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Lightening Round

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Grand Illumination Night is a uniquely Martha's Vineyard holiday. A group of a couple hundred small Victorian cottages called The Campground (different than the campground we live at) all hang lanterns on their houses and illuminate them at the same time. We've done some homecare in these houses too - neat, weird little places.

Grand Illumination Night is a uniquely Martha’s Vineyard holiday. A group of a couple hundred small Victorian cottages called The Campground (different than the campground we live at) all hang lanterns on their houses and illuminate them at the same time. We’ve done some homecare in these houses too – neat, weird little places.

I’m going to do now what I do every time I get crunched for time and realized I haven’t posted in over a month, whip off a quick stream-of-thought blog about what’s been happening in my life recently out on the open road. Life right now is in a camper in Martha’s Vineyard, so it makes for pretty easy writing, but it will be a brief one. Don’t expect great grammar, don’t even expect good spellign.

Life has been fast paced and it’s been tough to keep up with the website. There’s been a lot of you reaching out on the discussion boards who are just getting into travel, and we have some good discussions going – so keep it up! I have a couple of half-written blogs for you, but they are posts that require a little more thought, so expect those in a couple weeks. The main thing keeping me busy has been this dang 1/2 Iron Distance Triathlon that I have been training for since I arrived here on the island 4 months ago. It is going to be held right here on the island in just a week and a half, so the end of this crazy, time-consuming training is near. I’m really looking forward to it. The 70.3 miles will cover the entire island and some beautiful vistas, but the training has been ridiculous, so I won’t be doing another one anytime soon.

Living in a camper has been great. I was kept very busy when we first moved in. There were a lot of little repairs that needed to be done. Water heater work, re-sealing some seams, and installing a screen room were the major low-lights of the work. After a few weeks of maintenance and finding out what it’s like to be a homeowner, we settled in and evenings after work have been filled with dinner on the deck and typically a campfire. There’s a lot of things I like about living in a camper, including being minimalist in my consumption of space and energy. The main attraction to the 5 months of camping is being outdoors. I have spent many, many hours on the deck and by the fire. There will a be a couple blogs soon related specifically to living in a camper, so I will digress for now.

Kate working wicked hard on the Vineyard. As I try to claim I've been too busy to write a blog....

Kate working wicked hard on the Vineyard. As I try to claim I’ve been too busy to write a blog….

Being on an island has lent itself to a lot of beach time. Sunday is the big beach day around here. We’ve been captured by friends who throw us in the back of their truck where we drive out onto the beach and create a wagon-circle-type caravan – except instead of keeping women and children in the middle of the circle for protection, there is various grilled meats. Not a bad use of the weekend, every weekend.

Kate and I are both working for a home care company out here. The expected productivity is reasonable, and, being on an island, the driving distances aren’t too bad either. Regardless, it has been BUSY at work. With the seasonal bump of tourists and residents work has been in high-season mode for the last 2 months – Martha’s Vineyard goes from a year-round population of 15,000 to an estimated 170,000 people on island last week! There are signs of the work load letting up a little bit soon. It truly has been a great job.

Just another Sunday on the beach. Great fun carting friends, games, and meats out to the beach for an afternoon of relaxation.

Just another Sunday on the beach. Great fun carting friends, games, and meats out to the beach for an afternoon of relaxation.

The weather has been just absolutely awesome here. We have had about 3 rainy days in the last 2 months – good news for us camper dwellers, and us beach goers. Despite the dry summer, the island life lends itself to insane humidity and with humidity, mildew. Not to wish the summer away, but I’m about ready for some cooler weather so I can stop washing the walls. The campground has really quieted down this week along with the rest of the island. Last night was hoody-weather, but I know we have another month left of solid summer as exhibited by the return of 80 degrees and muggy this evening (peepers peeping like crazy in the trees, love it!). With the change of the seasons, the campground will close and we’ll have to move into an apartment for one month before returning to the mountains of Colorado for the winter.

Expect some more thoughtful and thought provoking posts soon. Among my topics will be new grads traveling, how to select where you want to go as a traveling therapist, and, of course, #CamperLife.

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Locum Motion

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This website is about being a traveling therapist, right? Then, why so often, do I get myself off-topic blogging and twittering about issues in PT and healthcare? Answer: Because I like it. Only once in a long while do the stars of the interweb align so that I can write about travel therapy and healthcare issues at the same time.

