Continuous Education

I recently gave up my Alaska license because I didn’t have enough CEUs to renew. For a long time, all the licenses I held didn’t require CEUs, so it hasn’t been on my radar. Alaska is the first license I have had that has requirements, but some of the states I’ve been licensed in for years are adopting new rules for continuing ed requirements. I am based in Colorado, the continuing education tracking will start there after the 2014 renewals. I’m somewhat personally to blame for this, I have long supported CEU requirements and have advocated for states to adopt these requirements. I’ve heard people openly criticize these requirements. They claim that all continuing ed requirements do is drive people out to order crappy CEU programs that have little substance. I think this argument itself is crappy and believe that most PTs who have to purchase continuing education to maintain their licenses are going to reach for something meaningful rather than be the bottom feeders of their profession and community. In my case, I have 3 years to meet my Alaska continuing ed requirements and can renew at any point during that time. I have already order and started a HIGH QUALITY home study course from APTA’s Ortho Section that I previously intended to get but have been procrastinating for almost a year now. So, to you naysayers of continuing ed requirements, here’s one PT that was forced into getting high quality education by the very requirements you dismiss. And to those who believe that your years of experience are a superior substitute for structured professional development, you are wrong. I may not have been practicing for 20-30 years, but I have been practicing long enough to see huge progressions in practice – the way we assess and treat low back pain, the way technology has drastically changed total joint replacements, the proliferation of dry needling and manipulation – the list goes on… Each year that goes by, I realize how much more there is to learn, if you don’t see this, you’ve already fallen behind. People have been criticizing con-ed repeatedly in public internet discussions (I’m looking at you PT Twitterverse) and finally I get to candidly respond: You don’t know what you don’t know, and by fighting continuing ed, you are making yourself sound self-righteous and crotchety. The majority of your peers will consistently choose high quality education over the path of least resistance. Stop talking down on continuing ed requirements, they are a good thing for our profession.

Whew, sorry about that. I guess that’s been building up inside for a while. I hope smoke is coming out your ears from reading that last paragraph (my hair actually burst into flames). OK! Back to the story!

On the beach? Best place in the world to read a journal or home study course for CEUs. Continuing ed has never been better.

On the beach? Best place in the world to read a journal or home study course for CEUs. Continuing ed has never been better.

It’s not that I haven’t been learning. I read JOSPT every month, I read other articles when I’m not sure of something in the clinic, I go to coworkers’ places to knowledge-mooch when they have ordered a webinar. Travel PTs are ALWAYS learning. Different clinics have different techniques, different patient populations, and all kinds of people to learn something from. As a traveler you may work at one hospital that has the latest and greatest in surgical techniques and then you’ll work in a private practice that runs a manual therapy fellowship. A traveler is surrounded by casual learning opportunities, but we are not surrounded by funding for formal instruction – that is our challenge, our weakness. Unless you travel with one company for more than a couple assignments, you are unlikely to see more than a couple hundred bucks for continuing ed courses. But, there are opportunities out there – great opportunities! Great courses! And many of them are convenient for the traveler.

I have written in the past (Traveling doesn’t have to mean professional sacrifice 4/11/2011) about the opportunities for travelers to take larger programs like residencies and certificate programs. These are a big commitment, but force you to stay on path of continued education. Many can be completed through a series of weekend courses offered all over the country, so you can access your next stage of learning where ever you go. As I eluded to earlier, dry needling is a technique that has gained popularity and has some very high-level and quality learning opportunities. It wasn’t on my list in 2011, but it should be now!

There are smaller things a traveler can do for continuing ed credits throughout the year. Many reputable journals have read-for-credit programs where you can hop online for tests to demonstrate your knowledge on their articles. Credits are small, but add up over a year or two. The Independent Study Course I recently ordered from the Ortho Section, Applications of Regenerative Medicine to Orthopaedic Physical Therapy, has me fascinated in the first portion of a 6-part home-learning program. It is very high quality and written by THE experts. I will take a test at the end and get 30 hours of continuing ed – 30 hours! I have a co-worker who is finishing up a Foot and Ankle course this way. It’s a great means for people on the go or far away from a big city to get high-quality learning.

There are ways to get continuing ed without a huge hassle and without resorting to lousy courses that blindly dole out CEU’s for entry-level knowledge. Plan ahead, learn your states’ requirements ahead of time, and you’ll be fine. I’m well on my way to being able to re-instate that Alaska license should an opportunity arise.

How Should I be Paid?

