just admitted to such a statement. As a factor in all aspects of life, it’s only reasonable to consider compensation when choosing a job or career. Prioritization determines the importance of compensation. Nevertheless, let’s discuss strategies to boost your income.

Social Media Advice

A cliché motif of financial pages on social media is the investment into yourself. Invest in education. College. Invest in training. Vocational or specialized work. Invest in skills. Think self-improvement or negotiation.

As CRNAs or other highly educated healthcare professionals, this investment has been made. Years of school plus hundreds of thousands of dollars. Done. Or nearly done. You are now your greatest asset and wealth building tool.

Job

Your career is anesthesia, but your job is the day-to-day. Hopefully you mindfully considered job-search criteria to select something appealing. Folks often consider distance from family, geographic location, work setting, work schedules, and compensation to name a few.

Even a CRNA job weak in compensation still pays well compared to the average worker in the United States. The advice to deliver pizzas or drive rideshare after work isn’t appealing when you make $150-$250+ per hour at your day job.

Sure, a weekend bartending gig may put a couple hundred bucks in your pocket at the end of the night, but so could two hours of overtime at the hospital. Your day-job is likely close to home and at a facility you are familiar with. Take it. If you are looking for extra dollars, milk that anesthesia cow.

Do your research

When applying for jobs, ask the weekly commitment. Is overtime available? Can I pickup shifts? Can I take other peoples’ beeper time (and pay)?

Want to fill a large bucket with milk?

Take it a step farther and consider locum work. I have a 3 on, 1 off position allowing for 13 weeks of time off. This allows for upto 13 weeks of locum work annually. The trick with this is to find somewhere looking for one week per month coverage. Or whatever your scheduled time away allows.

Locums is the route I’m taking. I cleared all of this in my primary job contract before signing. I have a 40 mile noncompete, but live by nothing…nobody…no hospitals. There is nothing within 40 miles, so it’s a formality I can accept.

There are not any facilities within driving range looking for one week per month coverage, which is a bummer. The remote area working against me here. Locum pay at the semi-local trauma centers is not great. Probably below market for locum dollars.

Reminiscing

I remember my first week at a new clinical site. Get lost despite following the clinical coordinator like a freshly hatched ducking. Don’t know anyone, so awkwardly ask random people for directions. Can’t find the cafeteria…LOL, can’t believe I used to get a lunch.

Everything is organized just a bit differently than what I was used to. It felt slow and clunky. And the learning curve with surgeons, procedures, and workflow. Good times.

My Locum Criteria

Because I really enjoy the critical access setting, I will ideally locum at a similar venue. I went through a recruiter, and they found a place meeting my criteria. They offered 5-7 days per month, whatever I wanted. Downside is the flight to and from, so I burn a day at both ends. Not efficient.

Good news is that the pay is solid. 1099 on top of my current W2. I’ll take it. The LLC setup is easier than it sounds. The recruiter offered call the entire time I am there. Lots of callback time. Trying to make up for the travel days. I’m away from home so I might as well be working.

Hopefully something within driving range will open up within the next year or so, but due to my current remote area, the options are minimal. Locums…great option for those looking for additional income.

OB

Polarizing. Love or hate, absolutely no middle ground here. I inquired about a few 24-hour OB locum gigs. Great for efficiency. It helps if your day job involves OB, C-sections, and epidurals. Usually not the best true hourly rate. Depending on how busy they are, it may be a good way to make $2,000-$3,000 and still have lots of time off. Maybe it’s a Saturday thing. Not a bad financial boost.

The Business Route

I’m not talking LLC for your locum work. Think clinic life. Lots of options becoming mainstream. Pain clinics. Ketamine infusions. IV therapy. Aesthetics. This is the “nearly done with education” reference from earlier.

Most CRNAs operating pain clinics have additional training. This gives them knowledge, credibility, and confidence. Often times the hospital provides a room, staff, and imaging for pain injections. This is sometimes the same hospital-provided setup with ketamine infusions.

Work with local hospitals or seek out your own space. The options are numerous, but the markets may be tough. It takes a bit of funding to open these practices. Something to consider, nevertheless.

Depending on the state, requirements are different for each of these clinics. There are blueprints out there, but this post isn’t the time for specifics. Best case scenario, you know someone currently operating one of the aforementioned practices close by.

