Last Day of a Travel Assignment

I just came in from fishing on my kayak on the eve of my last day of this travel PT assignment. As usual, I caught nothing, but got a killer view of the sunset. Tomorrow, my wife Kate and I will work the last day of our contract on the island of Molokai in Hawaii before heading back to our winter home in Aspen, Colorado. This transition seems a little more subdued than usual – maybe it’s that we have some time between assignments and aren’t in a rush to get on the road. I used to lose all motivation to do paperwork during the last 2 to 3 weeks of any assignment – of course the paperwork eventually had to get done, but it wasn’t pleasant. As time goes on, the switch has become a bit more mundane for me – one job ends, another begins… just like they always do. But I’m better at keeping my nose to the grindstone until the very last days.

Here I am fishing out front of our apartment on a similar evening where similarly, I caught nothing.

Here I am paddling out to fish in front of our apartment on a similar evening where similarly, I caught nothing.

With ending a job, there’s all the finals steps that need tending to: cleaning out/off your desk, finishing all notes, tying up the loose ends on the cases of any patients who may have gone missing, and preparing for the other therapists to take your patients. Bottomline is: you don’t want the last memory of you to be all of your unfinished work left behind for the other therapists to handle. There’s typically some pageantry as a traveler gets ready to leave an assignment. I try to avoid too much fanfare, it feels awkward to me – I’m very used to coming and going. If it were up to me, I’d leave the office on Friday with the typical wave of my hand and a “have a good weekend!” …and never come back. In the PT Department earlier this week, we had a nice, simple ice cream bar with just the 5 of us in our department. It was nice, simple, perfect – it was a wonderful, delicious gesture, but not over the top. This location has trouble finding a permanent PT because of its isolation, so they are used to a revolving door of travelers. Perhaps that explains why my style of a “goodbye” matches with theirs. Someone, Vikki, will come in on Monday and take my place. She seems nice, and I hope she is – I’ve been telling all the patients she seems good, and I bet she’ll take all the placebo effect she can get. The patients definitely don’t like it when a traveler leaves, but I still laugh when an unassuming grandma threatens to come to Colorado for PT this winter.

The greatest challenge that comes with moving along to the next job is the process of getting the next job arranged. After traveling for 10 years, and returning to the same seasonal job every winter, finding the next job isn’t usually too much of a process anymore, but it used to be! Figuring out where to go is the first major hurdle, and it needs to happen well before the last days of the job. If you’re on a 13 week contract, you should have a pretty good idea of where you’d like to go very early on in the contract – especially if you need to get a new license to go there. When it’s time to find the next job, it’s not uncommon to find me in little corners of a hospital, between appointments, making calls to recruiters for quick updates on potential jobs. There’s a lot that goes into getting the next assignment, and it can, and usually does, happen at a pretty fast pace in the middle of a busy work week.

I just read a couple articles in a ski magazine and it got me pumped to be headed back to Colorado for the winter. I cannot wait to get my skis out of storage and onto the mountain (it’s snowing there right now as I write). Kate and I have ordered a fair amount of ski gear on sale over this summer while we’ve been here in Hawaii, so we’ll have to box all that junk up and ship it ahead. We have almost two weeks of hanging out in Hawaii before we have to leave – I really think this is the ultimate traveler’s hack. I haven’t had to pack a thing while I’ve been working. It is so refreshing to not have a car full of stuff before my last day of work tomorrow.

Here's the Shasta camper we bought. I can't wait to get to work sprucing her up!

Here’s the Shasta camper we bought. I can’t wait to get to work making her shine again!

When we do leave for Colorado in 2 weeks, we’re going to swing through Oregon and visit some friends in Bend before flying into Denver where we’ll be buying two cars. The original plan was to have one car when we returned to Colorado and have some time to find a second car, but while we’ve been away, the Colorado car’s engine stopped working. I’m not very mechanically-inclined, but my understanding is that the engine is a fairly essential part. So, we’ll buy at least one, maybe two cars in Denver – one has to be able to pull the 1970 Shasta Camper we bought from a friend sight-unseen (more on this in the future). After we’re done visiting Oregon and vehicle shopping in Denver, I have a dry needling course in Colorado Springs to attend for 3 days. So excited to finally be a needler (but not excited to be needled for 3 days straight)! The course ends Sunday, and work will start Monday – guess I won’t be starting this assignment well rested regardless of my 3 weeks off.

Despite all the excitement that lies between today and work starting 3 weeks from now in Colorado, I’m bummed to be done here. It’s a community I have grown to know and love and the bitter is mixed a little more heavily with the sweet this time. I guess I’ve got a pretty good thing going here, I could keep working here for another couple months, but it’s that time of year to move on. This is our second time doing a contract on Molokai. When Kate and I came over from the Big Island 2 years ago for an interview, we thought it might be a once-in-a-lifetime visit to Molokai. Three contracts later, Molokai is a part of our life. We’ll be back. I don’t know in what capacity we’ll return, but we will return.

Hawaii, it’s been a blast and I shall return. Oregon, let’s see what you’ve got (I hear you’ve got mountains, ocean, and beer – I like those things). Colorado, I can’t wait to hit the slopes and reconnect with all the friends back there. Nose to the grindstone, one more day of work.

Health Insurance As a Traveling Therapist

As a traveling therapist, there are all sorts of things you can, and should, insure. This may end up becoming a multi-part blog, but for now, I want to focus on health insurance and the options you have available. Getting and maintaining steady health insurance can be a challenge when you change jobs, and possibly employers, every few months. Other than going uninsured (awful idea), there are three potential options to keep yourself insured.

traveling therapist health insuranceEmployer Sponsored Health Insurance
If you are working steadily for a single travel therapy staffing agency or for a combination of agencies, taking your employer sponsored program is clearly the way to go. All the agencies I have worked for factor your health program into your pay package. So, if for any reason you are not taking your employer’s insurance, ask if you can get more hourly – I typically get a dollar per hour extra for carrying my own insurance… more on why I carry my own insurance later.