With any job, there are a number of different ways you can be paid. There’s straight-forward salary, hourly, or some sort of productivity-based pay. Of course, when considering pay for a typical job, there are things to consider besides just the money – health care, retirement, life insurance, employment-related discounts, and the list goes on. In traveling physical therapy, the list gets a little bit longer and more complicated. A traveling therapist has more say in how he or she would like to be paid and needs to determine how much he would like to weight his taxed versus untaxed wages. There are IRS limits on how much you can take tax free in each zip code, but I have been told that taking those upper limits with low taxed pay can be a red-flag for an audit. So, I typically take $20-$30 hourly (taxed) and get the rest of the pay as stipends/reimbursements. I know a lot of travelers think hourly should be near the normal hourly amount a perm PT makes with the reimbursements being in addition to normal pay, but that’s just not the way it works. A more adventurous travel assignment can have some perks that can make the math of take home pay a bit more complicated: a loaner car from a boss, employee housing, a coworker’s mother-in-law apartment, or other non-monetary compensations.
Productivity arrangements in healthcare can get iffy real fast, think anti-kickback laws. I am not a fan of pay-per-code or percentage of billing situations. These can quickly turn an honest therapist nasty. It’s just too tempting to bill an extra modality or therex that may not be necessary when you know your own bottom line is linked to it – I don’t like it one bit. I’ve seen a number of positions, particularly for therapists in management, where bonuses (boni?) are paid for meeting certain productivity thresholds – number of patient visits or units billed. I occasionally see pay-per-visit systems go awry with a therapist seeing many patients at once, episodes of care dragging on, care extenders over-reaching their scopes of practice, patients getting less attention, and therapists getting burnt out. But, I can’t speak too harshly about pay-per-visit, since it is how I’m getting paid right now. Luckily I’m in a practice where all treatments are provided by PTs 1-on-1 for an hour. With the focus of 1-on-1 patient care, I find the arrangement ethically acceptable, but it’s definitely got its pros and cons. I’m well paid for my hour with a patient, but there is nothing worse than an initial evaluation that no-shows and leaves me unpaid with nothing to do for a full hour. I would encourage anyone considering a pay-per-visit position to first strongly scrutinize the care patients are receiving, and secondly, to ask for a little more money than you normally would, because the chances of batting 1.000 for attendance in any given week are slim.

Advance Healthcare Network

From Advance – Click to access their full report

New travelers are always asking me what they should get paid – I don’t know. Pay varies so much regionally and even town to town. It can be real tough to know if you’re making all you can of if a recruiter is taking you to the cleaner’s. Just find a recruiter you trust and get as much as you can out of each contract. I may try to establish a database where travelers can anonymously input how much they got paid on assignment. It would likely be a small sample size, but may provide all of us some information about what other traveling PTs are getting paid in each state. As I mull over that idea, here’s a nice piece that Advance puts out each year based on their survey results of PT pay. I just stumbled across the APTA Workforce Data page, not as sexy or user friendly as the Advance survey, but lots of good info in there if you click around (APTA Members only).

Some advice for the new traveler: Remember that your recruiter is working on commission and doesn’t get paid if you don’t get hired- it is in their best interest to get you on board even if it lowers their own bottom line. You are a temporary worker for a facility that needs help immediately, you are willing to pick up your life and move to that job to fill a position they desperately need filled – this has big value to it. With all these things working in your favor for higher pay, the costs of travel, furnished apartments, and miscellaneous other will likely cancel out a big chunk of the extra moolah. But, traveling PT can be an exceptional lifestyle that is worth so much in personal experience and growth – so get what you can financially out of a contract, but more importantly, just get out and see some more of this world.

In other news, a series of conversations this week have lead me to believe that the travel PT market is rebounding from a couple of more difficult years, I’m finishing up my SCUBA certification with four dives off the coast of the Big Island this weekend, and (in a crazy out of this world experience that only traveling PT could provide) a hospital has bought Kate and I plane tickets to fly out to interview for a possible once-in-a-lifetime travel assignment this fall – we shall see and more on this later.

Keep living the dream 13 weeks at a time!

Wiki Wiki

The increasing infrequency of my posts is a clear sign that my work hours panned out. Just a wiki wiki (quick) update on the travel and jobs in Kona.

A wave crashes near our campsite in Laupahoehoe last weekend. Real dramatic ocean on this part of the island. There was a tragic tsunami here not too many years back - interesting history everywhere you look.

A wave crashes near our campsite in Laupahoehoe last weekend. Real dramatic ocean on this part of the island. There was a tragic tsunami here not too many years back – interesting history everywhere you look.

The hospital gig, which was a wishy-washy thing from the get-go did not work out. I had tried to get something going at the hospital through one of my go-to recruiters. When he wasn’t able to come to an agreement, my recruiter gave me his blessing to try to establish a contract with the hospital on my own. So I tried. I spoke with the rehab director and later on the contract manager (the fact that they have a full-time position dedicated to manage contracts should have been a dead giveaway to steer clear). They were very encouraging that something would work out for me to be at the hospital. As they requested, I sent them a written proposal of what I would expect in my contract – 2 weeks went by and they requested I establish a contract through one of the recruiters I had used previously. The situation started to feel a little icky since my original recruiter had found the job, and working with another recruiter on the same job can start to cross travel PT ethical borders quickly.  Hesitantly, I went along with it. As everyone who has been doing travel health care for any period of time knows, credentialing for a job can take up a fair amount of time. So, I got underway on getting my paperwork and vaccinations all set for the staffing agency; I did the tedious skills checks online, I requested old varicella titre reports from my alma mater, I took a drug test at one facility, and I went and got my TB test up to date at another facility – all to find out just a couple days later that the contract wasn’t happening. Bummah. At least I got a free TB test out of it…. silver lining? Whatever, ainokea (“I no care”).