We call ourselves travelers. Traveling therapists, traveling nurses, travel PT or OT assistants – we are all “travelers”. But not MD’s, they, call themselves locum tenens, or just locum for short. Locum!? What the heck does that mean? locum tenens; locum – place, tenens – to hold; all together now, “Place holder”. Turns out locum tenens is actually a Medicare term that applies to someone temporarily filling in for another provider. When someone qualifies to work as a locum, they are able to skip a lengthy credentialing process to be able to bill Medicare patients. The list of providers that are currently eligible for locum status during temporary employment include Physicians, Dentists, Certified Registered Nurse Anesthetists (CRNAs), Nurse Practitioners (NPs) and Physician Assistants (PAs).

There is a Medicare bill currently working its way through congress that would extend locum tenens status to Physical Therapists in certain situations. Currently, in PT private practices, if a temporary therapist is brought in, it can take 3 months to be able to bill to Medicare under their own NPI. Most private practices doing their billing above board and truly the “right” way avoid travelers for this reason. I’m not sure what happens when a private practice hires a therapist through an agency – what I believe happens, is that the private practice bills under one therapist’s NPI. The practice of billing for an entire practice under one NPI, as far as I am aware, is frowned upon, but not illegal. I have done a couple independent contracts with private practices who have made me become in-network at their facility with Medicare, it’s a long process (2-3 months), mostly paperwork, and discourages a lot of employers from getting involved with short-term staff. This bill could change the whole arrangement.

bill

Forget how this whole bill to law thing works? Click above and return to being as smart as you were in middle school.

This new Medicare/locum tenens bill, titled the Prevent Interruptions in Physical Therapy Act (House bill: H.R. 556 and Senate bill: S. 313) would create some exceptions for certain PT private practices. The bill, if passed, would decrease interruptions in patient care that may occur through a PT’s temporary absence due to illness, pregnancy, vacation, or for continuing ed by allowing practices to hire PTs on a locum tenens basis. That would cut out the whole Medicare credentialing process that currently takes place when hiring a temporary PT. While this bill is certainly patient-centric, I do see a secondary opportunity here for travelers. If there’s a current process that inhibits some clinics from taking on travelers (Medicare credentialing), and that process is eased, there’s a lot of opportunity for an increase in the number of available travel assignments. As this bill stands in the Senate, locum tenens status would only be allowed in areas designated as non-Metropolitan Statistical Areas, or areas designated as Medically Underserved Areas (MUAs) and/or Health Professions Shortage Areas (HPSAs) – that’s a lot of private practice clinics that could soon hire temporary employees with less fuss when billing through Medicare. Ideally, the bill would be amended to include ALL areas in the country, not just those of special designation – that would be pretty sick. (it’s a Medical pun, get it?) Be sure to let your Senators know that ALL Medicare beneficiaries deserve uninterrupted access to PT, not just those in underserved areas.

All traveling PTs, everyone in private practice, and all recruiters should be pretty psyched about this bill and should definitely be contacting their Congress Men and Women today. Jump over to APTA’s website to get more information on the bill. From there, you can link straight on over to contact your Senators and Representatives. Get on it now!

SLPs and OTs, don’t worry, I haven’t forgotten about you. If the legislative bug gets you revved up, you have good resources to contact the people who represent you in congress. For OTs: http://capwiz.com/aota/home/ and for SLPs: http://takeaction.asha.org/

I do get fired up about issues, and this one is more special to travelers than most issues are. It was too good not to write about, but I realize healthcare politics can get a little dry. I promise more excitement in my next post!

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Camping and Working

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The world of outdoor showers is something I have never been privy to. But here, on Martha’s Vineyard, outdoor showers are a very serious thing. I have been out on home visits with multiple patients 90+ in age who refuse to shower indoors, because, of course, it’s summer and you use the outdoor shower during the summer. Everybody has an outdoor shower here. We’ve been living at the campground for about a month now. Our camper’s water heater has been on the fritz (more on that later), so most showers have been over at the main campground building – quite nice, actually. Good water pressure, hot water, what’s not to like. But, the row of six outdoors shower stalls has been taunting me across the parking lot with the “closed” sign hanging prominently in front. This weekend, that closed sign changed and I took my first outdoor shower on Martha’s Vineyard. I’m a long way from being considered a local here, but an outdoor shower is a good start.

Typical midweek campfire at or site. Loving it.

Typical midweek campfire at or site. Loving it.