Typically, what agencies have available for choices are good plans that cover you with providers nationally. When you accept a plan from your employer, you are not subject to pre-existing conditions or other demographic categories that might cause your rate to be higher – you pay into the group price that the insurance has contracted with your employer, simple and right to the point.

A staffing agency that I worked for when I first started traveling physical therapy would drop you from their insurance if you weren’t actively working for them for 14 consecutive days. This used to scare the heck out of me and force me to get right back to work quickly. If a job wasn’t coming together within 2 weeks of the last assignment, I felt the pressure to take anything that was available so I wouldn’t lose my insurance. The truth is, it doesn’t matter if they drop you from their insurance, COBRA (federal gap insurance) covers you. What COBRA does is extend your employer sponsored program when your employment ends. You have up to 60 days to accept COBRA coverage and it works retroactively. This means, if you are taking anything less than 60 days off between assignments, you can go without insurance and if something happens, you can adopt COBRA after-the-fact and you will be covered under your previous plan. The catch is that COBRA is not cheap – unless you need it, then it is a great deal cheaper versus the medical bills you would otherwise incur. Once you have adopted COBRA, you can keep it active for up to 18 months, but in most cases, if you need insurance for more than a couple months, it will be much cheaper to go get a plan on the open market.

I’ve said it before, I’ll say it again: Always look for jobs with 2 or 3 agencies, it helps you get a handle on the local markets and gives you more options for assignments that could be a better fit to your needs. One of the big downsides to jumping between companies is all the “new hire” paperwork – which includes a few healthcare enrollment forms. Don’t worry about the paperwork, the benefits of searching with a few companies outweighs the burden of a couple hours of paperwork every few months. Paper work, JCO quizzes, and constant TB tests are a part of being a traveling therapist, deal with it.

Pros: Everything. Take this option if you are consistently working through agencies. You pay the employer rate and are not subject to rate increases for pre-existing conditions.

Cons: Becomes expensive and complicated if you take more than 60 days off between assignments or do independent contracts. You may have to take short-term insurance to fill these gaps.

Short-term Insurance

Doing a single independent contract? Taking a few months off from therapy to just travel? Unexpected circumstances keeping you out of work for >60 days? This might be the option for you.

The job I work every winter in a Colorado ski town is arranged directly with the hospital and does not offer health insurance for my seasonal position. This can be more common that you would think, especially with seasonal positions in resort towns. Frequently these facilities will not hire through agencies and rely on independent contacts for their seasonal hiring. The first couple of years I worked in Colorado, I got temporary insurance plans, and they were the perfect fit for my needs.

These plans last up to 6 months, are cheap, and are available through most insurance brokers. I got mine through eHealth.com, but I really have no allegiance to them and you should be able to get a temporary health plan through any insurance broker. The downside to these plans are that they only cover conditions that happen during the 6 months you have the plan. Any pre-existing conditions are not covered. If you have an injury or illness that extends beyond the 6 month period that is insured, payment will stop after the last day your plan covers. Also, there is no gap coverage, like COBRA, that would help you if you ended up with no insurance and an injury immediately following the completion of your temporary plan.

Pros: Cheap. Keeps you are covered for any 6 month period where you don’t have other insurance.

Cons: Covers only that 6 months period. Nothing that started before that 6 months, nothing that extends beyond that 6 months. No preventative care coverage.

The Open Market

If you find yourself, like myself, doing frequent independent contracts or in a repetitive rotation to a facility that doesn’t provide health insurance, then the open market might be your only choice. The open market can be unforgiving in its cost. I choose to find insurance through a broker who can compare rates and plans of multiple companies, or you can just go online and start searching rates by individual companies. You’ll find different insurance companies available in different states, and even certain companies are conspicuously absent from specific zip codes due to local laws or other factors. You should always apply for health insurance in your home state and at your home address. It may be tempting to get insurance in a state you are working in if they have lower rates than your home state, but by getting insurance at your home address, you are ensuring the insurer (pun intended) will cover you when you travel temporarily for work. Also, having your insurance based at your home address is one more feather in your cap if you ever have to defend the location of your tax home. It’s worth mentioning that when buying an insurance plan in the open market, there are some plans that only have in-network providers locally. You should make sure that the plan will cover you and has providers nationally – especially when buying from a state’s healthcare exchange marketplace (state Affordable Care Act plans). If you do end up with a plan that has providers nationally, but you happen to be in an area isolated from those providers, there are typically ways of getting your care covered in-network  by contacting your health insurance company – I have had success getting in-network coverage with United Healthcare when working in “far out” places.

State healthcare exchanges offer a good place for you to go and find a plan – so whether you are looking for a subsidy or not, you may want to start there and see what’s available. I almost hate to even mention the subsidies available through the ACA. I don’t think traveling therapists are who the subsidies are intended for, but at the same time, buying your own insurance can be expensive, so you might as well get as much help as you can. I know, with my half year working fully-taxed in my home state of Colorado, that my taxed income is too much for me to qualify for a health insurance subsidy. However, those of you working the entire year in situations that are heavily tax-free and for therapists that are recently graduated from school, I bet you’ll qualify for a subsidy to help with your health insurance plan. The one catch with the subsidy is that even though it’s called a subsidy, it’s really a tax credit that you’ll receive when you do your federal tax return, and if your income is more than expected through the year, your actual subsidy can be decreased. Proceed with caution. Here’s a link that provides good, easily understandable information about the health insurance subsidies: http://obamacarefacts.com/obamacare-subsidies/

Pros: It might be your only choice. It will travel with you where ever you go.