Waipio Valley - "Valley of the Kings" - We hiked here after camping in Laupahoehoe. King Kamehameha the Great was raised here and many Hawaiian royalty have had homes here.

Waipio Valley – “Valley of the Kings” – We hiked here after camping in Laupahoehoe. King Kamehameha the Great was raised here and many Hawaiian royalty have had homes here.

BUT, I got lucky, again, and landed on my feet. Everything is coming up James! The private practice prn job now has me booked 40 hours/wk and would gladly book me 50 hours if I let them. That job is doing just fine. And the kicker is that some of the staff at the clinic also work for a local coffee shop up the street, so I have found my Kona Coffee hook-up!

I have to get going, time to get to work. Upcoming island excitement includes a state holiday tomorrow, Kamehameha Day, celebrating King Kamehameha “the great” who united the Hawaiian islands which has previously each been under separate rule. He united the islands primarily through war and execution, and he also ended human sacrifice in the Hawaiian Islands right around the year 1800… different stories for a different day.

We will start SCUBA training this weekend, so that should lend itself to some good stories and pictures.

Aloha!

A Little Ketchup

One of the many beautiful sunsets this fall from our apartment looking back on Boston.

One of the many beautiful sunsets this fall from our apartment looking back on Boston.

Another travel assignment has flown by and I again have written far less frequently than I intended. I have a short list of meaningful topics I’ve been wanting to get to, but today you’ll have to settle for just an update on the travel life.

It’s been a great autumn in the Boston area. Kate and I got a killer apartment on the coast just north of the city and have made up for a lot of lost time with old friends. Lots of fun, a few shenanigans, nice cold evening sunsets, and being here for another World Series championship have made it a great fall! It’s raining right now, but its probably one of less than 7 days it has rained during our 3 months here. It’s been a fantastic fall… but, man, am I ready to get out of here and head to Colorful Colorado!

Highland Bowl

Highland Bowl, one more reason to get out and get acclimated… that bowl ain’t gonna hike itself!

This will be our 6th year working seasonal positions out in Colorado. I have worked for the same hospital out there for 5 years now – I am so excited to get to the mountains, see good friends and co-workers, start up the low-stress life of a professionally employed ski bum, and most importantly,get to laying down some powder turns. After a delay in finding a job for the fall, this contract is running a little later in the year than I’d like it to, and some weeks of the ski season are slipping by. I’m also losing out on some precious time for altitude acclimation that makes a huge difference for some mountain races later this winter – and just trying to keep up with the other locals around town – and not being out of breath sitting at my desk at work.

 

Accord

The ol’ Accord road tripping in all its glory.

I think part of my extreme anxiousness to get out there lies in a newly fine-tuned proficiency for getting ready to move. I have no bags packed, but I feel like I have been preparing to move for 3 weeks now. Just a few drawers of clothes to shove in bags and we’ll be packed up. To add to the ease of moving this time around, we have upgraded to an SUV. I sold my old Honda Accord that I had put 120,000 great miles on (plus 70,000 miles from its original owner). It drove some of the great roads in North America – made the trip up the Alcan Highway to Alaska, drove East through Canada to Prince Edward Island, and touched the Southern and Northern tips of Rt 1. But, for two people routinely moving cross-country multiple times each year, I can’t believe it took us this long to get a bigger car. I sold the Accord this weekend on Craigslist and I am driving a rental for my last week working in home care – 4 more days on this contract – head down, nose to the grindstone. Short-Timer Syndrome be damned!

I, of course, will be updating on the Facebook and Twitter (@hobohealth) pages all along the road trip, but this trip will be less of a meander out west than some of our previous trips. We will get to catch up with some friends in Chicago along the way, but otherwise this trip is going to be a straight-shot westward in just a couple long days of driving. Expect updates soon and travel safe! -James

Get a Haircut and Get a Real Job! (Part 2 of 2)

This is part 2 of a 2 part blog on the job market and job finding in traveling physical therapy. Find part 1 here.

————–

For the last seven years, I have been working as a travel PT. What a job! Every few months, I tell my recruiter where I want to go, what practice setting I would like to work in, and a few weeks later I have a job that fits my criteria.  …Or at least that’s how it worked until the past 6 months.

Key West, "Home of the Sunset." Also, by car, it is about half way between Colorado and Maine.

Key West, “Home of the Sunset.” Also, by car, it is about half way between Colorado and Maine.

