Travel PT Independent Contract Question


I recently received an email question about setting up your own travel contract without an agency. Here is the question and response.

Traveler:

I was just reading your post on independent contracts. I’m wondering if you were able to negotiate a pay package comparable to what a clinic would pay a staffing company. For my first assignment I found out that the recruiting company took about 37% off the top of what I made. Would you be comfortable sharing how much you were able to get out of independent contracts?

Thanks for you time and help! Really appreciate your website.

 

HoboHealth:

Great to hear from you again. Glad to hear you are enjoying your travel experience!

I truly only did independent contracts when I couldn’t find an assignment through a recruiter in the area I wanted to go – or when there was only one job available and my wife or I needed a second job. I always had the dream of making crazy-money by offering to work for just a bit less than what a clinic would pay an agency, but it never worked out that way. I made typical travel money on my independent contracts.

Two examples of independent contract pay that I can think of off the top of my head: one private practice was paying me $52 per patient in a typically low paying state, another place paid me $1800 weekly. After taxes, those work out to about typical, if not low, for travel money. So, I never achieved the dream of beating the system and making more money than I would through an agency.

I guess my takeaway is that independent contracts are a good way to find a contract when there’s not one to be had, but it never really worked out for me to make crazy money.

Hope that helps, do let me know if you have other questions.

 

For more info on making your own independent contracts, check out these resources, along with examples of actual contracts:

How To Set Up An Independent Travel PT Contract

THE BEST Travel PT Job

I get questions like this all the time: Where should I go on a travel PT assignment? How do I find a good travel PT assignment? Is working in this particular health care setting the best I can do?

The answer: I don’t know what is best for you!!!! These are personal decisions that rely on the balance of many different factors. The right assignment for you may be very different than what somebody else wants. To be successful in travel therapy, you need to be flexible where you can, but you also need to know what is important to you and pursue it. I’d like to explore a few of the factors that will play into you choosing the assignment that is (hopefully) the best one for you.

Location

Location has ALWAYS been my top priority traveling. Where you should go as a traveling therapist is a very personal decision. For instance, in the winter, I want to be where it is cold, snowing, and I can ski. I recognize that many other people want to be somewhere warm in the winter instead – our wants and preferences will vary wildly. If you have a very specific city or town in mind to travel to, you might need to be much more flexible in other details of your job search. If you don’t have any specific places in mind at all when you start to travel then you already have some good flexibility to your options.

…or mountains AND ocean… jobs available now in Sitka, AK. Click the picture for more info.

If you’re unsure where to go I recommend thinking about the types of things you would like to have around you when you arrive at your assignment:

  • Coast, Mountains, or Open Spaces
  • Hot or Cold
  • Rural or Urban

If you can easily pick a favorite in each of those categories, you are well on your way to finding a location that will make you happy. Some logistical issues that may help you further narrow down where to look for a job are the speed of a certain state for getting a license (perhaps fastest through the PT compact) and availability of travel jobs in a given area – your recruiter can help guide you in either of these criteria.

Traveling as a couple, my wife and I typically picked a city we wanted to live in and would give our recruiters an amount of time we were willing to commute to find two jobs within a reasonable radius of our homebase. More often than not a community hospital or home care agency would have two travel PT jobs available at the same time, but that’s something that can be very dependent on the region.

Clinical Setting

This is another very personal decision, but the more flexible you can be on setting, the better chances you’ll have of checking the boxes on all of your other priorities…. but is there such thing as being too flexible?

So often, I talk to new grads who have leapt straight into traveling. Many of these new grads are looking for outpatient jobs, but often told that SNF jobs are their only option. If you have no experience as a therapist, then you have very little bargaining power to explore anything but the options that are first presented to you. So, I advocate for two things – get at least a little experience before you travel and put up a bit of  fight before accepting a setting you absolutely do not want to work in – hold out, be patient, and be flexible about where you might travel to to get a setting you desire.

On the other hand, one of the things I love most about traveling is the variety of practice settings I have been exposed to. There is so much in PT that I never would have experienced if I hadn’t gone into travel. There is a balance to be reached between pursuing the setting you want and being open to other settings that you are willing to work in. Yes, please strive to be in the setting you most want to be in, but also work to acquire the experience and expertise you need to pursue those jobs. Also, be open to accepting jobs in other settings that might expand your clinical experience and allow you to grow with more diverse clinical skills.

