Travel PT Assignment Red Flags – With the Vagabonding DPT

In this piece, The Vagabonding DPT and HoboHealth are teaming up for the 3rd time to present to you the major red flags we look for when choosing a staffing agency or when choosing to accept a specific travel assignment. These red flags shouldn’t be treated as absolute no-no’s for taking an assignment or using specific recruiters, but they should make you pause and think, “Is this what I want in an assignment?” If you run across these red flags, your antenna should perk up and you should be asking yourself if it is the right situation for you.

Red Flags for Recruiters

We may use recruiter and agency interchangeably. The recruiter is your main point of contact who also represents the agency. So, if you are working with a recruiter that starts checking the boxes on several of these red flags, move along. There is enough options for agencies that you shouldn’t be working for one that employs any recruiters with shady practices.

  • One of the most egregious red flags is if your recruiter ever tells you that you can only work with them and not for any other agency. “If you don’t commit to me, I can’t give you my full attention either,” is usually how this is presented. The thing is, that is EXACTLY the role of a recruiter: To give you their full attention, to work as hard as they can to find the best job for you. If a recruiter can’t find you a job, they don’t make money. A good recruiter should be going above and beyond to win you over. YOU, the therapist, are the commodity. YOU hold the power, not the recruiter.
  • When searching for a job, your recruiter should stay in touch with you often and actively search for jobs. Many agencies are passive in their job searches – they sit and wait for jobs to be posted to them through subscriptions to staffing databases. If your recruiter isn’t in touch with you often and communicative about the process of finding you a job, they may be solely relying on these databases. There are recruiters and agencies out there who will do the footwork of getting on a phone and calling around to clinics to look for jobs that match your priorities. You should feel like your recruiter wants to find you a job that meets your needs.
  • As we’ve mentioned, constant communication with your recruiter is essential for your success as a traveling therapist. An excellent recruiter will disclose all aspects of your contract including the cancellation clause.  All contracts include a cancellation clause in which the facility reserves the right to cancel your contract in the event that they hire a full-time therapist or therapist assistant to take over your position. This clause will typically give the traveling therapist either a 2 or 4-week notice prior to terminating the contract.  Many new travelers may not even know about this until their contract gets cancelled. If it isn’t obvious in the contract, ask questions of your recruiter. While having a contract cancelled isn’t extraordinarily common, it does occasionally happen and you should know what the process is in case it happens to you.
  • Some red flags may take a couple assignments with an agency to reveal themselves. If you find yourself in a situation where a company is refusing to pay referral bonuses you earned by referring colleagues, or if situations develop where previous pay is being reclaimed for questionable reasons – it’s probably time to start looking for a new agency. When things of a financial nature begin to creep up that don’t seem completely above-board, it is usually a good indicator of where the agency’s priorities are – in their own bottom-line, not the wellbeing of their travelers.

Red Flags for Facilities

The phone interview is typically your only chance to interview a facility. These red flags below come from questions you can ask on the interview to reveal what you really want to know about a facility. The interview isn’t just your chance to convince a facility that you are right for them, it’s also your chance to learn if the clinic is right for you! Ask the right questions on your interview, search for these red flags, and you may never have a bad assignment.

  • During your interview with the facility, you must ask about productivity expectations.  Skilled Nursing Facilities are notorious for unrealistic productivity expectations of 95%.  This means that they expect you to have direct patient care for 7 hours and 55 minutes leaving you less than 5 minutes each day for chart review, documentation, team meetings, progress notes, re-certifications, discharge summaries, etc. Home care companies can also vary wildly in their expectations, it makes a huge difference whether you are expected to see 5 or 7 patients daily and whether different types of visits (i.e. Start of Care visits that can take multiple hours) are credited on your productivity as more than one visit.
  • Ask the facility if they’re caught up on documentation.  At times, SNF’s with staffing issues may have PTAs or COTAs running the facility and have a PT or OT off-site, which means that they may be behind in clinical documentation.  If they are behind, you may be placed in a position in which they will ask you to update documentation for a time period before you were hired. This is a RED flag. Don’t ever risk your license.
  • Listen intently to the flow of your conversation with the person interviewing you. Is it curt? Do they ask you about your experience, skills, or interests? We’ve both had interviews, which were brief with little insight to the work culture and dynamic. Our patients thrive when we are immersed in a collaborative environment that supports us as clinicians. Don’t be afraid to directly ask, “what is the work culture like?”
  • If you’re interviewed by a regional director who does not work onsite, ask to speak with someone who does. If they say no or try to dodge this, then that should be a red flag.  You want to speak to someone who can attest to the daily challenges of that facility. A regional manager, who lives in a different state, will not be able to provide you a realistic picture of those challenges. You will have a direct clinical manager, this person should be available for a conversation.
  • Ask why the facility is short-staffed. Is it location? Is a therapist on sick leave or maternity leave? Have they recently expanded? It’s important to know what kind of staffing need you are filling for a couple reasons. If you would like the potential to extend your contract longer than the initial 3 months, it’s more likely to happen if the staffing need is ongoing rather than only for an employee’s temporary leave of absence. Chronic staffing needs occur for a variety of reasons. Some reasons for long-term staffing needs are completely reasonable, like being in a location far from any PT schools – these clinics often have staffing needs. Another reason that a clinic may have ongoing staffing needs is because they are, frankly, a lousy place to work. Asking more questions about the clinic’s staffing needs may help you discern between clinics with staffing needs for good reasons and clinics with staffing needs for bad reasons.
  • If you are working in a stand alone clinic, ask who the owner is. In all other situations, it’s at least practical to know who your direct supervisor is. This seems like an innocuous question until it isn’t. James once didn’t ask this question and the owner and clinic supervisor was an unlicensed Chiropractor from South Africa. Ask this question, if the answers get weird, it is worth asking more questions.
  • Find out who you’ll be working with. How many therapists and of what type? How many therapist assistants? How many other kinds of care extenders (ATCs, Massage Therapists, Techs/Aides)? An abundance of Assistants is a big red flag and a good indicator that as the therapist you will be spending more time doing evals and discharges than actually carrying out treatment. These questions can also help paint a picture in your mind of what a day in this facility looks like.

If you try to suss-out these red flags with your recruiters and during interviews, and if you are willing to walk away when the red flags stack up, you are likely to have a successful, enjoyable travel career. Failing to ask the right questions and have a meaningful dialogue on the interview can set you up for a frustrating time as a clinician and traveler. Good luck out there!   

If you’re a traveling therapist and have any additional advice feel free to comment below.  

April Fajardo, The Vagabonding DPT can be found on her blog at https://thevagabondingdpt.org/

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