Cons: Can be expensive, rates are even higher if you have pre-existing conditions. You must make sure your plan covers you nationally.

A Tale of Two Cars

After 9 years of working as traveling Physical Therapists together, my wife and I have found cars a lot of interesting ways. When we started traveling, we would each drive a car cross country to get where we were going, but in time found road trips were a lot easier when we shared the driving in one car. This has led to us buying a lot of random vehicles on Craigslist when we arrive at our destinations… and later selling them on Craigslist. Throw in a handful of assignments in the 49th and 50th states, and the resume of vehicles we have owned is, from my viewpoint, impressive: A 1984 Chevy RV in AK, a VW Passat in Hawaii that broke down within 2 weeks, a subsequent 3-month rental car in Hawaii, and a Honda Civic in Maine that the entire exhaust system fell off of gradually piece-by-piece to be collected in the trunk and eventually sold to the next owner – so many memories too: the power back window of a 97 4Runner (best SUV feature ever), the Camry with the cockroach infestation, strapping 2 kayaks right onto the roof of that same roach-infested Camry, and living-in/maintaining/improving a camper all last summer back East on Martha’s Vineyard.

I take any opportunity I can to share pictures of the camper we lived in last summer. The ends pop-out, so our living space was slightly larger than it appears here. We'd eventually set-up a tent room on the deck and made it look a lot more homey too.

I take any opportunity I can to share pictures of the camper we lived in last summer. The ends pop-out, so our living space was slightly larger than it appears here. We’d eventually set-up a tent room on the deck and made it look a lot more homey too.

There’s so many vehicles, homes, and vehicle-homes, I can’t even remember each one. For now, I do want to share the two very different stories of the two vehicles we have right now in Hawaii.

We were working in our usual winter jobs in Colorado when we secured our jobs way out here in the Aloha State. Having worked previously on the rural island we’re currently on, we knew we wanted to have a 4-wheel drive vehicle. It can be tough to get a decent 4×4 here, because everyone who has one drives it into the ground. Lucky for us, we already owned the perfect vehicle for the trip. Our 2007 Toyota Highlander (“McLeod” – there can only be one Highlander), has been an awesome car, but we’ve started to pull more and more toys that are above its towing capacity. A Highlander is a great SUV offering a comfortable ride and good handling on rough road and in the snow, but it is definitely not meant to tow campers over 12,000 ft mountain passes – and we like to do that sort of thing. So, it was decided, McLeod would come to Hawaii with us, we would enjoy having a 4-wheel drive vehicle to access the off-the-grid mountains and beaches. We hope to sell McLeod here at the end of of our time in Hawaii – he will live out his retirement years in the islands. We will then return to Colorado and buy a truck.

A lot of research went into the logistics of getting McLeod over to Hawaii from Colorado. We (Kate actually) learned a lot about the vehicle shipping business. We have friends who shipped a car from Colorado to Florida for about $800 a few years ago, which sounds very reasonable to me – I’ve recently heard similar prices from other travelers. There’s a lot of different ways to try to find a good deal for shipping the car cross country. You can ship by rail which I think offers the best deals, but seems to be inhibited by the time it can consume in transit and the need to drop off and pick-up the vehicle at a major hub. It’s not unusual to have a narrow window of time to drop the car off with several weeks wait to receive your car on the other end. Shipping the car by truck is more common and, in theory, easier, but is didn’t mesh with our schedule.  The way the trucking system works is that the shipping companies you contact simply act as brokers between you and the truck drivers. You set a price you are willing to pay as a bid, and truck drivers are able to accept or negotiate the price – there are numbers available to give you an idea of what a typical car transport from, in this case, Aspen to San Diego might cost. Basically, you submit a bid and if there’s a driver headed West that likes the price and wants to swing by and pick up your car, they will accept. Also, if you live in an isolated place, you can offer to bring your car to a place closer to a major highway and this will cost you less as it’s more likely to be on the driver’s route. Because of this arrangement, you can find a trucker to take your car on pretty short notice. It’s a great system, except that you frequently don’t know exactly what day the driver will show up to take the car, and you need to have someone available to drop off the car and then receive the car on the other end. For us, it just didn’t work. We only had one week between work in Colorado and work in Hawaii and needed to dump the car quickly and get out to Hawaii.

Last year, we were leaving Colorado and wanted both cars back in New England. But, we wanted to share the driving. Our solution was McLeod towing our un-named Celica on a U-Haul dolly. I'll never do this again. The dolly made such a racket, and we couldn't pull off the highway in any cities where parking might be an issue - might not sound that bad, but, trust me, it was pretty awful.

Last year, we were leaving Colorado and wanted both cars back in New England. But, we wanted to share the driving. Our solution was McLeod towing our un-named Celica on a U-Haul dolly. I’ll never do this again. The dolly made such a racket, and we couldn’t pull off the highway in any cities where parking might be an issue – might not sound that bad, but, trust me, it was pretty awful.

We eventually set a plan to drive to San Diego and ship McLeod from California out to Hawaii on a boat – it costed us about $1000 to Honolulu, another $400 for the transfer to the island we’re currently working on – reasonable as far as I’m concerned. A few days before we were set to wrap up work in Colorado and get on the road, our boat was cancelled (with our money already paid), and an alternate boat had to be scheduled. We ended up having to leave a little early and make a sprint straight from our last day of work in Colorado on a Saturday to San Diego for a Monday car drop off. We ended making the trip with time to spare and saw some of the South West which I truly haven’t seen a whole lot of. Then, we were off to Hawaii! Unfortunately, the car would take 3 weeks in transit, so we had to come up with another way to get around the island in the meantime.

