“You can get past the dead end. You can break through the ceiling. I did and so have countless others.”

Telemedicine from Nicaragua!

Greetings to all my nurse practitioner sisters and brothers from Nicaragua! I have been flip flopping between Costa Rica and Nicaragua this week and wanted to give everyone an update to fuel your motivation 😊

It is beautiful down here. The sun is shining, it is 88 degrees, monkeys are in the trees, and I have an amazing view of the Pacific Ocean. What better office to do some telemedicine visits and write an article out of? I have high speed internet and full cell service too! Who said you can’t work digitally at the beach and in the rain forest in Central America!? It is awesome and thanks to modern day technology, it can be a reality for ANYONE reading this!

Integrating telemedicine into your life is a game changer for any nurse practitioner that wants more freedom in their life. 10 years ago this would have been almost impossible to do, but secondary to COVID and the radical change in healthcare delivery, it can be a total reality for the nurse practitioner that is willing to put in the work into building their own practice and ensuring telemedicine is a compononent of it. It truly is the MODERN practice and one of the most freeing things you can do to increase your freedom.

Outside of that, from a business perspective, the best part of this trip is that I can deduct a large portion of it because I am doing some CME and also throwing a little business into the mix. Tax-free trips! This is one thing I wanted to touch on in terms of the benefits of being a nurse practitioner entrepreneur: the tax incentives!

Having a small business is the last tax haven left in the United States. There is no other way to lower your taxes in any considerable way. NONE! Being a business owner not only accelerates your financial position and freedom, but it also lowers your legal tax obligations. Please tell me how you could write off trips, airline tickets, your vehicle, utilities, equipment, laundry, and much more without having a business? You can’t! The wealthy have known this for years and it is a reason why every wealthy person (and politicians, what a coincidence right?) owns businesses and real estate.

Listen, I am able to write off this trip because I included CME activities into it, I am seeing patients via telemedicine, I am writing and answering emails for The Elite Nurse Practitioner, and also looking for a piece of real estate so I can have a short-term rental down here. Some of you are like “I am on vacation; I don’t want to do any of that!” and that is fine! But you know what? Just spending a few hours doing a little work results in THOUSANDS of dollars in deductions. So in my opinion, I think it is worthwhile if your goal is to accelerate your financial goals. It is not like I am not having any fun. Trust me, I am having plenty! I hiked up an active volcano over the weekend and did some surfing this morning before I saw telemedicine patients. I just structured the vacation in a way to reap in the benefits!

It was great overlooking the pacific and seeing some men’s health patients via telemedicine for a few hours. The weather was beautiful, my spirits were up, and I had a great internet signal, so it was work as usual. I typically see patients for a couple hours while I am on vacation, so I do not get too behind. Remember, a business should continue to operate even if the owner is away, which means sometimes you need to put a little work into it unless you totally outsource work to other nurse practitioners, medical assistants, etc.. You have two options in terms of vacation and operating a business:

  1. Continue doing some work to keep operations running so you don’t get super behind when you get back.
  2. Outsource work to others so you don’t have to work at all (even though chances are high you will have to do a little bit as a business owner).

I am pulling from both options. I have multiple nurse practitioners that work at my men’s health practice, so they have been seeing all the new patients this week. I also have 4 medical assistants who run the day-to-day operations. But I also have my own patient census that needs follow up, therefore I needed to spend a few hours this week while on vacation keeping up. If I had not, then chances are high that when I got back, I would need to work extra to catch up. Personally, I don’t like the thought of homework and extra work!

So, how was I able to write off the majority of this vacation? Multiple strategies (as discussed in the tax lowering course):

  1. Include CME activity. If you are spending 4 hours a day on CME, then the entire day of expenses can be written off. If you sandwich the CME on a Friday and Monday, the entire weekend is deductible even if no CME activities were done! This is called TAX planning folks, and is critical in accelerating your financial position.
  2. Include a small amount of business. I still must handle administrative tasks and some patient care while I am away. Therefore, if a certain amount of time one day is allocated to that, then the entire days expenses are deductible (we are including meals here as well).
  3. Actively look for real estate. I happen to be exploring the local beaches and rain forests while I am looking for a piece of rental real estate. Therefore, I can deduct those days because I am looking for business opportunities that happen to be in paradise. A win-win! Oh, and you don’t need to be successful in your efforts just FYI.

With just a little advanced planning, I can write off a significant amount of my trip. This is completely legal, but you need to understand the rules! Those that understand the rules can play the game, those who don’t know the rules can’t! Remember that as you venture down your nurse practitioner entrepreneurial journey!

If I can design a life this way, so can you. I know many nurse practitioners that work in similar fashions. I even know one who moved to Puerto Rico full time, and he operates a telemedicine men’s health clinic back in the states which also allows him to only pay 4% income taxes!

This is the beautiful part about owning a business: you can structure it anyway that you would like that delivers financial security and freedom into your life. It is much easier than you think as long as you are willing to take a SMALL risk, provide an in-demand niche service, keep your expenses low, and stay persistent. The recipe for nurse practitioner success is rather simple! Working for others and being a wage slave is harder in my opinion! Anyways, this week’s article is going to be short. I need to hop off here and get ready for bed as we are waking up early to do some offshore fishing. Wish me luck and I want to wish every one of my nurse practitioner sisters and brothers luck as they start up their own businesses or continue to grow their current one. Stay persistent and FOCUSED. If you do those 2 things, you WILL succeed!

14 Responses

  1. Just wanted to say you are truly an inspiration to our profession and I applaud your success!!

    1. Thank you for the warm comment Roseann 🙂 I am just trying to motivate other NPs to venture out on their own and get started!

  2. This is where I was engaged. So nice there, Enjoy! Thanks for all of your help to us Nurse Practitioners!

  3. JUSTIN!!!!! Thank you SO MUCH for that TAX course..OMG. EVERYBODY would benefit from it. You would be surprised how many of my MD friends know about these “jewels” and just “forgot to mention it”. I am going to the FL Keys on business thanks to your tax tips.

    1. You are welcome! Happy to hear that you enjoyed the course and are actually implimenting the steps and advice in it! Wealthy people have known about these tricks for years, so I thought I would share them with my NP colleauges!

  4. You should do a conference in person for Nurse Practitioner owners and cover all your secretes to success!

    1. Heather,

      We have it planned. It is just finding the time to actually make a conference happen at this point. Keep an eye out for the announcement at some point in the next 6 months!

  5. Great article! What are your current thoughts on starting a 100% online men’s health business? Is this space too crowded?

    1. Mike,

      I think they can work great as long as you identify a niche target market. The online space is VERY big, so you need to find your niche market. This well help you in your marketing efforts. Just targeting men between the ages of 30-55 will not work. You need to be VERY specific. Read this:

      Marketing Tip Monday #4: Your Practices Target Market

      I also discuss this and how to start the practice in the men’s health courses!

  6. I just spent a week in Ireland and Scotland. During that time, I answered the questions that I could on my text app: Spruce. Could that type of activity make it a tax deduction?

    1. I don’t think so because the intent of your travel was NOT for business. The intent for my travel WAS for business. There is a big difference.

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