My wife and I have been trying to find jobs in Southern Maine. We took our first shot at Southern Maine for the first half of the summer, but struck out. We were searching during a drive back to New England from Colorado, via Key West… a side-trip I recommend on any roadtrip. After we left Florida and were heading north through Connecticut, two possible job locations started to come together. Two jobs in Northern Maine and two jobs back in a sweet mountain town in Colorado. While turning around to head straight back to Colorado sounded like the most convoluted roadtrip ever taken, the chance to spend the summer playing in the mountains was pretty enticing. In the end, the Colorado jobs had one major flaw, Kate and I would be working opposite schedules and likely only have one day off together each week. What’s the point of travel PT if you don’t have the days off to enjoy your “home” town. To be honest, we weren’t psyched about heading to Northern Maine, but we recognized that it was the smart job to take – There were two jobs, they started on the day we hoped to start working, the location was relatively close to where we really wanted to be, and we were totally striking out on Southern Maine.

A couple blogs back, I wrote about our time in Northern Maine. The assignment turned out great. Goods jobs, good people, good times, but just a really, really far drive from everything. We had a few things working against us in looking for a job at the beginning of the summer. 1. We needed two jobs, not just one; 2. We only had active licenses in three states: Alaska, Maine, and Colorado; 3. We, as always, were pretty picky about our jobs. 

There were a couple things we could have done differently to address our above weaknesses: 1. Nothing can really be done about us needing two jobs instead of one, it’s the only downside about traveling with a companion. 2. We could have kept more licenses active to expand the potential search area. We previously had Massachusetts licenses, but had let them lapse. If we had applied for New Hampshire licenses, we could have lived in Southern Maine and commuted across the border to New Hampshire; 3. We could have been more flexible about what jobs we would work. We turned down SNF jobs based on setting alone, if we were more willing to work in a greater variety of settings, we would have found work more easily.

By mid-July, we were back on the job search, hoping to start-up down in Southern Maine the Monday following our Friday wind-down up North. Got it?

Northern Maine sure is beautiful, it's just really far from everywhere.

Northern Maine sure is beautiful, it’s just really far from everywhere.

After a few weeks of searching for jobs, it wasn’t looking good, again. Friday came and went, we moved out of our rustic one room cabin in Northern Maine and headed down to our condo in Old Orchard Beach (OOB). We had hoped to spend the next several months living in the condo in OOB, but after 4-5 months of keeping an eye towards the Southern Maine travel PT market, it seemed like a job, nevermind two jobs, was going to be really hard to come by. It was time to pull out the stops. Along with our recruiters searching for jobs for us, we were conducting our own search for clinics that might not be willing to work with a staffing agency but that would entertain hiring an independent contractor. I’ve written in the past about finding independent contracts, but it wasn’t meant to be this time. A couple phone conversations with office managers and clinic owners yielded nothing. It seemed that just as a job would start to look promising, someone who was willing to sign on permanently would swoop in and take the position.

I try to stick with 2-3 companies that I trust to find me the assignments I want. But, in a situation like I was finding in Southern Maine, it was time to start calling around to the agencies further down the list. “Phishing” was something I rediscovered through calling recruiters further down my list. Phishing is when you see a posting online for a job, but when you call the company advertising the job, the job doesn’t exist. They say something like, “Oh, someone just took that job. Let me see what else I have in that area for you.” Bottom line, the job doesn’t exist, it never did exist, and they’ll post the same imaginary job online next week. They just want to get information on you and see if the can talk you into taking a different job. It’s dishonest and dirty.

Luckily, one lesson had been learned from the search through Southern Maine several months earlier. We might need to expand the search beyond Maine’s borders if jobs continued to be elusive. We had considered New Hampshire licenses, but New Hampshire has a longer process for licensure, and it didn’t seem like having our NH licenses would make all that many more jobs available to us anyways. We each had an expired Massachusetts license and a number of friends living around the Boston area. We had started the process of re-activating our Massachusetts licenses, but had several states to get verifications from before the licenses would be ready. While we waited for the licenses to come through, we shifted gears to focus on Boston instead of Maine. Quickly, we had some options popping up. On Kate’s first phone interview in Boston, difficulties continued. The interview started backwards. Kate was to call the facility, rather than the facility calling her – the way it usually works. After several minutes of trying to make the receptionist understand that she was calling in for a scheduled interview, Kate was asked to call back later. So, she did call back a few minutes later. This time, she was connected to the person she was scheduled to interview with, except he connected her to a supervisor who told her that they were not interested in hiring a traveler at this time. By far the strangest interview either of us has ever not had.