We had considered having a second vehicle – for the time until McLeod arrived and for the occasional times we would want a second vehicle. Maybe just a moped or dirt-bike would do for traveling the short island distances. There’s some rental cars available on the island, but they would cost us $200-$300 for each week we had to wait for McLeod to arrive. By some stroke of fate, it turned out the PT traveler before us had been driving a car around for the last 7 months that he wanted to sell for $1000. Honestly, I didn’t need to hear anything else – a $1000 car that drives? Sold.

I spoke with the traveler on the phone about buying the car, a 1982 Cutlass Supreme. The traveler was a real relaxed guy who I would later get to know personally – he clearly fits in with with the island lifestyle. Side note, he would explain to me, “I like to get in the ocean at least twice a day.” He had bought the car for $2000 from a traveling RN, and after his 7 months of use, he felt he had gotten his monies-worth out of it, and he was willing to let it go for 1000 bucks. He had no trouble with car, it always started up. The windshield wipers could occasionally get stuck in the on position on a sunny day which could be embarrassing, but other than that, it was a great buy for $1000. The travel PT had told me that the car only had 25,000 miles on it, “after all, it’s been on an island its whole life”. Upon further investigation, there is no 6th digit on the odometer of this car, so who knows how many times it has been past the 100,000 mile mark. But this 1982 Cutlass Supreme does drive. It likes to go. It’s a Brougham edition – I’m not totally sure what that means, I think Brougham might be the company that did the interior of the car (upholstered front bench seat and all) – naturally we have named him “Brougham”.

Jai, the previous travel PT still trying to sell me Brougham, even as I'm returning from getting cash out of the ATM. Awesome car.

Jai, the previous travel PT still trying to sell me Brougham, even as I’m returning from getting cash out of the ATM. Awesome car.

Brougham has been a blast. Great beach/island car with real street cred. We know the local guy who originally owned the car for its first 20-or-so years. He occasionally stops me in the middle of traffic in town to harass me about taking care of the car. It floats like a boat around corners and over speed bumps – Brougham is pretty awesome. I was able to restore some original glory through re-attaching the hood ornament and some of the original insignias to the trunk that had fallen off over years due to rust and who-knows-what else.

After about 2 weeks of work, McLeod finally rolled in on the Monday barge – barges come on Monday and Thursday with all the supplies for the island, including everything you could end up buying at a store. The barge is a nice reminder of what an isolated place we live in, how all packaged food and supplies come from somewhere, and that the waste we produce has to go somewhere as well. McLeod has been the 4-wheel drive beach-and-mountain-mobile we have needed him to be. It’s also nice to have A/C on an 80 degree day. Even with McLeod here and offering a smooth, cooled ride, Brougham has not sat idle long. The Cutlass Supreme is just a fun car to drive and gets us enough puzzled looks that we take it out frequently.

We hope to extend this contract for another 13 week stint before returning to Colorado for the winter. If for some reason we can’t extend, then we need to get For Sale signs on these cars soon and let the cycle start over again. When we get back to Colorado, we’ll be looking to buy a truck – preferably something from this decade with some good towing capacity. Until then, McLeod and Brougham will keep driving us in circles around this island, up in the mountains and down to the beaches. I suspect we’ll create some good memories of each of these vehicles between now and then.

Aloha! See you out on the open road!

 

A Tale of Contract Negotiation

travel PT contract negotiationAfter a few hours of skiing this morning, I had one heck of a day wheeling-and-dealing a travel contract. I ended up with a couple extra hours and thought I would quickly share the experience.

Kate and I are trying to return to a small, remote community hospital that we worked at a couple years ago. We absolutely loved the community and would love to return this summer for 3 or 6 months. We’ve been speaking with the rehab director over a few weeks and have established that there are 1.5 jobs (60 hours/week) available for the two us this summer. We’ve just been waiting, and waiting, for some details and pay numbers to come through. We had previously worked for this hospital through an agency, but the hospital requested we do an independent contract if we could. Finally, this past week, the ball got rolling, we filled out applications with the hospital and a proposed pay package came to us. I was pleasantly surprised with what the package offered – a rental car and housing included but a little too modest hourly pay. I sat down to crunch some numbers and with my estimates of housing cost, rental car, etc, the package fell well short of what we would be making at the same facility through an agency. I figured there was some wiggle room and while a rental car was a nice perk, we don’t really need a rental car and could perhaps negotiate it into a higher hourly pay. When I got on the phone with HR this morning, I was briskly informed that there was no room for negotiation – the offer we received was the final offer. Could we remove the rental car and turn that cost into hourly pay? No. Could any of the money be offered as tax-free per diem? No. How much are they paying for the condo? …a lot more than we would pay for a condo on our own. Bottom line, there was no wiggle in the pay package and I had to insist that we figure out a deal through a staffing agency because we would make a lot more moolah working the same exact job. But, the insanity wasn’t finished yet – just inform our recruiter to work with the hospital to set up the gig, right? No, the hospital has a policy that travel jobs must be posted publicly through a “vendor management system” (more on this later).