Free advertising if you want to sell yourself in the comments section to those seeking advice. Someone may buy you lunch just to pick your brain. Some clinics have narrow margins, and they carry much higher risk (and potential higher reward) than working as a staff or locum CRNA.

I have not personally started any of these practices. During my SRNA clinical rotations, I spoke extensively about pain clinics at two of the critical access hospitals. We discussed workflow optimization, patient referrals, reimbursement, pain assessment, and the skills necessary to become proficient at performing the injections. Deeply knowledgeable crews. You know who you are MN and IA.

Staffing Contracts

Another form of business where you agree to fulfill anesthesia needs for a facility. Again, lots of variables, lots of risk, and a potential to leverage your time and money. This may be a volume gig meaning you make a percentage off each contract, so acquiring multiple contracts is the way to see that income grow. This approach can certainly become a full-time job as there are multiple CRNAs who have done just that.

I’m not qualified to speak any farther on the matter. Again, resources are available. Knowing the right people helps tremendously.

Academia

Another way to remain relevant in anesthesia without having to wear ill-fitting scrubs, consider training the next generation of CRNAs. In the classroom giving back to the profession. The transition to doctoral programs makes teaching difficult for some veteran CRNAs, but there are accelerated programs providing the necessary credentialing.

Become an Investor

Investing is a powerful wealth building avenue. Most CRNAs are, at a minimum, stock and bond investors through their retirement plans. One can additionally invest via a number of other accounts including a personal brokerage, solo401(k), IRAs, HSA, ect…

Investments can be setup multiple ways. My current investments all “reinvest” any dividends and interest. The money stays in the pot. I don’t “see” this income since it stays in my accounts, but growth shows up on my monthly net worth spreadsheet.

Folks living off their portfolio may choose to receive dividends as quarterly payments to cover the cost of living. Maybe you want the dividends and interest to flow into a money market account so you can invest them in something else. There are plenty of assets to invest including stocks, bonds, index funds, mutual funds, ETFs, certificates of depression, cryptocurrency, derivatives, and commodities.

Real Estate

A fan favorite. A very oversimplified investment strategy described online. I’m probably overanalyzing this investment, but I’m not in it to lose money. Conservative numbers from me. And I’ve had terrible fortune contacting reliable realtors in this small town.

Turnkey – Renter ready. Simply purchase and rent out. Maybe turn your current place into a rental when you move.

BRRRR – Buy, Rehab, Rent, Refinance, Repeat. The goal is to have a rental with no money left in it. Sounds good, but it’s basically a second job.

Fixer upper – Need capital and time. Can flip or rent. Similar to BRRRR strategy.

Multifamily – Rapid scaling, but you play by commercial rules. Requires significant capital and an accurate estimate of costs and gross income.

Real Estate Investment Group – A third party that does the leg work in exchange for your capital.

The long and the short is real estate money is made off the buy. If you had money in 2008 when prices went through the floor, you would have made out like a bandit.

Sometimes people buy houses and take the loss for the first few years hoping that increasing rental rates plus a fixed mortgage lead to positive net returns in the coming years. I’m not into losing money the first few years.

I have run the numbers on many rental properties figuring in vacancy, maintenance, cap ex, and management fees. It’s tough to find a place that cashflows from the start. The BRRRR method has the best prospects for rentals in my area. It then requires capital and time to fix the place up. That’s a second job.

Yes, there are huge tax havens with real estate. Yes, there may be money in flipping a property. Lots of people make solid money off real estate over a lifetime. All of this considered I generate more income giving anesthesia. Average house flip taking weeks to months and nets $20,000. A week of anesthesia might gross $20,000.

Venture Capital

This is playing in the startup world. Maybe you provide private equity to a multimillion-dollar tech startup or a local hotdog stand. Either way you are getting in on the ground floor. Huge upside. Huge downside.

You will likely have equity and possibly decision-making capabilities depending on the investment. Significant variability between opportunities. Be sure to do your homework before diving into this end of the pool. This may be an exciting endeavor that doesn’t feel like a second job.

Back to the Basics

And ya know what…if delivering pizzas, driving rideshare, or bartending is something you have always wanted to do, nothing is stopping you. I’d go as far as encourage it. One gal that helped a friend find a dress was an attorney by day, wedding dress consultant by weekend. Good for her. Heck, I progressed into leatherworking and blogging. Haven’t made a dime doing either, but it’s kind of fun. You do you.