I’m currently sitting out by my campfire in the “seasonals” portion of the campground. There’s 180 sites at this place (huge!), that will apparently fill up in the next couple weeks once everyone is out of school and summer really hits. But, we’re insulated from that madness, surrounded by people who have reserved their spot for the whole summer. It turns out that a lot of these people have homes on “the mainland” and go there frequently. Ed and Nancy on one side of us – Ed is mostly here, Nancy is mostly here on weekends – I’ve made up a back story, based on no evidence, where Nancy is a school teacher – she spent the full week here this week, so maybe her school year ended, and my gut instinct about her being a teacher may actually be right. Mike and Kathy are on the other side – they have New York plates and are mostly here on the weekends. I wonder if they’ll stay for longer periods of time once the summer gets going strong – maybe they are teachers too. They usually roll in after dark on a Thursday or Friday. When they showed up this past Thursday night, Kate and I were sitting by the fire, I shouted over the shrubs, “Welcome back!” Mike replied, “You’re cheating by staying here all the time!” It was funny… but I realize it might not read all that funny, so you’ll just have to trust me. Funny stuff.

Pipe wrench in the water heater on the leaky pressure relief valve. If you don't reconnect that tube at the bottom left tightly when you're done, it throws fireballs up the side of your camper.

Pipe wrench in the water heater on the leaky pressure relief valve. If you don’t reconnect that tube at the bottom left tightly when you’re done, it throws fireballs up the side of your camper.

Anyways, aside from a handful of on going projects, camper life is becoming normal. I’m enjoying the simplicity of living at a campground, and, otherwise, there’s not much to living in a camper – it’s just regular life, condensed. My greatest victory so far is fixing the leak in the water heater this week. A series of projects on the water heater led up to the changing of a valve that was spewing hot water onto the ground outside the camper. I may have almost burnt down the entire place (no, seriously), but the water heater now makes great, piping hot water – 6 gallons at a time. I might start taking more showers here at the camper, but it’s tough to resist the allure of the outdoors showers just down the road.

On the work front, we are back in the grind of home care. It’s been a good assignment so far. The schedule is nice and flexible, so it’s been great to get some mid-afternoon exercise before fully finishing paperwork in the evening. And, to top it off, weather has been great, so what more could you ask for than driving around an island for work during the day and hanging out at a campground every night?

Pretty sweet so far, more updates coming soon. This was just a quick one to keep you up to date on what’s happening with us! Hope your summer is going well and, where ever you are, you have some exciting plans for the 4th!

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Camper Life

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The cold has finally broken me. I just went out to the trunk of the car, where our ski gear is stowed, opened up the bag, and grabbed my wool cap. Back inside the camper that we have been living in for almost three weeks, the oven door is open after dinner to help get whatever residual heat we can from it while the propane heater kicks on and off. When I thought of living in a camper on an island for a summer assignment, I tricked myself into thinking it was already summer in New England – just a couple more weeks and maybe it will be.

It feels like I’ve been waiting forever to write anything of substance about the camper we’re living in. I guess, in reality, we’ve only been living in this camper for less than three weeks. I’d like to wait a few more weeks to write anything so that I have some firm conclusions on what life in a camper is really like, but it’s going to be a long process of adjustment. There’s another 5 months ahead to share all the other things that come up, so why wait… this is the first installation of a series of posts on camper life that I will be putting out this summer and into the fall.

Kate and I have lived in close quarters before. On my very first travel assignment, before we were married, I had a studio in Boston that is still the smallest place I have ever seen – at less than 6 feet in width, you could not lay down on the floor cross-ways without bending your knees. The length of the room wasn’t much longer. Just a twin bed, a shelf, and a very, very small attached bathroom. Later, we would live together in far Northern Maine on a travel assignment in a small one-room cabin. I think this was the first time we became aware of “tiny-living” through some blogs like tinyhousetalk.com. The tiny living movement has really caught since then and shows about tiny living appear nightly on HGTV, DIY Network, and the like – or so I’ve heard, since we’re living without TV.

The cabin we rented in Presque Isle, Maine. Fun fact, "presque isle" means "near an island." Presque Isle, Maine is land-locked and near no islands.

The small cabin we rented in Presque Isle, Maine. Fun fact, “presque isle” means “near an island.” Presque Isle, Maine is land-locked and near no islands.

Let’s address the no TV thing. I love it, I just absolutely love not having a TV. Last summer in Hawaii was the first time we went without TV, or at least without cable. The only thing I truly missed was sports. Last summer/fall we would go out for football games or sometimes miss them if the Pats weren’t being televised. For now, since we’re in New England, we’re able to catch our precious Red Sox on the radio nightly, and if we’re out some where, it’s always on TV. Last summer, without TV, completely ruined us for our return to Colorado during winter where we rent an apartment pre-supplied with cable. At first, TV was hard to watch. Having to tolerate multiple minutes of advertisements between brief segments of the actual show was infuriating, but, with passing weeks, the time the TV was on during the day began to grow and my tolerance for ads returned. I don’t think I ever fully got back to my pre-Hawaii TV routine, which I’m proud of, but I did continue to watch far more than I needed to. I’m really glad to be back to no TV. I’m getting more done in my life, relaxing with a book more often, and the radio is usually all that’s needed for a little entertainment, although the Sox need to pick up some slack if that’s going to continue to be the preferred programming. Occasionally, once or twice a week, we’ll treat ourselves to a movie or show on Netflix – a sensible amount of mindless TV.