Pay

Last, and least, pay. Yes, you can make lots of money in traveling therapy. But if you go into traveling for only the pay, you won’t last very long. I’m not saying to cast aside all thoughts of pay. It is very important that you are paid well for being highly educated and having the flexibility in your life to pick up and move for work. If two otherwise equal options present themselves, by all means, take the one that pays more! But don’t set pay ahead of all other factors, I believe you’ll eventually come to regret chasing the money in the absence of person and professional satisfaction.

You have to find that balance between your pay and the other factors that can make or break an assignment. If you’re not happy, you won’t last long in travel – the best travelers go into traveling therapy to live a better life. If you are doing it only to pay off loans or make as much of you can, you will burn out quickly and head back to a settled life in order to gain satisfaction in other life-areas you have neglected.

Finding both happiness and success in traveling requires a balance of several factors. Sit down, write down your priorities, and figure out where you are willing to be more flexible. Finding the balance that uniquely suits you is what will help you succeed, find joy in your work, and allow you to continue traveling.

Careers in Travel PT with Regis University DPT Students

I had the opportunity to talk with Regis University DPT students. We covered a whole lot of topics in just 30 minutes – housing, tax home, finding a recruiter, searching for assignments, independent contracts, PT compact and licensure, health insurance…. and a lot more.

The presentation and Q&A were video recorded and are here for your enjoyment!

Traveling Therapist Q&A: Considering Travel

This recent post on the discussion board from a new traveler had so many good questions in one place that I thought I would take the time to answer a little more in depth and share the dialogue more broadly. I hope this helps other therapists who are new to traveling!


I’m a Respiratory Therapist with 5 years of experience and am considering doing Travel Therapy for a few years. The thought of traveling to new states and having increased income is very attractive. However, I do have a few concerns that I was hoping someone with experience could assist me with.

Housing/Insurance

On paper, it appears traveling is a tremendous increase in pay versus permanent jobs and with allotments boost the net even further. My question is if I elect to have housing provided to me and to have health insurance coverage, does that negate the increase in pay? To those who have traveled before: where else could you live short-term (3-6 months) and come out ahead instead of electing to have housing provided?

Yes, taking health insurance through your employer and allowing them to place you in housing will cut into your hourly pay. Insurance will only minimally cut into your pay. For most of my time traveling, I carried my own insurance and was only able to get $1 extra per hour worked into my contract. So, figure $1/hr out of your contract for insurance,

There are a lot of different options for housing, and in my opinion, taking the housing assigned by the agency is the worst option. If you do take housing through the agency, as I did on my first travel assignment, you will find it very convenient. The agency will arrange a nice apartment for you with furniture, ready to move in, but it will cost you considerably. It will take a little more footwork to find a furnished space on craigslist or by looking up local classified ads in the community you are headed to, but you will be able to choose a living space in a neighborhood of your choosing, and you will likely be able to beat what the agency will charge you for housing.

The camper I lived in on Martha’s Vineyard. We had considered a houseboat initially…. maybe next time.

The final, more eccentric option, is living in a camper. A lot of people who plan to travel for a a while in temperate places take their whole life on the road with them. This can also be a more convenient option for travelers with pets. If this appeals to you, the facebook group Highway Hypodermics can be a great resource.

Taxes/Reimbursement

If I work in multiple states as a traveler, are there any tax exemptions? I don’t want to owe a great deal at the end of the year. Will I be reimbursed for travel, new licenses, uniforms?

One of the main benefits as a traveler is the tax free monies you can receive. First is your housing stipend. If you don’t take the agency’s housing, they provide you a tax free stipend – hopefully you find housing for less than the stipend so you can pocket the rest of the money. The second main source of tax free money is your per diem. The IRS regulates both the housing stipend and per diem – a cap is set on each by cost of living in the area code you are working in. If the per diem or housing stipend is low compared to your hourly pay, there may be an opportunity for you to negotiate some taxed hourly wage into a tax free category. It’s one way to maximize your take home without too big of a hit to the agency. However, too low hourly pay compared to your tax free monies can be a red flag for an IRS audit of your employer, so many agencies will have a limit to how far they will push that barrier. With all of this said, income tax laws vary wildly by state and you may find you owe states a certain percentage of your earnings at the end of the year – but this only applies to your taxed hourly wages, not your tax free money. 

