Does Travel Therapy Really Pay Better?

People ask all the time if it’s really true that working as a traveling therapist pays better than working as a permanent employee. The easy answer is “yes,” as a traveler you make much more money hourly than as a permanent employee. But I have often wondered if the costs of moving frequently, unpaid time off, and more expensive temporary housing eat so far into the net gain that we come out about even. After additional costs, I think travel therapists likely end up taking home about the same as permanent therapists, but let’s do a little math and see if we can reach a semi-scientific answer. As I begin to write this blog, I have no idea what the answer is going to be – this will be fun.

We’re going to have to make some assumptions to get a rough estimate of what a traveling therapist takes home each year – there are a lot of factors that can drive the take-home up or down significantly. I will make assumptions based on what I would consider a typical year in a traveler’s life:

  • Let’s assume 3 contracts in one year. This allows for either one longer 6 month contract or one contract extension during the year. Also, most people can’t keep up consecutive 13-week contracts for more than a couple years, it gets tiring.
  • I know some people jump right from one assignment to the next with little, if any break. I tended to take 3 or 4 weeks between contracts to visit family, take road trips, or go on vacation – that’s probably more leisurely than most. If you have trouble finding a contract, you may find yourself out of work a little longer than expected. Let’s go with 2 weeks between contracts, this is more time than some will take, but it allows some wiggle room for travel and job-finding.
  • Let’s assume we’ll take the housing stipend and find housing for cheaper than the agency would give it to us – it’s the smart and frugal thing to do.
  • We’re going to have to agree on “typical” pay for a traveling therapist, this is tough because geography and setting cause great differences in pay everywhere. With pay in desirable destinations being as low as $1450/wk and a really good paying jobs being up around $1850 or higher, I think the middleground and a typical travel contract pays about $1650/week. This number is after taxes and with that housing stipend that we have decided to take.

So, at $1650/wk for 48 working weeks, that’s 79,200 after tax – or the equivalent of a $110,000 salary taxed at 28%. Whoa, that’s more than I thought it would work out to, an impressive salary for a staff PT. So these are the base numbers that makes travel look appealing compared to permanent work – now let’s do some subtraction and bring these numbers closer to reality:

  • As a traveler, you’re not going to get paid for sick days and there might be some holidays your facility takes that your agency doesn’t recognize (local, state, and other frivolous holidays). There’s also the common circumstance that your desired start date doesn’t quite line up with the facilities needs, or some extra work days are lost to travel. Maybe you miss a day or two at a continuing ed course or conference. Perhaps, you are waiting for your new state license to come through. Anyways, doing some rough math, let’s say there are 10 other work days in a year that you will miss – 2 weeks. -$3300
  • The actual transportation part of moving can vary wildly in cost. Road trip? Probably. Fly there? Depends. Ship a vehicle? Maybe. Will you need a couple nights in a hotel, or at least campground fees? Food on the road is not usually cheap. The saving grace is that as a traveler, you will get some sort of relocation reimbursement. It’s unlikely to cover all of your costs, but it will cover a good portion. Let’s say the average traveler on the average assignment will spend $250 of their own money on relocation if they travel wisely (getting to 3 assignments this year)  -$750
  • Also included in moving costs are all the things you need in a home when you move: TP, cleaning products, staple foods, condiments, etc. I typically spend about $500 at target at the start of every assignment stocking up on the things I’ll need to live comfortably. -$1500
  • In this scenario, we’re going to take the housing stipend so we can get furnished housing for less than the stipend and keep the extra tax free money. But, the furnished, short-term housing is going to cost us more than we would spend with a typical long-term lease in an unfurnished space. I believe it’s reasonable to say we will spend $400/mo more in short-term, furnished housing. -$4800

$10,350 less for our estimated traveling costs brings us down to $68,850 after taxes, or the equivalent of a $95,625 taxed salary.

I’m honestly surprised that the salary equivalent of what we’ve just calculated as a typical traveling job is so high. We can see from the pseudo-math above that the great boost in pay for travelers is the tax free money. To make the most of the tax free advantage, it is vital that you have an established tax home. Also, I believe this scenario represents someone who is being financially conscious and making attempts to get back to work in a timely manner, find inexpensive housing, and live within his or her means.

There is going to be a lot of variation to these numbers based on whether your assignment pays more or less and a number of personal factors.There are years I took 10 weeks off throughout the course of the year – that affects pay. I’ve heard of people renting cars on assignment, that’s a lot of money (comparable to a second housing rent). You can be frugal with your choice of housing, or you could be frivolous – you could even take the housing provided by the agency rather than the stipend. All of these choices greatly affect how much money you are left with at the end of the year.

Clearly, if you want to make more money through traveling PT, you could find the high paying assignments in the high paying states, live a frugal lifestyle, and rake it in. If you are doing traveling PT for the money as your first priority, do us all a favor and don’t. Travel PT should be about traveling. Enjoy seeing the places you go to work. Take time between assignments to relax and soak in some leisure time. Maybe you do a couple contracts as a traveler to explore different employment options or get a variety of experiences. But don’t do it for the money. The extra money is a nice addition to a lifestyle that you should enjoy for other reasons. Travel to travel, you’ll be a lot happier than slaving away in a terrible facility that will pay anything to anyone because it’s an awful place to work. My recommendation would be the same with permanent jobs. Money should not be the only factor – quality of life, work-life-balance, enjoying your job, being supported by your employer to provide the best care you can to your patients – these are good universal reasons to work anywhere as a therapist.

If you have an interest in doing traveling therapy to see the different ways to practice in a variety of settings and a bunch of different places, get out there and do it! You are in for an unbelievable experience and lifestyle. You’ll meet all kinds of different people, expand your clinical skills, and see some really cool places. As it turns out, while you’re scratching that travel itch, you could make a good chunk of cash while you’re at it.

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!