That assignment in Hawaii last summer plays another interesting role in getting us into the camper this year. The Hawaiian Island of Moloka’i, where we were without the TV, was a very rural and uncomplicated place with a very straight forward life. After work, there was little that “needed” to be done. Life was simplified to working, getting some exercise, and relaxing. Relaxing usually came in the forms of going to the beach, reading a book, or watching the sun sink into the Pacific ocean from a lounge chair on the driveway. I think last summer was the first time I came to truly appreciate a more simplified life, with less going on, and more relaxation – this is the first thing I most appreciate about living in a camper at a campground. We frequently have camp fires and once the day’s work is done, nights can be pretty lazy, or least I expect them to become more lazy once we have settled in and have finished more of the projects that need to be done around the camper.

For now, I’m going to leave the camper talk at that. I realize I really haven’t said much about how living in a camper is going so far, but that will develop over the next couple weeks. As far a life in a camper to this point? I’m having flashbacks to episodes of Tiny House Nation and people talking about consolidating their belongings, coming up with inventive storage solutions, becoming more conscious of their water and electric usage, and having to be more organized on a regular basis to prevent living in total squalor. That’s all you get for now, but I’ll post more soon.

Today, I’ll leave you with the first video I have ever done for this site – a tour of our camper. Enjoy!

 

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A Working Vacation

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Now is as good a time as any to mention that I really don’t know what you people want me to write about. I try to mix it up but there are 400 or so of you out there every month, silently reading my blogs. So, if there’s a broad type of post you’d like me to write about, here’s your chance to let me know. In the meantime I’ll continue with my completely random stream-of-thought ramblings about travel therapy tips, my personal experiences, and more PT-politics issues than I should rant about on a site that is supposedly dedicated to travel therapy.

The view out the front window at the hut. Pure relaxation and solitude.

The view out the front window at the hut. Pure relaxation and solitude.

This time around, we have a simple travel blog. Hopefully it’s a fun catch up of what I’ve been up to for the last few weeks in the prolonged move from Colorado to Martha’s Vineyard (an island off of Cape Cod).

Kate and I wrapped up work back on April 25th and immediately hiked into the woods for a couple nights in a hut in the snowy Aspen back country. The hike was meant to be 6 miles in, but we inadvertently took the scenic route and turned it into a 10 mile hike – it was well worth it for a couple days and nights of really deep relaxation in solitude without another human around for miles. Upon our return home to our hospital-owned apartment, we busted our butts to get packed for the remaining 2.5 weeks off of work.

We eventually got packed, stowed our winter gear in our usual storage area, and hit the open road. With a final destination of Martha’s Vineyard in Massachusetts, we promptly headed 6 hours West. Kate was taking the second half of her Dry Needling training in Salt Lake City, which seems like a very intense weekend of learning. Learning the skills of dry needling sounds wonderful, but 3 full days of being needled by other beginners sounds awful. Anyways, Kate worked really hard all weekend, and I just played – some hiking, brewery hopping with a good SLC-based friend, watched some horses and boxing on TV, and I found a small traveler’s gem called “The Heavy Metal Shop,” seems pretty self-explanatory. All good things must come to an end, and we needed to start heading East.

Great view of the city during my hikes in SLC while Kate was working hard at her course.

Great view of the city during my hikes in SLC while Kate was working hard at her course.

We hammered the 45 hour drive to the east coast, made it in 4 days including one very long all-day, all-night drive from Indiana to Maine.  At 3:30 in the morning, we stopped outside of Boston to disconnect and drop off a trailer at Uhaul. The world is a weird place between 3 and 4 AM, I think it’s the way the end of some peoples’ day collides with the start of others’ day. Eventually at 7 AM on Wednesday, we rolled into Maine where we would spend time with family, and occasionally zip down to Boston to have some time with friends. 11 days to go before starting work – sounds relaxing, right? No. Wait… Hell no! We had the task ahead of buying a camper to live in for the summer.

Light houses are definitely a prominent tourist attraction here on Martha's Vineyard. So, being tourist, we got right out there the first weekend looking at these things. "Yup, there's another light house."