It’s good to ask for any potential reimbursements prior to signing your contract. Licensure fees are typically reimbursed. You will usually get a set amount for relocation – anywhere from $500 to $2000 at most (another good area to target for negotiations to squeak in a little more money. I’ve never had uniforms reimbursed, but it sounds like a very reasonable item to ask your recruiter for reimbursement on.

I’m an adult RT therapist with experience in acute and an LTACH, are the opportunities less if my Peds experience is limited?

As long as you are open to new experiences and settings, I think you will find your options wide-open. Traveling has been a wonderful way for me to gain experience in settings I otherwise never would have worked in. After a couple of assignments, my breadth of experiences had expanded greatly and even more opportunities were available to me. After those initial experiences, I could confidently step into almost any setting.

Cancelled Contract

Has there ever been a time when a contract is rescinded prior to start? In that case what does the company do?

I have never had a contract cancelled in 10 years of traveling – except for one time when I broke my arm and couldn’t work. However, it does happen. That is the main risk in traveling and you just have to be willing to roll with the punches and be flexible to adapt. Typically, there is a clause in your contract that allows you to leave a contract with 30 days notice, but you do not necessarily receive the same protection from an employer cancelling the contract (ask your recruiter about the policy for your company). Typically, a facilities staffing needs are well thought out. They don’t hire a traveler unless they need one. If you are a good employee and good fit for the facility, you shouldn’t have to worry about your contract being cancelled.

Recruiters

Since I have a lack of experience in traveling, I also don’t know which companies are the favorable ones. Any suggestions?

I’m going to refer you to this blog post on your first travel job for a couple tips on selecting a recruiter. Basically, if you don’t feel well taken of, move on to another company. There are many, many agencies and a lot of them recognize that the clinician is the commodity. Without us working, willing to take travel jobs, there would be no travel industry and there would be no recruiters – find one that’s willing to make you feel needed.

Surfing Waikiki after work one day. Traveling therapy is the best thing ever.

Overtime

Can you sign up for overtime?

If you are considering overtime, take that into consideration when arranging your contract. Typically, overtime is paid at 1.5 times your regular hourly rate. However, your hourly is going to be pretty low because of all the tax free money you will also be receiving. On one job, I knew I would be working some overtime, so I was able to negotiate a flat rate for any overtime hours to make sure I was making reasonable overtime pay for overtime hours.

It is really going to depend job-to-job on whether overtime is available – make sure to ask during any interviews you have.

Overall, I’d like a good experience and to be able to earn enough to pursue my dream location. I just want to know it’s worth it.

Traveling therapy is awesome. Pay can vary greatly place-to-place. Just weigh your priorities and if getting out and seeing new states and facilities is one of your priorities, then travel is definitely for you!

For other therapists trying to figure out where to start, this link is a great place to get started with travel therapy. Also, don’t forget to follow HoboHealth on Facebook and on Twitter @HoboHealth.

Search With One Travel Recruiter or Several?

Introduction

HoboHealth:

When I first started traveling, I worked with just one company, I had steady health benefits, I would accumulate PTO, and I even got a free wifi printer as a loyalty bonus. The printer was too big to travel with, but I still use it when I have it with me. The company I worked with initially has big name, and they were always able to find me a job. But, when I started looking around, I realized the deal I was getting might not be as good as I thought. Other companies were offering me as much as $200 more per week for similar jobs and seemed a lot more attentive to my needs. $200, that’s one wifi printer per week! That started me down a path of searching with multiple companies about 7 or 8 years ago.