Within the following week, two jobs had been offered in the Boston area, but as always happens, opportunities in Maine were popping up at the same time. In the end, a decision had to be made and 1 bird in your hand is worth 2 birds that are not in your hand (or something like that), so we accepted the Boston jobs. It left us with a couple weeks off, but it was far better to know the job searching was done. So a couple weeks were spent doing a lot of work around our apartment, doing a lot of couch-surfing at friends’ places, and sneaking in some beach time. One last speed bump and work would start on Monday…

Thursday before we started work, a scare – Our Massachusetts PT licenses would not be ready until Tuesday and our new boss was threatening to cut off the assignment if the licenses weren’t in hand when we were scheduled to start work. A series of frantic phone messages to the MA licensing board, an email, and maybe even a fax somehow produced our licenses on time.

Our view of Boston from our new abode. I'll be enjoying this view daily over the next 12 weeks.... guess we're down to 9 weeks already.

Our view of Boston from our new abode. I’ll be enjoying this view daily over the next 12 weeks…. guess we’re down to 9 weeks already.

…and that’s how we ended up working for the next 12 weeks in Boston. Our housing is another story for another day that also ends well, but the couch-surfing, or more accurately, futon-surfing, continued into the first week of work.

This post has dragged on much longer than I like, so it pains me to keep writing, but I believe this topic of the current job market is a very important one, and there are points to be made. I would like to discuss some highlights from the above story about how my wife and I finally got two jobs nearby where we wanted to be in what , locally, was a very difficult market. 1. We recognized a tough market locally and expanded our search methods through looking independently and using additional recruiters; 2. We were able to improve our possible job options by getting an additional state license and expanding our search area; 3. Even though the jobs we got didn’t start right away, we accepted them because we were willing to be flexible.

This whole post is about being flexible and opening yourself up to more opportunities. Carry extra state licenses, look with a couple recruiting companies, consider varied practice settings, and be willing to be patient for a couple weeks. Traveling physical therapy is a job that has a lot of upsides to it. We may be in a small dip in our employment options, but the market will recover quickly and there are currently numerous opportunities out there for anyone willing to be a little flexible. I hope that you can take some of these strategies, apply them to your own situation, and continue living the dream as a traveling PT.

I personally plan on reinstating more of my expired licenses to expand the possible jobs options. There’s a good job out there in a great location, open up your possibilities and allow yourself to find it.

 

Get a Haircut and Get a Real Job! (Part 1 of 2)

I have had one heck of an experience finding a job this last time around. I wanted to share the experience, but felt that there was some hard fact searching and job market research that needed to happen before we got into the more entertaining stuff. So this post is really all about prepping for my next blog (to be posted next week).

———-
A semi-pertinent music video:

———–

A lot of the trouble I had finding a job this time around mostly had to do with very local/isolated trends, but I know friends in other areas having difficulty getting assignments too. I have begun to wonder if finding a job in travel PT is as simple and lucrative as it was several years ago. I’m not going to make you wait until the end of this post for my conclusion – the outlook is bright and sunshiny with increasing job numbers, increasing wages, and an overall prediction of continuing to live-the-dream! Onward we go with the discussion of why it’s not that bad and why it will soon be so good…

When I was looking at colleges as a high school junior back in 1998/1999, I remember the sage advice of my biology, genetics, and home room teacher Mrs. Sheffield, “Don’t go into physical therapy, there’s no jobs! You should go into computers.” Thanks for that. Wasn’t she supposed to be encouraging my young, vulnerable mind to head towards the sciences!?

The late 90s was a particularly bad time to be going into healthcare. The Balanced Budget Act had recently been passed , and everybody was in a panic cutting staff and freezing hiring in the medical sector. Somewhere in my search for college programs and a potential career, I (or more likely my parents) came across a chart showing trends in employment in PT. Historically, there was a cycle where employment would increase for 6-7 years and then dip downward for 6-7 years. Looking at this chart in the late 90s, I concluded that 1999 and 2000 should be the bottom of the market and that by the time I graduated in 2006, employment in PT should be back near the top! So, I proudly defied Mrs. Sheffield a pursued an education in the jobless field of physical therapy.

I don’t know why employment in PT follows this cycle, and I have tried relentlessly to find another chart that shows what I saw in 1999, but I haven’t been able to find a chart that graphs PT employment over decades. What I do know is that when I graduated from PT school in 2006 the market was great, classmates were turning down jobs that didn’t pay enough, and Mrs. Sheffield was dead wrong. Now, here we are 7 years later, and while I remain gainfully and happily employed, I am finding it harder to get the travel assignments I want than it was just a couple years ago.

I propose that we are maintaining this 6-7 year cycle and we now are at the bottom of that cycle. With the implementation of healthcare reform, similarly like following the Balanced Budget Act in the late 90s, we are in a period where hospitals are tightening their belts because of uncertainty. Soon, the full reform will be rolled out, employers will adjust to the changes in the payment system, and our job market will triumphantly march upward for another 6-7 years. Here’s the kicker! If this really is the bottom of the market for us, we are sitting pretty. Unemployment in PT remains ridiculously low, and there are still plenty of locations out there with a drought of PTs.