Light houses are definitely a prominent tourist attraction here on Martha’s Vineyard. So, being tourist, we got right out there the first weekend looking at these things. “Yup, there’s another light house.”

Several days later, we bought a camper in Southern Maine and towed it with our Toyota Highlander, which we have named “MacLeod” (there can only be one Highlander) – MacLeod barely handled it. Transmission fluid heat warning lights and a general struggle up hills were the pertinent symptoms – I set a speed limit of 60 mph for the rest of the time towing the camper and emptied the full sewage tank to lose some weight, no more warning lights. Who new they were throwing in 40 gallons of free sewage with the camper!?

We got the camper back up North and had a few days to visit with family but mostly worked like heck to get the camper ready for move-in. Washing, vacuuming, scrubbing, and caulking would fill the majority of the week before hooking the camper back up to MacLeod and getting down to Martha’s Vineyard. On Friday, we took the short ferry ride from Cape Cod to Tha Vineyahd and have spent the rest of the time setting up camp and moving in. I’ve been dying to share more about the camper, but I’ll save it for a (preview-of-coming-attractions) blog devoted completely to the camper life. Spoiler alert, space is tight in a 21 ft camper.

Here's the ferry we brought the camper over on. We saw it out offshore headed to the cape, in the background.

Here’s the ferry we brought the camper over on. We saw it out offshore headed to the cape, in the background.

So, here I am, hooked up to the wireless internet signal that comes from a box strapped to a wooden post out back of the camper. Inside, I am surrounded by more belongings than should exist in a camper this size. We’ll be living on this camp site for the next 6 months, so I suppose the abundance of supplies is warranted, but we have some organizing to do.  It’s a chilly night, so the propane heater is kicking on and off. Work started two days ago, and so far, the most challenging thing about living in a camper is getting work clothes out and getting them unwrinkled. At 3:30 AM this morning I was walking around the campground trying to find out where a smoke alarm was going off, the detector was outside an unoccupied cabin and fog was setting it off – weird time of day. If wrinkled clothes and a stray smoke detector are my worst problems with living in a camper, I’ll easily take that trade off for a summer full of nights by the campfire.

That’s all for now. You’ve got some blogs about home care and camper living coming up, so if you want me to write something different, you better let me know!

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Your First Travel Gig

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first traveling PT assignmentAfter being a traveling PT for 8 years, I sometimes forget that what now seems like a pretty routine process was very intimidating and complicated at first. This post describes what you can expect in the process of getting your first traveling therapy job. I have another page that you can link to under the “Getting Started” tab. There’s some similar information there, but with a slightly different focus. Here I have tried to focus on the details of your interaction with your recruiters and the order of how this should all happen to get your first job in traveling therapy. Here we go!

Get a License

Do this first. Start working on a license for the state you want to go to as soon as you decide you want to travel. You can start this process after you start looking for jobs if you are still trying to figure out if you want to be a traveler (trust me, you do). But, if you wait too long, waiting on a license can delay the start of a job or prevent you from getting a particular job all together.

Contact a Couple Recruiters

This section was the impetus for this whole blog. I have heard more and more from people that their recruiters are telling them, “If I’m not your only recruiter, then I can’t give you my full effort.” If a recruiter ever says something like this to you, my suggestion is to hang-up and never talk to that recruiter ever again. Of course the recruiter wants you to work solely with them! It takes any competition or reason to hustle for you out of the picture. A good recruiter will understand that you are working with some other recruiters and will work harder to be the one to get you the assignment you want. Recruiters usually work on commission and get their pay from getting you a job. YOU, the therapist, are the commodity, without YOU, nobody gets paid. Seriously, if a recruiter says you have to work with them exclusively, they are playing you – ditch ’em!

Here are the reasons for working with multiple recruiters: First and foremost, talking with a few different recruiters should give you an idea of the going pay rate in a particular area which can vary wildly place-to-place. While different recruiters will have many of the same jobs available, there will be some jobs that are different between companies. Some companies have exclusive contracts with certain hospital systems – it all gets very complicated when you get into the details of how temporary jobs are posted and who they are posted with, but the bottom line is that having multiple recruiters working for you increases the number of potential jobs available to you. Also, when you do get ready to accept a job, having several irons in the fire will give you more leverage in negotiating better pay.

Get Submitted

When you are “submitted” for a travel assignment, it means that you have heard of a job from a recruiter, and you want your resume to be put in the applicant pool for the job. Some jobs will have dozens of applicants, while for others, you might be the only applicant. The number of applicants for an assignment has very little to do with the job itself and likely has more to do with the location of the job and how the facility chooses to post their available position with agencies.