That’s the story on how this contract has come to be, but there’s a lot of nuance to break down and comment on that I believe offers some insight into the travel industry. First, non-negotiable!? Why wouldn’t we be able to negotiate a different pay package? While I did enjoy what was offered to us directly by the hospital, a lot of the value of the total compensation was spent on things I don’t need. Also, the tax free benefits available through an agency give them an edge on what the hospital could offer me. Here’s the factors that I believe led to the breakdown in the hospital’s ability to offer Kate and I jobs directly:

  1. A rental car. This is a huge cost. When going to remote areas, we tend to buy a Craigslist car and sell it at the end for minimal loss. If the money the hospital was pouring into renting us a car was converted into hourly pay, we  would have completed a deal directly with the hospital.
  2. Housing – When working for an agency, we typically take the housing stipend and find our own housing rather than taking housing offered through the agency. We do this, because with a little footwork, we can find housing that is better suited to our needs and costs less than the generic, supplied housing. This is exactly what happened with the hospital’s offer – we had budgeted $1200/mo for housing, and they were estimating $2000/mo. Sure it’s convenient to have housing set up for us, but not at a total of $2400 above our budget over the course of a 3 month assignment. (post-script update: We secured housing for $1100/mo – in the same exact condo complex the hospital was offering us housing in. This works out to $2700 more dollars in our pocket versus our initial  contract offer from the hospital.)
  3. Tax advantage – The hospital told me they had looked into their ability to do tax free payments (like per diem) and that they had chosen not to take it on for the tax difficulties it presented. When a portion of your pay is tax free, it really ads up. That was one reason I initially liked them supplying the housing. When they rent it for us, it’s like getting money before it is taxed. A great benefit!
  4. The nail in the coffin: HR literally told me, “We only pay a few more dollars per hour when we work with an agency, so we’re fine with that option.” A few dollars per hour!? That really ads up. Offer ME that money, man! Come on.
Kate and I enjoying the waning moments of our spring-time skiing before jetting off to the next contract in a couple weeks.

Kate and I enjoying the waning moments of our spring-time skiing before jetting off to the next contract in a couple weeks.

While I believe those are the main factors that ultimately led to the breakdown in our ability to work out an independent contract, the insanity was not finished. I mentioned that they had to use a vendor management system (VMS). There are several big VMSs and our contract was posted through the one I am most familiar with – if you have traveled for a while, you have probably had a job that was posted with this system. What exactly is a VMS, you ask? It’s the 4th party in a 3 party contract. VMSs collect job postings from facilities by handling a large portion of the foot work for the facility. These VMSs blast those jobs out to a bunch of different staffing agencies who subscribe to be a part of their listings. Have you ever had multiple agencies post the same job at the same time? If so, that job is posted through a VMS. Some larger companies that own multiple staffing agencies also own a VMS so that they can collect exclusive postings from facilities and post them solely through the staffing agencies that they own – big, shady business. The VMS that this job was posted through (where the facility, the clinician, and the recruiting agency were all known entities) charges a price of 4% of the total contract. So, again, rather than just paying the therapists, more money is being thrown at paying another company a good chunk of the available pay.

Lunacy, complete lunacy. But, you know what? Kate and I are returning to the jobs we want this summer. The contract eventually worked out through a staffing agency and we’re happy with the deal. It’s too bad that when you have a facility and a clinician that want to work together, it takes two other private companies to organize the employment. But, as long as facilities refuse to pay clinicians the money they are willing to pay to outside companies, traveling therapy will remain a strong industry and a great career choice for therapists all across the country.

There might be a second chapter to this story. We only have 60 hours of work between the two of us this summer. I’m currently working on establishing a contract with the state to do some part-time work in a very cool, very unique consulting situation. They are a little concerned with my temporary status, but I think I could do some great work for them in the time that I do have. I know, I have given you no details here …top secret… for now. Hopefully this part-time job will work out and I’ll have some very cool, very unique stories to share with you all. See you out there on the open road!

Traveling Therapist Taxes – It’s Complicated

I haven’t shared an email in a while, so here’s one I received recently that I thought offered some insight into the complexities of traveling therapist taxes.

Traveling Therapist TaxesTraveling Therapist: My wife and I traveled for a while but then had accepted permanent jobs, we are considering the traveling therapist life again and this brought up some questions in our minds. We are currently renting in Kansas, but when we go to travel again, we are trying to figure out what we need to do as far as claiming a tax home. I was originally living in my parents’ retirement house in Florida and was paying rent to them. My concern is that I might not have a place to claim as my tax home when we go back to traveling. Have you bought a house? What is the best way for us to claim a tax home?

HoboHealth: Oh man. Good questions, complicated questions, more complicated answers.

A while back, Kate and I bought a cheap condo up in Maine that we thought would be our tax home. We figured it would be an easy return on our money: 1. The market was way low, and we bought the place dirt-cheap 2. We were paying monthly storage fees that would be eliminated by moving our spare furniture into the condo 3. We’d have a nice, solid, unwavering permanent address as our tax home to collect all of our tax-free bene’s.

Unfortunately, at the same time we purchased the apartment, we had racked up a few years in a row returning to the same job in Colorado seasonally in the winter. Apparently, this is one overriding exception to the standard rules for maintaining a tax-home. If the majority of your work is done consistently in one place year-after-year, that becomes your tax home. The example I get from my tax guy is always pro sports players. If a player maintains his permanent home in Green Bay, but plays for the Texans, the majority of his work is consistently in Texas, and Texas is his tax home despite Green Bay being his permanent address.  You see, Texas is his work place, that’s where he consistently makes his money, it doesn’t matter that he lives in Green Bay. This doesn’t apply to most travelers, because they move often enough to avoid establishing a consistent place of work.  Confused yet?

The other thing that completely blindsided us was that Maine was taxing us at 4% income tax on everything we made, everywhere we worked – despite Colorado being our tax home, Maine considered us permanent residents by their law. We owed Maine over $5000 at the end of that first year with a condo there! Bush league, we got hosed. Just thought I would share my convoluted situation to demonstrate some of the complexities of the tax-home issue before actually answering your question.

So, to summarize your situation: You had a tax home established at your parents and were paying them “fair-market” rent to maintain a home there, but then went to live and work in a different state and have been renting a place there. You’re wondering how to establish a new tax home for when you return to traveling shortly. Has it been less than one year? …I’m thinking you may just be able to pay your parents back-rent for the year and file your 2015 taxes at their address, then you can just carry-on with the situation you had.