Below, I have included several links that I think help paint a good picture of what we are seeing happen in our job market currently and what we can expect to see over the next few years. I encourage you to take a few minutes and check them out, particularly if you are currently or will soon be searching for a job in physical therapy.

The writer in this first reference equates what he is seeing now in the PT job market with what happened after the Balanced Budget Act: Looking to the Future For The Rehab Professions. I wish the writer had gone into more detail about the parallels he sees between the BBA and now, but he describes, in more details than I ever could, the various forces that will influence our employment opportunities in the years to come. A good read for sure.

Some more of the details about what was happening following the Balanced Budget Act can be found in this 2000 article by CNN.

I’m sticking to my guns. If you want to be a travel PT or PTA, do it. It is a very rewarding choice and there are plenty of jobs out there. If you, like me, are in an area that doesn’t have a whole lot of travel jobs, consider working in other areas. Here’s two more links that demonstrate two facts: 1. The current market and outlook for PT employment is VERY good, and 2. there are areas where you can look for a job where it’s ridiculously easier to get hired… Fairbanks anyone?

Top 5 paying locations in the US for PTs

Upward and downwards trends in ease of filling positions in PT mapped nationally <-Really cool map

In my next blog (next week – part 2) I will tell the tale of my last job search that launched me into this look at the job market and offer what I think are some of the ways that each travel PT or PTA can do be more marketable and continue to take advantage of the wonderful opportunities that come through work in travel physical therapy.

Vagabonds, Vagabonds Everywhere

Balloon

Launch site of the first trans-Atlantic balloon flight – Presque Isle, Maine. Jonathan Trappe, who is really cool thinks this is really cool. It must be.

It’s been too long since my last post, so let’s get right into it.

I realized recently that one of the fascinating things about being a Physical Therapist and traveling is all the different people that we get to meet and get to know as we work with them. This thought started when a man showed up at the door of our cabin looking to rent it, because our landlord has left the “For Rent” sign out front. We got to talking about this first TransAtlantic Hot Air Balloon launch site which is just down the road. At this point, the guy introduces himself Jonathan Trappe and whips out his phone to show Kate and I why he finds the balloon memorial so fascinating. “I guess it’s just a small group of us that find that kind of thing really cool. This is my balloon,” he says while showing a picture on his phone of him hooked into a harness attached to a bunch of toy-like latex balloons floating above the clouds. I say to him that it looks like he’s pretty far up. He says, “Yeh, this picture is taken at 20, 000 ft above the Alps!” You gotta check this stuff out ClusterBalloon.com – There’s place down the street that Jonathan might rent. I hope he does, maybe we can be friends.

I don’t know why this came as some sort of revelation to me that I get to meet a lot of people doing what I do – afterall, being able to be a social creature at work is one of the major reasons I got into PT in the first place. Now, I’ve been practicing for 7 years (which through some very rough math works out to 12,000 to 14,000 hours in the clinic), and I can think of a lot of really interesting people that I’ve been fortunate to meet. There’s a couple of patients I’ve treated that opened my eyes to some different and cool stuff. There was this Buddhist monk that would show up for her treatments in her burnt-orange monk robe we’d talk about the different veins of Buddhism. She’d tell me about how she was one of the first female monks in her particular denomination of Buddhism, how it was the most pure of the denominations, and how she brought it to the US several decades back. Just a fascinating woman, I don’t really remember all that much else about her, but she definitely sticks out in my mind as a cool person to have known.

There was this man in his late 80’s I saw for home care a few years back. He opened my eyes to the religion of Spiritualism. He was a leader nationally in the Spiritualist Church where they believe when people die they exist in the same world as us as spirits. To dumb it down: they believe in ghosts. And this guy was a medium who could communicate with the dead. He lived with this much younger roommate who was a tarot card reader. They were always making this soup that I can distinctly remember the smell of – It may have been some sort of mix of the soup and just the particular smell of their place that I remember, it was very distinct. I go over and work with this man a couple times a week. Somewhere inbetween he and the tarot card reader telling me fascinating stories and explaining more about Spiritualism, we’d sneak in a few exercises and some work to improve his mobility. He believed that anyone could be trained to be a medium — that you didn’t particularly need to have a knack for it. Besides this religion that fascinated me, he was just a sharp, open minded guy that I think of occasionally and wish I had kept in touch with. I did think to call him one day, but enough time had passed that I had changed phones and didn’t have his number anymore. Too bad, I’d like to know how he’s doing….. and take him up on that medium session he offered.

"Hey! Look a van with a New Hampshire plate. What are the chances out here in Alaska. On an unrelated note: Brrr, It's cold, glad we're not in a tent...."

“Hey! Look a van with a New Hampshire plate. What are the chances out here in Alaska. On an unrelated note: Brrr, It’s cold, glad we’re not in a tent….”