Once submitted for a job, you cannot be submitted for the same job by a different agency – this is where having more than just a couple agencies working for you can trip you up. Early in our traveling, my wife, Kate, and I had 6 different companies we were working with, it got complicated. We had multiple agencies submitting us to the same jobs and arguing with the facility that that each had submitted us first. It was embarrassing – don’t let it happen to you.

Different agencies will vary in how they handle the process of submitting you. Some agencies will want all your information right away, I prefer not to give them my info (references, resume, etc.) until they have found me a job to be submitted for. So, if you can, delay giving a company all your details until it’s time to be submitted – but, some companies just won’t have it and want your info before they do anything for you. Some recruiters may ask if they can submit you for jobs without contacting you first – basically, they find a job that meets your criteria of location and setting, and they will submit you without hopping on the phone to notify you first. If you are working with just one recruiter that you trust, this is fine. Also, if you are searching in an area where there are many people looking, like Hawaii, and want to be one of the first people to apply, then this can be a good strategy. But other than those two situations, I have a hard time justifying giving my recruiter a “green light” to submit me for whatever, whenever. By having the recruiter check in with you, you are keeping control of what jobs you are applying to and where your resume is being pumped out to.

Interview

If a facility you have been submitted to is interested in you, your recruiter will arrange a phone interview for you with the facility. Simply remember that this is your chance to interview the facility as much as it is their chance to interview you. Ask questions, but come into the interview knowing some stuff about the place you are interviewing with. Usually, at the end of the interview, you and the interviewer will report back to the recruiter separately to let them know how the interview went.

The Job Offer

If the interview has gone well, you will receive a job offer. If your recruiter does this verbally, ask that it be sent by email also so that you have it in writing and can crunch some numbers. Swiftly move along to the next step.

Negotiate!

Therapists. We are really bad at this step. But, if the pay seems low compared to what you’ve been hearing through other recruiters, or if there is a benefit that you want that isn’t included in your package, ASK! It never hurts to ask. Don’t underestimate your ability to name a price and see if it can be matched. Remember, YOU are the commodity!

Accept

Don’t get so wrapped up in your negotiating and getting every little bit out of your contract that another therapist signs their contract first and takes the job. Sure, negotiate, but do it swiftly.

 

That’s probably more details than you really need, so I’ll stop here. I’ll again refer you to the “Getting Started” page that is somewhat redundant to this post, but offers some other details including a link to what benefits you should expect or ask for. Happy job searching, I’ll say something here that I don’t say nearly often enough: I love being a traveling PT. If you have the itch to get out there on the open road, you should do it now, because life is a funny thing, and you don’t know how long this opportunity to travel will last. Happy travels!

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Preview of Coming Attractions

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Matha's Vineyahd

The Cape and Islands

So much to talk about. There is a lot going on in our world right now. The normal hecticness of finishing up the assignment and end of ski season parties has been compounded by actually knowing where we are going in May. Usually at this time of year, as the winter season wraps up in Colorado, we’re discussing where we would like to go for the spring and just starting to get some leads from our recruiters. But, this year, we locked down our May to November assignment in March, a true luxury. Normally, 2-4 weeks ahead of an assignment is good lead time to get everything set for the next assignment, but we have been graced with a full 2 months to get ready for our summer doing home care on Martha’s Vineyard. There seems to be a lot of confusion about exactly what and where Martha’s Vineyard is.

I grew up nearby around the Boston area, so I do know that Martha’s Vineyard is an island off the coast of Cape Cod – Nantucket’s next door neighbor. There once was a man from Nantucket…. um, nevermind. Anyways, Martha’s Vineyard is an island, there is no actual vineyard that I am aware of. I’ve only ever been there for one day as a kid – I seem to remember it being a fall day with pretty lousy weather – Kate has never been there. An unknown adventure awaits!

Housing is coming together pretty well for us despite running into a few challenges along the way. We originally were looking into houseboats for the summer, but there’s a lot of logistical challenges to how long you can stay in one harbor, what to do when a storm comes, and whether you are actually allowed to live on your boat at all in certain places. Basically, if you plan on working a 5-day-per-week job on land, it gets really challenging logistically to live on a boat. So, we shifted our focus to finding an apartment. At first glance on Craigslist, apartments looked very reasonable for rent – unfortunately, all the rent rates I was seeing were weekly rates. It quickly became clear that finding a reasonable place to live without having half a dozen other roommates was going to be a real challenge.