The other thing I have heard of, but not ever from anyone that I actually know first-hand, is purchasing super-cheap housing in a 0% income tax state like South Dakota or Florida and establishing that as your tax home. If only it were really this easy. My understanding is that there’s a lot of other factors that the IRS looks at to strengthen your claim for a tax home – driver’s license, vehicle registration, memberships (gyms, clubs, etc), bank location – the more things in your life you can put in one place, the better your argument for that place as your tax home. It is not black-and-white.

Now, let’s say you either re-establish your parent’s home as your tax home, or you somehow establish somewhere else as your tax home. Remember this mantra that has helped me keep my life more sane: You live at your tax home, you are only working temporarily at your travel destination. This is an important distinction. Some states want you to get a driver’s license in their state or register your vehicle there after living there 30 days or less – in your case, you are not living there, you are only working there temporarily. If you are pulled over, you should be clear with the officer that you are only in that location working for several months, you live at your tax home location. Clear?

Staffing agencies will try to make these issues very clear-cut. They’ll frequently give you a checklist for tax home and if you are able to check off a certain number of boxes, you are OK in their eyes to receive tax free money. They may tell you if you work 60 miles from your tax home, you are OK to collect tax free money. There are no laws related to travelers that are this precisely defined. The real laws are much more vague and open to interpretation. Do the best you can to strengthen your case of claiming any one particular place as a tax home so you can confidently defend when/if the IRS comes knocking. And when a recruiter assures you that your tax home is legit, remember that the end responsibility is YOURS and yours only.

Your best bet to get your taxes right is to talk to a tax professional who specializes in travelers. Searching for “travel RN taxes” on Google will give you a variety of options. Good luck trying to understand all this stuff, it’s complicated.

All That Junk

For a traveling Physical Therapist supposedly living some sort of minimalist lifestyle, I have a ton of stuff.

There's our slick little trailer. Super-easy to tow. Perfect for us, except that we have no place to keep any of the stuff inside it.

There’s our slick little trailer. Super-easy to tow. Perfect for us, except that we have no place to keep any of the stuff inside it.

When Kate and I moved into a camper this summer, we brought a concise amount of stuff with us from our seasonal life out in Colorado. We typically leave our ski and winter gear in a small storage area, this year we left some additional stuff knowing we’d be living in the small confines of a camper. Living in a camper went awesome. Having just a couple suitcases worth of clothes and very little other belongings was a great way to simplify and organize life.

Kate and I had a ton of stuff stored at her Mom’s house up in Maine – and we needed to get the majority of it out. We ended up leaving a few canisters of clothes and other things at her Mom’s house, but were able to regain ownership of a lot of stuff that we never actually missed. Originally, we thought we’d rent a Uhaul to make the trip, but after looking at prices, we reconsidered and bought a new trailer for just a few hundred dollars more than the price of renting one for the week. We filled the brand new 4′ x 6′ trailer to the brim with pictures and knick-knacks from childhood, college, and our wedding. An entire pick-up truck worth of stuff including several boxes of text books from PT school found its way to Goodwill. I would love to have the luxury of time and space to bring the books with us and try to sell them on Ebay for some easy cash, but we only had a few days to get on the road headed west and no space at all for the books to tag along – they had to go. Following 5 months in a camper, we were of the minimalist mindset and did a good job of tossing away A LOT of stuff. Regardless of our success in eliminating as much as we did, we headed to Colorado with our SUV and trailer both full to the brim.

Several weeks, and a couple trips to the storage area later, we have all of our stuff safely inside our hospital-owned condo in Colorado. Life appears mostly normal in our condo except for a persistent stack of plastic bins hanging out. I move multiple times per year, what on Earth do I do with old photo albums, framed diplomas, and my most favorite DVDs and books!? These things have no place in my current life, but I think I would really miss them some day if I were to throw them out. On the other hand, what if a camper becomes a more regular part of my life, or if we move into a small home without much room for storage – then these things that I like having, but rarely miss, will certainly have no place in my life. The idea of a perpetual storage area seems like such a waste.

Rad. Traveling Physical Therapist

Doesn’t everyone bring a totally rad pair of skis from the 80’s on any good road trip?

So, for now, we have one car-load of stuff that travels with us – this is the stuff we actually “need” in life. We have a 4′ x 6′ trailer and a 5′ x 5′ storage area of other stuff. Admittedly, a good amount of the storage area is dedicated to ski equipment and other forms of winter recreation, but the volume of stuff remains overwhelming. So, what am I to do? I have much more stuff than I truly need, but most of the things that don’t have a utilitarian purpose in my life have some high sentimental value. In talking with a few friends, it seems most people have a couple boxes of similar stuff despite efforts to whittle it down. For now, I suppose I’ll keep going through the photo albums and memory boxes to try and identify the difference between important memories and junk that holds little value. It seems that the only time I see this stuff is when I’m trying to pare-down. So, maybe the process of elimination is exactly what puts the objects with out any real purpose to use. For now, the process of going through and reducing the clutter is exactly what allows me to crack the binding on these old albums and enjoy them.

I do look forward to sorting through old photo albums and newspaper clippings that I have long forgotten – reliving memories that may be lost without these little reminders tucked away in a closet or storage area. Should be a fun winter exploring all the knick-knacks, but let’s hope that there’s a lot I can part way with, because it’s not all going to fit in the 5′ by 5′ storage area at the end of this winter.

My Landlord is a Clown

As a travel PT, I have learned that interesting housing situations present themselves frequently. I thought living in a camper for 5 months this summer was the great housing tale of the summer. Maybe not…

10/13/15
It’s Tuesday evening, the campground closes tomorrow morning and we have to move from our camper for one month before this assignment is over. The camper has sold, tentatively on Craigslist… the plan is to grab the cash for the camper when we move out tomorrow morning and have the buyer tow it away. Until then, the Craigslist ad will stay active.