The travel really increases the amount of people from less-than-ordinary circumstances that pass through my life. When actually out traveling on the road or in airports, I don’t typically go out of my way to chat up people, I’d rather not deal with the inconvenience of them asking me where I live :-), but occasionally someone will creep into the daily interactions and stick as a memory. The only reason cluster-balloon-guy stopped in is because the “For Rent” sign was still up. If we had been well settled into a place for months or years, that sign wouldn’t have been out there and Jonathan wouldn’t have come-a-knocking. “New Hampshire” was the name dubbed to the couple on the Alaskan State Ferry ride to Washington who were driving a big van displaying a New Hampshire license plate and with a big aluminum canoe strapped to the top of the van. We first met them in the line of cars waiting to get onto the first boat out of the Anchorage area. The gentleman of the couple noticed our Maine plates and came strolling over saying something like, “Hey! Maine!? We’re from New Hampshire!” We continued to see this couple everywhere on the 10 day trip down to the lower 48. We saw them on the boat, we saw them out in Juneau on a 2 day stop there, and we even passed them on the highway headed out of Bellingham, Washington. My most amusing memory (of these people whom we never really got to know that well) happened one afternoon on the boat when seas were rough and water was splashing and blowing up over the top of the several story high ship. New Hampshire was hanging out nearby and I remembered they had been tenting out on the deck of the ship. It wasn’t unusual for people to tent on the deck of the ship, but this was getting late in the season and they had the only tent out there in November. The tent was tied to a railing after they were overhead paged on the boat to attend to their tent. According to the ship’s crew, it’s not unusual for winds to whip up, taking unsecured tents weighed down with gear right off the boat into the Gulf of Alaska. I was a little scared to ask them if their tent was out on the deck during this patch of rough seas, but I remember as things calmed a bit and no more water was coming over the top of the ship, Mr. New Hampshire stands up and very matter-of-factually says, “I guess I’ll go see if the tent is still there.” What a character, and neat people living a cool life, cracks me up.

Anyways, just because I feel like there’s supposed to be some conclusion here, let me say this: I like meeting people and I think PT and traveling is a nice combination that lets me meet some pretty cool people. We’re trying to buy a second car off Craiglist this week, that’s a process that lends itself to some strange people getting involved… should be fun!

Ask James

Hey everyone. It’s hit that time of year where April comes around and I realize I haven’t posted in 3 months. Don’t worry, I haven’t been working too hard, just skiing too much. 🙂

I thought one quick way to get back in the blog-habit is to post a recent email conversation I had with a new traveler. I think he was asking the right questions and made the right decisions in the end. Maybe our conversation can help someone else out there who is working on getting into travel PT.

Happy reading and happy travels! I’ll write again soon.

 

New Traveler: My wife and I have ventured out to begin traveling therapy. We left sunny SC and drove 2800 miles to cloudy OR last week. My wife had a for sure job but my opportunity fell through somewhere around Wyoming.

But now I have been contacted by a SNF and they want to offer me a contract directly.

They asked me to name a price and I asked to have time to think it over a while.

I have a little idea of what to say because I know what the travel company is paying my wife. But before I respond to them I am hoping to get some advice from y’all.

Here are my details: This will be my first job; I graduated in December. It’s going to be a 6 month contract. I have no experience in a SNF but I had 2 clinical rotations in outpatient (1 manual focused), 1 acute rotation, and 1 inpatient rotation.

One traveling company recruiter told me I should make 1400 dollars a week if they didn’t cover housing or insurance. I have both through my wife’s job.

Any thoughts?

Thanks

HoboHealth: Awesome to hear you guys are taking the plunge and hitting the road!!!

I have two thoughts. If the SNF job sounds like something you wouldn’t mind doing, then go for it. But if you’d rather be doing something else, then I think holding out another week or two may yield some good results if you’ve been seeing other opportunities in the area come and go. So, make that decision first… Is this really an assignment that’ll be ok for you? (Also, since you haven’t done SNF before, are there other PTs to help guide you? …the more the better.) Do you need another recruiter?

My 2nd thought is that $1400 sounds really low to me. I know therapists that made about $1500 wkly after taxes through an agency on their first assignment after only 6 months PT experience. Figure on top of that (or whatever your wife is making) that the agency is charging another $10-$20 an hour. That’s a lot of bargaining room for you. I would say as a new grad doing an independent contract $1600 is a very acceptable starting place for take home ($40/hr). I think you should aim higher $2000 ($50/hr)? I’ve heard of independent home health contracts going as high as $70/hr. Depends how ballsy you’re feeling…. Doesn’t hurt to ask. Also, just make sure you’re getting what perks and reimbursements you can.

Here’s some links in case you haven’t read them already (the second is some sample independent contracts):
The Job Search
Independent Contracts

New TravelerGonna give you a quick update. I went in for the interview on Friday and loved the facility as well as the other PTs and PTAs. I decided that it would be a great first job for me as a PT. The managers do a lot of the extra stuff like billing, etc so it will allow me to concentrate on solidifying my eval and treatment skills. As you know it’s quite different being an actual PT than a PT student. No one looking over your shoulder and checking behind you.