Dear Champ, Hey there Champ, Kate and I need to talk to you about something. We had some great times out there on the road - some of our more memorable times in all our years of traveling. But, well, it's time for us to move on and get another camper - something newer, something sleeker, something a little more "liveable." I know you'll understand, we'll think of you often. - James

Hey there Champ, Kate and I need to talk to you about something. We had some great times with you out there on the open road – some of our more memorable times in all our years of traveling. But, well, it’s time for us to move on and get another camper – something newer, something sleeker, something a little more “liveable.” I know you’ll understand, we’ll think of you often. – James

Kate and I have long dreamed about living in a camper since riding around in our old RV “Champ” every weekend during our assignment several years back in Anchorage, AK. It turns out that Martha’s Vineyard has one campground and we have locked down a campsite for the summer. The only problem is, we don’t own a camper yet. Our main logistical problems will be 1. Finding a camper small enough for our SUV to tow, but big enough to live in for 6 months. 2. Reserving a spot on the ferry to the island not knowing the exact size of our camper yet. 3. Figuring out how to watch as many Red Sox games as possible without cable!

I’m really looking forward to the adventure of living in a camper this summer. At some point we’ll have to make a decision whether to sell the camper at the end of the summer or keep the adventure going. I guess whether we keep or sell the camper depends on how much we like it. In the meantime, the end-of-season parties are wrapping up here in Colorado. Work parties, ski mountain parties, and just party parties will keep us busy over the next 3 weeks before starting the road trip back “home” to New England. The first leg of the trip going back East will be to head West for a dry needling course in Salt Lake City! After that, I hope to grab a couple baseball games in random stadiums along to route and couch-surf with a few old friends from the road.

Stay tuned! Lots of adventure and fun ahead!

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Licensure Tips

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hobo licensure tipsI find myself coming back to the topic of licensure a couple times every year. Licensure is the great challenge and barrier to a much more free travel life. If licensure was centralized in one place, we could go where ever we wanted, when ever we wanted. Nurses have co-ops between states that allow transfer of licenses across state lines in particular states, but PTs are at the mercy of each individual state’s licensure office to grant access into the state in a timely manner. There are plans in the works to improve reciprocity between states, but it will be several years before we see any of these changes.

Yesterday, I was speaking with some other travelers who are just wrapping up their first travel assignments and looking to move onto other states, but struggling with licensure. I realized I have taken for granted the jaded nature with which I view getting new licenses that has developed from years of being repeatedly disappointed by state licensure offices. Here’s my advice, from my acquired jadedness, that should help your transition to your next state go much more smoothly.

Start Early

Getting a license in another state is going to take longer than you think. Get started as early as you can. The more state licenses you already have, the longer you should plan for. For instance, Illinois takes 6 weeks to process anything, so if you applying to another state and have an Illinois license, you’ll need to get a verification from Illinois and this will add 6 weeks to whatever estimate you have for the time it will take to get the new license.

Snail Mail Verifications

Most states require you to have each state you have ever held a license in to send a verification by mail (yeah, real mail). Additionally, many states require you to send a written letter to them to get a verification. Does it make sense in 2015 to have to send a letter by mail to a state office to get them to send a letter to another state by mail? Absolutely not, but get over it, it is exactly what you have to do. Fortunately, there are a small number of states that are now accepting online verification – they will let you go online, print out that page that shows you have a license in good standing, and fax it into them. But, unless you have spoken to someone in the state’s office that says they will accept online verifications, do not count on getting away with this. The majority of states still require the pony express to get involved.

Follow Up!

When you request verifications from states, follow up by phone to see if the verification was ever sent. I have had checks cashed for verification by states that never actually sent the verification. 2 weeks after I send out my verification requests, I will typically call the state I am applying to to see which verifications they have received and which they have not. I will then call the states that they have not received the verifications from yet. This can be very time consuming, but it prevents me from waiting around weeks for verifications to arrive that will never be sent.

California

Build in at least 6 months to get a license from California. I’m not sure what you’ve heard, or exactly what the state of California is telling candidates for licensure, but it takes 6 months to get a California license. There is a finger printing process, there is a juris prudence exam, and there is no lack of bureaucracy. If you need to be in California in 3 months, you are too late, Just build in 6 months for California – add six weeks if you already hold an Illinois license. 😉

 Don’t Fret

The licensure process is there to protect the public from the worst of the worst, but the system is far more cumbersome than it needs to be. Don’t get all flustered by all the changes that need to be made to the system. Just know that with some patience and a little bit of paperwork, you will eventually get that state license you are chasing. The more level headed and methodical you can remain through the whole process, the less stressed you will be.