The place we’re moving into is a small one bedroom cottage in Oak Bluffs, housing and rent are brutal on Martha’s Vineyard, that’s what pushed us into the camper in the first place. We had heard from our new the landlord that there was a septic issue that was being fixed earlier this week, today, we learned more.

The landlord said, “I hope the septic is done by the end of the week, but the plan still needs to be approved by the town.” Well folks, I know a developing story when I hear one. We’re stuck, housing is awful here, there’s no choice but to move into the toiletless cottage. We can’t use running water, but luckily, the landlord lives in a house across the driveway with various renters. Looks like we’ll be walking over there for cooking, bathroom, showers, etc for a while. I hope this is a short story, but I’ll be entering journal-style entries until this saga comes to an end. Fingers crossed, wish us luck!

South Beach on the left, wrapping around to Chappaquiddick. We spent many-a-weekend on South Beach grilling and chilling. Took this picture on the way over to Nantucket for a weekend visit with a travel PT/friend over on the neighbor island.

South Beach on the left, wrapping around to Chappaquiddick. We spent many-a-weekend on South Beach grilling and chilling. Took this picture on the way over to Nantucket for a weekend visit with a travel PT/friend over on the neighbor island.

10/14/15
It’s move-in day. We have cash for the camper and no longer own it. An unattended backhoe sits on a pile of dirt beside our otherwise quaint and cute little cottage on Martha’s Vineyard.

Our landlord, a professional clown (no, literally), has given us a tour of the main house where we will be doing anything involving water. Funny tangent: Kate told me one of her patients who lives nearby had asked who our landlord was. When Kate gave her our landlord’s name, the patient replied, “Oh, I think she is the clown.” At the time, Kate left it alone not knowing exactly what the patient meant.

There’s one tenant staying in the main house until Friday (two more days) named Nefertiti who the clown says is from, “Serbia, no that’s not right. Hungary. No. I don’t remember.” We’ve been in and out for two days now and have no sightings of the other tenant. The sun is setting, we’re moved in, a normal work week goes on, I’m pooped.

10/16/15
It’s been a busy week. We’ve worked a normal week, moved out of the camper, sold it, moved into the cottage, and been otherwise generally busy in life. I’m slowly adjusting to going over to the main house to use the bathroom and wash dishes. I’ve avoided taking a shower there and instead used it as an excuse to hit the gym before work and shower at the gym instead. I routinely showered at the gym when we were getting the camper shower water-tight earlier this summer. Kate has been showering in the main house and calls it, “a mild inconvenience.”

Last night, I met Nefertiti on her last night renting in the big house. She came downstairs just as I was standing in the kitchen chopping avocados and holding a giant knife. I saw her and said, “Hi I’m James.” She quietly and nervously introduced herself asked if our landlord was around. Our landlord was not around. “Neffy” quickly headed back upstairs, leaving me in the kitchen with the avocados and the knife. I think she is used to random renters being in the kitchen, but I can’t help but wonder if I startled her.

Today is Friday, and our landlord said she had been calling the town planning board, but hasn’t heard back yet. I guess hope for the septic tank being completed by the end of the week is a thing of the past. I feel like the walk across the driveway to the bathroom and kitchen is what it must be like living in a mansion, walking really far to get to other rooms. We’ve started referring to the main house as “The West Wing”. I doubt any developments will happen over the weekend, to be continued on Monday…

Our small, but quaint cottage peaking out behind the mounds of dirt and constant ground work.

Our small, but quaint cottage peaking out behind the mounds of dirt and constant ground work.

10/17/15

Today, we evolved. We got a large wash bin to use in the kitchen sink. That way we wash dishes, or whatever, in the sink, when the wash bin fills up, it gets dumped in the bushes out front. It’s nice to have a sink. Still no Toilet.

10/19/15

We’ve really settled into the situation here. The landlord has been away at a conference… clown conference? Nefertiti’s season has ended, and she is gone. So, we’ve had our little cottage and the big house across the driveway all to ourselves. The walk across the driveway in the morning for a shower has become casual. I feel truly suburban for the first time in my adult life as I stroll across the driveway in full view of neighbors wearing my plaid bathrobe and LL Bean moccasin slippers. This isn’t a bad set-up, but I wish the work would get underway to fix the septic.

10/21/15

Today, the septic guy showed up, and it’s game on! He says we’ll be without plumbing for a couple hours while he hooks up the new tank tomorrow, but then we should be good to go! He got the back hoe up and running today, and, as far as I can tell, just pushed some junk around in the yard, might have smoothed out some dirt too. The backhoe is in the yard directly beside the cottage, it is also just about the same size as the cottage. Should be an interesting process.

10/22/15 – PM

Houston, flushing is go. All our plumbing needs are being met. Today the septic guy, Vinny, had me flush some toilet paper inside. We rushed outside and we saw the TP happily float into the tank. A clear sign that Vinny, as he noted, “has enough pitch in the tube. Shouldn’t have any problems.” Very relieved to be done with the West Wing and my morning strolls across the driveway for a shower – hopefully, this story is over.

Two weeks later… 11/4/15

Vinny and his rig at work just off our front deck.

Vinny and his rig at work just off our front deck.

I thought we were done. When this tale started, I thought I saw a developing story and would write because it would probably turn out tragic… entertaining, but tragic. It hasn’t been tragic, but the story isn’t over either. The day after the cottage was hooked up to the septic, the main house got hooked up. Every day since, I have thought it would be that last day of excavator work in the yard. Except now, the holes in the yard and piles of dirt by the cottage are getting bigger. Apparently Vinny is working on the leach field now. While it is kind of educational to look in the hole every morning and evening and see the process, there is a little wear to having construction vehicles in the yard everyday. We leave the island for a little R&R today before our next assignment in 10 days. The race is on, Vinny. Who leaves first? Is it us? Or is it you?