It is a unique situation. The clinic is considered an outpatient clinic because it is in a retirement village and serves an independent living community as well as a SNF so I will see a wide variety of patients.

The pay is good. It’s right around what we were discussing. I feel like it’s excellent for a new grad. $42 an hour initially and $48 after a month because I will decline the benefits. I am insured through my wife’s job.

Thanks for sharing the link as well. I used some of the pointers from your blog when negotiating the contract. The whole process went pretty smooth. My wife and I are planning to stay in Oregon for 6 months and then move on. We want to hit up Alaska in the next year. Maybe y’all will still be there and we can get a beer.

Thanks for the help. Hope to stay in touch.

HoboHealth: Thanks for the update. Sounds like a great gig and like you made some good decisions over the past few days!

Good luck and keep in touch when you start working towards AK!

PT International Travel – An Introduction (part 1)

People are ALWAYS asking me about travel abroad. Unfortunately, I have never traveled abroad to work and know very little about it. Recently, a friend, packed up her bags and headed for Qatar where she has now resumed work as a Physical Therapist. She has been kind enough to put some of her experiences to paper and share them with us.

Over the next month or so, we will post several blogs by Amy Sheridan about her experiences finding work abroad and the logistical and cultural obstacles that she has contended with.

Without further a-do, here is an introduction to Amy and we will soon follow-up with the next several pieces.

-James
———————————————

Doha, Qatar largest city. A population of about 1 million.

Doha, Qatar’s largest city. A population of about 1 million.

Ever think of working as a PT abroad? My husband and I had been throwing that idea around for a year or so before a great opportunity arose for him as an engineer in Qatar. We jumped, and I left my physical therapy job in the US and followed him there. Why Qatar? Why work abroad when you can work as a traveling PT in the US? Well, hopefully our tales will give you some background on not only work and play life abroad but also on the process that I had to go through to work in Qatar.

Prior to jumping ship, I worked as a Sports and Ortho PT in a private outpatient clinic in Boston. I had been working there since graduating from Northeastern University in 2006. Having a boss that traveled to the Middle East for 10 or so years to treat athletes actually prepared me to work abroad. I always thought it would be awesome to start traveling with him there. Instead, I ended up here myself.

Amy getting around Qatar via some local transportation.

Amy exploring Qatar via some local transportation.

The number one reason we ended up in Qatar, of all places to relocate to, was contacts. And patience. My husband must have posted his resume on 50 job websites for work all over the world without a single reasonable follow-up (very frustrating, I might add!) before a conversation with a subcontractor led him to a brilliant contact and a job. My job also came from a contact I made 3 years ago at a conference. If that’s not an ad for keeping old business cards, I don’t know what is!

Over the next few blogs, I’ll share the seemingly never ending production of preparing to relocate, the millions of questions we asked before and during the relocation process, securing visas and residency, idiosyncrasies of living in another country, culture shock, and finally what it is like to work in Qatar. I’m hoping that my experience will guide any of you looking into it or in the midst of the process.

-Amy

THE Housing

Finding an apartment here was TOUGH! …more on this in a minute.

There’s a lot of different ways to get your housing on travel assignment. By far the easiest way is having your staffing agency set up the housing for you. If you don’t know the area and really have no preference on location, the housing is typically pretty nice and turn-key ready. On the other hand, you could take the tax-free housing stipend and find housing on your own.

There is a financial advantage to figuring out the housing on your own and taking the cash. It keeps all the money in your reimbursement package and away from the resources it takes for a staffing agency to find and arrange your housing. In fifteen-or-so assignments, I’ve only had my recruiter get housing for me once. If you haven’t searched for your own housing on assignment, you’d be surprise at the amount of temporary and furnished housing that is available. Craigslist is how we almost always find our housing. If we can get to the assignment a few days ahead of time, that’s usually enough time to hit Craigslist hard and find good housing in a fun neighborhood before work starts.

It turns out Anchorage rental housing has a 98% occupancy rate. That’s REALLY high. We were lucky enough to have an open invitation with friends in Wasilla, whom we ended up crashing with for over 2 weeks. [whom?] There was so little availability in rentals around Anchorage that we really didn’t get a chance to see many apartments. Luckily, among the 3 apartments we looked at, was a nice two bedroom, utilities included, deck, washer/dryer, and parking.

The apartment is more than we like to pay for rent, but with a location convenient for work, plenty of room for visitors, and slim pickings for other options…. it’s worked out just fine. Which is a lovely segue to the larger message: With a little patience in finding housing and finding a job everything works out just fine. As a travel PT or PTA, you may go a week or two without a job or work for a week while living in an extended stay with all your junk in your car, but IT ALL WORKS OUT JUST FINE.

The Things We Look For In An Apartment:

-Furnished               -Short-term lease

-Washer/Dryer        -WiFi

-Parking                     -Utilities included