These are just a few simple tips on licensure. There are a few states that stand out from the pack that are better than others to get licensed in, but do know that your typical state licensure office is understaffed and will take weeks to do anything. I picture a cyclone of papers swirling around every licensing professional. If you want more info on licensure, click in the search box at the top of this page and type “tag:licensure”. Good luck!

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At Least It Wasn’t In Boston

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Hang with me. I’m amped, I motivated, I’m psyched, I’m downright manic – and I only have a short time before this feeling fades to make as much progress as I can, including pumping this blog out to you.

Actually the weather when we left Denver, but Indy was very similar upon our arrival. The weather bothered a lot of people, me too actually, but at least I was used to and prepared for it.

Actually the weather when we left Denver, but Indy was very similar upon our arrival. The weather bothered a lot of people, me too actually, but at least I was used to and prepared for it.

I just got back from CSM (APTA’s Combined Section Meeting) and I have the same feeling I always do after one of these conferences – I need to make an impact, and I need to do it now. For those of you who may not be familiar with CSM, it is a 4 day conference held annually that brings together over 10,000 PTs, PTAs, and students for some high level education. Well, education is the pre-text, I find myself more drawn to the social… excuse me, “networking” events. The reunions with old classmates, professors, colleagues, and friends are totally priceless. These people, automatically by being at the conference, are also all jacked up about PT and what we need to be doing to make it even better. So, while I indulge heavily in the social “networking opportunities,” I look forward to the conversations all year: Conversations about the research friends are engaged in, different practices in different clinics around the country, and what every individual therapist is doing to improve PT and all of healthcare in their communities and nationally. Don’t get me wrong, I found the actual, formal programming fascinating too and have several clinical-pearls to bring back to the clinic an implement immediately, but I just love getting together with everyone.

Lots of education, meetings, and receptions at CSM. Luckily many of the meetings come with ample networking and a cash bar.

Lots of education, meetings, and receptions at CSM. Luckily many of the meetings come with ample networking and a cash bar.

CSM is an ultra-boost, one of the highest forms of motivation, but not everyone can or needs to go to CSM. BUT! Everyone should do something to get a similar charge. As travelers we can exist very isolated in our individual silos unless we make a concerted effort to expand our horizons and take in some new information. There’s a certain stereotype of the traveler out there that just simply doesn’t apply to the vast majority of travelers – let’s give this stereotype a name, how about “Clint” – definitely just a random name, yeah, random. Clint is a lazy slob. Clint hasn’t had a meaningful continuing ed experience in 4 years. Clint is at work to survive the day and definitely not to excel. The thing about Clint is, I’ve never met a traveler like him. Travelers are generally insanely fascinating people who have the motivation, gall, and cajones to drop convention and get out on the road. A seasoned traveler can be dropped into a clinic on Monday and be completely indiscernible from the permanent staff by Wednesday – a true chameleon. In PT these days, autonomous is a hot word. If there’s anything more autonomous than loaning your services out for 3 months at a time to the flavor-of-the-month employer, I haven’t seen it. A traveler is truly autonomous, highly resistant to the negative influences that colleagues, bosses, and referral sources can build over time. The hyper-autonomy of the traveler’s life, moving from place to place and determining your own path, can be isolating. We must seek out education and motivation if we don’t want to end up like Clint. There are tons of great options out there: Courses offered locally during contracts, courses offered at a distance on a road trip between assignments, state meetings of your professional association, and more long-term certificate and specialization courses. We must make sure we get out there and get supremely jazzed-up by interacting with other professionals and finding out what else is happening beyond our small sample of personal experiences. There’s nothing worse than seeing a new traveler show up to a job with all the confidence in the world that they know everything there is to know. A traveler will learn over several assignments that while there are great things about the way they have been taught to treat already, there is much, MUCH more to learn. Let me be clear, mastery of treatment and skills does not come from one clinic or one model of treatment, it comes from exposure to a great expanse of different treatments and styles over years (another advantage of travel).

Sunrise in the Indy airport after the last night of CSM. As you can see, the weather did get better, it was actually pretty nice by the end of the conference.

Sunrise in the Indy airport after the last night of CSM. As you can see, the weather did get better, it was actually pretty nice by the end of the conference.

So, go find your own CSM. Whatever gets you excited about your PT, OT, or SLP career, explore it in more detail, get exposed to all the different tangents that surround it. Put yourself in groups of other therapists and talk about what you do – more importantly, listen to what others do. I’m psyched, I’ve got video gait analysis techniques to implement, new post RTC repair techniques to use, emails to send to old friends to tell them how nice it was to see them, and emails to new friends to ask them to tell me more about their projects and passions. While out exploring the country, get invigorated, don’t get isolated in your own silo, don’t justify the stereotype of Clint.