The Vagabonding DPT:

I started traveling about 2 years ago as a new grad.  I was fortunate to have a Travel PT mentor who set me up with my current recruiter.  Yes, that’s singular.  I have one recruiter.  I know that the majority have multiple recruiters, but for now, having one recruiter has helped me build my career as a physical therapist. My recruiter is fully aware of my abilities, professional goals, minimum pay rate, and setting preferences.  He’s submitted me for positions that I may not “qualify” for (i.e a requirement of 5+ years for a job assignment) because he was confident in my skills and that the position would be a perfect fit for me. Even as a new graduate with my first assignment, I’ve stood firm on negotiation of time off as well as pay rates.  I got exactly what I wanted because I had a recruiter who was willing to negotiate those terms on my behalf.

What are the advantages of having one recruiter vs. multiple recruiters?

HoboHealth:

Compare pay rates between companies. It becomes clear very quickly whether what you have been making is competitive with other companies’ rates or not. Knowing what other companies are able to pay you in a given area can be a great negotiating tool if you do decide to stay with just one company.

Different companies have different jobs. You will see many of the same jobs posted across most agencies – the jobs that are the same across agencies are all listed on databases that many facilities contract with to fill their jobs. The databases sell subscriptions to the staffing agencies to have access to their jobs (the databases also charge 3-4% of the total contract price to the recruiters). To beat this system, agencies have gone out of their way to make contracts to exclusively staff particular facilities. So, it is possible that you can’t find a job in a particular area because you aren’t looking with the agency that has an exclusive contract with a facility in the area. Also, some agencies rely solely on what comes across the databases; Other companies are willing to call around for you. All recruiters will say they are willing to canvas an area for you, but less will actually do it (the smaller agencies tend to be more willing to put in the footwork of tracking down novel contracts). Broadening your agencies, may open up additional options.

The Vagabonding DPT:

Each travel company provides different perks the more time you spend with them.  The benefits listed below are solely representative of one company:

Paid Time Off: My company provides paid time off for 40 hours after working 2,080 hours and 1 year with them.  A travel therapist would be free to cash out that PTO to fill any requested time off during an assignment or in between assignments. From that point thereinafter, you accrue some PTO for every hour you work.

New Grad Bonus: A new grad who works 3 consecutive contracts with this company will earn a $1,000 bonus.

Continuing Education Bonus:  When you’ve stayed with this company, you receive $400 of continuing education credit valid also for conferences such as Combined Sections Meeting or NEXT.

Less Paperwork: Every company has a set of protocols that they must follow to be compliant with TJC including BLS certificate, licensing, NPI number, vaccinations, physical exams, TB tests, drug screen and physical examination. In addition, each company will have a mound of paperwork in regards to the company’s policies and procedures about expectations, benefits, clinical competency, etc.

Staying with one company allows you to focus on what you need: less paperwork and more time to invest in your passions and interests.

Health Insurance: If you choose to go with one company and choose to go with their health insurance, you won’t have to worry about switching health insurance companies.  Travel PT companies will typically allow you a 30 day grace period in which you will be covered by the company while you’re between assignments.

Consistency: Some larger Travel PT companies will bounce you around with various recruiters who manage a particularly region.  If this is the case, then you will have to take the time to let each recruiter know your preferences and want-list.

Do you feel there are any disadvantages to the approach you have taken?

HoboHealth:

The obvious downsides to working with multiple agencies are the benefits you don’t get for being loyal to one agency and the extra paperwork you do get – as April mentioned above.

If you do work with multiple companies, remember this cardinal rule: “You take a particular job with whichever agency offers it to you first.” Meaning, you can’t take an assignment offered by one agency, and tell a different agency about it to try to get a higher pay rate. Things can get sticky fast.

It takes some management to work with multiple companies. At one time, I was searching with 6 or 7 different agencies. One job came up and they had received my resume from multiple different agencies, each claiming I was “their guy”. While I went with the first agency to present the job to me (the only agency who had permission to submit me for the assignment), another agency bullied the facility into only accepting my interview through them. I was unable to go with the agency I liked best and who had presented me the assignment first. It was embarrassing and it’s why I now limit my searches to 2 or 3 agencies. When you are working with multiple agencies, you have to be clear that you need to be contacted before being submitted to a job, otherwise you may end up in my situation with companies bickering over ownership of you with the facility – it’s embarrassing and a good way to blow the interview before you even have it.

The Vagabonding DPT:

As James mentioned above, working with one company requires much trust in one person to provide you with the best pay rate, location, and setting.  By doing so, you may limit your options for future possibilities.  You must trust that your recruiter is negotiating the terms of your contract to the best of his/her ability to provide you with the best overall package.  To decrease this, you could also ask other Travel Therapists about their pay rate for that setting in that specific region.

The same facility may be working with several travel recruiting companies to fill a need. So when you work for multiple companies, you may be offered the same position via two different companies which can actually work against you. In the end, you may not end up with the assignment.

Conclusion

We present you with the advantages/disadvantages to assist you in making the best informed decision for your travel career path.  We’ve each done our research to negotiate our contracts.  Stay informed and ask around.

This is the second blog HoboHealth and The Vagabonding DPT have done together, you can link here to our first blog together about whether or not to travel as a new grad.

Check out our websites: www.hobohealth.com and www.thevagabondingDPT.org. Follow us on Twitter @HoboHealth and @AprilFajardoDPT. Finally, follow our Facebook Pages to keep up on our latest blogs and what/where we’re up to: HoboHealth and The Vagabonding DPT

 

Locum Motion

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!

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!

Feast or Famine

When we last left off (Just Go With It – 5/9/14), I was headed 3,000 miles west out to Hawaii with the verbal assurance that there would be work when I arrived, but without anything in writing. Would there be work when I reached the islands? Would I be a kept man depending on my wife to bring home the bacon? Exactly how much snorkeling can one unemployed PT do in 13 weeks?

After some flip-flopping* back and forth, the work seems like it’s coming. In fact, I think I’ll have too much work in 2-3 weeks.

I arrived here 6 days ago, on Friday night. Luckily, the day before, my employment packet and job offer arrived in the mail from a private practice I have been speaking with. So, I learned how much I was going to be paid hourly if I worked, but had no guarantee of any hours. All there was to do was to get my feet on the ground in Hawaii and hope for the best.

O'hana Papaya

Papaya from the back yard garden! Included in the garden are the following trees that I can identify: 4 papaya trees, 2 mango trees, a hot pepper tree, and a coconut bearing palm tree.

When we arrived, we spent the weekend Craigslisting to find an apartment and a cheap car for the next three months. We found an awesome o’hana apartment! O’hana is the Hawaiian word for family, they call what we know as a mother-in-law apartment an o’hana. Because this island is essentially a big volcano with the top portion sticking out of the ocean, everything is on a hillside, and, therefor, everything has an ocean view. Our ocean view mother-in-law apartment is quite the pad – it also has a pool and a fruit-bearing garden in the backyard. Bugs, mostly cockroaches, are simply a fact of life in Hawaii. When we were out here a few years back, I had an old Toyota Camry with a roach problem. This time around, I have upgraded to a Toyota 4-Runner with a roach problem. I think bigger cars come with bigger roach problems…  back to the contract story.

I didn’t have any wok scheduled for this past Monday, so after dropping Kate off at her job, I popped in to visit the contract manager at the community hospital who I’ve been talking with about setting up an agency contract. All I had heard at this point was “we will need you, we will have work for you.” When I arrived on Monday, the story had changed, “It sounds like we may not need you at all,” says the contract manager. Uh oh, I was depending on there being work when I got out here. So, my efforts were refocused on the independent contract with the private practice. Originally I had told them I would be available Mon/Wed/Fri with the hopes of filling in at the hospital on Tues/Thurs, but with the changes in what I was hearing from the hospital, I offered to work all five days per week at the private practice. Right now, I don’t have a lot of appointments scheduled, but I can see how after evaluations are performed, and a few days go by, the schedule will grow considerably into a full 30-40 hours of work. This one private practice job should be just fine.

This morning, I heard from my recruiter on the hospital job, “James, call me when you wake up, I have good news.” The hospital changed their tune – census is up, and they need some extra help. At this time, I’m feeling conflicted about what to do. The private practice is bending over backwards to accommodate me and to try and fill my schedule. At this time, there’s not a very full schedule, but a couple weeks will fix that – unfortunately, they aren’t will to guarantee any hours. The hours patients are there with me are the only hours I get paid. On the other hand, the gig with the agency at the hospital will pay more and there may be a couple days worth of guaranteed hours.

4runner

The roach mobile, o’hana in the background!

When it rains, it pours. I’m currently working about 10 hours this week with a long-weekend quick approaching, it’s been a nice break, but I need to get back to consistent work. On the horizon, I can potentially expect 60+ hours of work any given week. While the thought of bearing down, working long hours, and stacking up piles of cash is appealing to me, I’m in paradise (again) for 3 months, and I’m not going to blow it by working indoors 60 hours a week.

For now, it’s back to waiting. I’ll have to see what the hospital really wants from me before I commit to anything. If they do guarantee hours, the decisions will get difficult – will I choose the higher paying guaranteed hours? Or will I stick by the practice who has not guaranteed me any hours, but has been good to me thus far?

Time will tell, for now it’s back to researching which beach to camp on for my 3+ day weekend.

Happy Memorial Day! Aloha!

*In Hawaii, flip-flops are called slippahs. example: Take ya slippahs off when ya come in da house, brah.

Email From Traveling Physical Therapists

Traveling Physical TherapistI’ve been getting the same type of question from new traveling Physical Therapists a lot lately…. so let’s hash it out in public. The question goes something like this: “I want to travel, I know where I want to go, but where do I start?”

I have had a “getting started” page for a while now, but just tuned it up, it should be a good companion resource to this blog: https://hobohealth.com/wordpress/faq/

Below I have pasted an email conversation I had recently had (lightly edited for anonymity). I hope this helps some of you out there get your travel career going.

Email:

Hi James,

I am a PT, and I happened upon your blog after beginning to research travel therapy. My husband (also a PT) and I have been working for almost a year and are planning to become traveling Physical Therapists this summer. We have a couple of PT friends traveling now and have gotten some perspective from them, but their experience is still pretty limited.

Thought I would reach out to you for a bit more perspective. Here are a few things we’re curious about:

-best companies/recruiters to work with
-states requiring significant paperwork/time for obtaining license
-what comes first: obtaining a license or obtaining an assignment

Any other tips to get started travelling would be greatly appreciated!

Response:

Very glad you found the site!

My wife and I have been traveling Physical Therapists together for 7 years now… we originally thought we would travel for 2 years. We absolutely love it, and I hope you guys find some fun in it too! I started into travel after 6 months of working in private practice, and my wife started after a year of practice. I think you guys have done it right by getting a little steady experience before jumping into travel. I so often find myself trying to convince new grads to get just a few months of experience becoming a traveling Physical Therapist. So, good work, you’ve gone about it the right way!

We have worked with a bunch of different recruiters and companies at this point, and always search with 2-3 companies when looking for a job. I have heard of people sticking with one company for years, but I definitely don’t think that working with just one agency offers you the best selection of jobs available. I make sure to use recruiters that will have my back if something is not right about an assignment, and who won’t encourage me to continue working an assignment if it is toxic (i.e. ethical or scope of practice issues – rare).

California is notorious for licensure taking forever (4-6 months). I recently heard from someone that New Jersey is a pretty big process too. Otherwise, the process varies state-to-state, but shouldn’t take more than a month or two if you get all your ducks in a row with the paperwork. The more licenses you have, the more complex getting additional licenses becomes. So, I recommend that if there’s a few states you know you want to work in, get all of them now.

Start licensure ASAP, a lot of jobs won’t hire you until you have a license – but some will higher you conditionally with a projected start date if you’ve started the process. I would also get in touch with some recruiters soon. They can help inform you of how long licensure takes for particular states and help you start getting an idea of what kind of jobs may be available where you want to go – some agencies have resources to help you with licensure. New jobs pop up constantly and other jobs are filled quickly, so the sample of actual jobs will change, but the recruiter will be able to help you see what a particular geographic market is like.

OK! I’ve gone on too long. Here’s a simple page about starting travel PT if you haven’t seen it yet. https://hobohealth.com/wordpress/faq/ Let me know if you have other questions, and keep in touch about what happens with you guys!

James