Post-script

The kind of movie I hate the most is the kind that isn’t a story. You know, movies that are just a snippet of time and don’t really have a beginning or ending. The most recent one I saw like that was Silver Linings Playbook. What the hell was that, Bradley Cooper!? No ending to that movie, just ends mid-story. Oh wait, did I just ruin the ending for you? No, because there isn’t one.

Anyways, I feel like this snippet of time needs a conclusion, consider this the special content after the credits have rolled. When we ran into trouble with this place, we didn’t really have any other choices for housing. This was it. We could either worry about the constant work going on around us or just accept it and live our lives in our cute little cottage. We could have worried and battled our landlord to hurry the process up, or give us money back, but we didn’t. We accepted it and thrived. I think this is a vital survival instinct that anyone who is a healthcare traveler needs to have – don’t stress, just cope. Most of the travel therapist life is smooth, but if you travel for more than a couple years, you’re bound to run into some sort of adversity: a contract gets cancelled, you go unemployed for several weeks looking for a job, your new assignment isn’t what you had thought it would be, or, ahem, your housing has no working toilet. The bottom line is, if you can roll with it, it will pass. The nature of life as a traveling therapist is that things are constantly changing, progressing…. moving on. If every bump in the road gets you in a tizzy, you’ll struggle. But, if you accept these situations for what they are – passing inconveniences – you’ll move along quickly to the next stage. Hopefully, at that next stage, you’ll find that things are going better than you had hoped: your new job is better than expected, your employer wants to extend the contract, your new housing has an awesome shower.

“Just Roll With It” was the alternative title to this blog. That’s the conclusion. In traveling, roll with the punches. If one assignment has troubles, the next one is bound to be awesome. Good luck out there in your ever changing world!

Vinny did get the hole closed up and grass seed down 2 full days before we left. Strong work, Vinny.

Onto the Next Travel Assignment

hoboblockBeing a traveling Physical Therapist requires frequent, and constant change. Week 13 or whatever is the last week of your contract will inevitably be your busiest. Hopefully work slows down a little bit that last week as you discharge a bunch of your clients and transition others to different therapists, but life outside of work gets busy. That last week is full of organizing, packing, working on logistics for travel to the next assignment, and often time actually interviewing for and nailing down your next job (and, if you’re really dense, you’ll try to write a blog this week… brutal).

All the chores outside of work on the last week of an assignment make it a stressful week. I’m currently 3 days from my next move and finding myself relatively relaxed. Clearly I’ve learned something over time about making the transition from work to road trip to work. But what is it? Here’s my reflection on the things you can do to take the crazy out of your next job change.

Acceptance

Accept it! This week is going to suck. At work you’re doing a ton to discharges and transitioning patients to other therapists. Embrace it, every waking hour this week you will be working or packing or planning. The only way everything gets done is by finishing one single task at a time, start chipping away.

Goals

If you can identify one group of things you have to accomplish each day, you will break up the burden. To take everything on in one day is too much. Today, I wanted to take the recycling to the dump, get the tail light on the car replaced before the drive out west, and get out one last blog before disappearing on vacation. Boom! Done! I got stuff done today, I feel accomplished, and I’m a few steps closer to being ready to jump in the car and be on my merry little way.

Say Goodbye Efficiently

Yeah, it’s very unsentimental of me. Get over it. You will get requests from friends, co-workers, and mysterious others  for one last hoorah, a chance to say goodbye. The more saying “goodbye” you can do the week before your last week, the better. Get out ahead of your friends and start inviting people to dinner before it’s your last week. You’ll have a blast, you’ll get to spend some good time with friends, and it won’t take precious hours out of the time you need to be packing. If you get stuck in the last couple days tight for time, invite friends over to hang out at your place while you putter around packing and cleaning – if they can drink your wine and eat your food, you don’t have to move it.

Be Good

Everyone knows you’re busy, but do take the time to do the right things. Wrap up all your paperwork at your job. Close cases that have been left inactive. Clean up your work space – effectively tie up all your loose ends and make it seem like you were never there. They say the best referees in football are the ones you that you don’t notice are even there, same goes for travel therapists.

A Time for Rest

When the opportunity arrives, take a break. I very frequently find I reach a point where I have done what I need to do for a day, and rather than stopping, I press on. You’re a traveler. Hopefully you’re living this lifestyle to experience different places and cultures. When break time comes, get out to that restaurant you meant to go to one more time, or go enjoy one last sunset at your favorite vista. Hopefully you’ve enjoyed the town you’ve lived and worked in for thew last few weeks, take one last chance to soak it in.

——-

I think that’s all I have tonight, folks. Most of my bags are packed, but I’m doing home care, so the car has a lot of work stuff in it. I need to finish work before I can start packing the car.

From here, on Martha’s Vineyard in Massachusetts, we’ll make trips to Maine, Florida, and Italy – for family time and fun – before driving out to Colorado for the next assignment. I’ll post pictures on the travels as I go, but you may not here much from me for a few weeks.

Enjoy where ever you are!

 

#Camperlife

Watching football on the camper's big screen.

Watching football on the camper’s big screen.

Kate and I had wanted to live in a camper for a while. We had this old, awesome RV in Alaska a few years back and had always talked about living in one for a full summer. When we accepted our assignments on Martha’s Vineyard this summer, we started looking at apartment rents and quickly realized living in a camper was our cheap way out.

The funny thing is, 5 months of camper living have passed and I barely even recognize that it happened. I had all these grandiose intentions of sharing all kinds of tidbits about “#CamperLife”, blogging about the great advantages of living in a camper and having some great take-away message after almost half a year living in 150 sqft. I posted less during the time living in the camper than I intended. When I did post, it was mostly pictures of campfires. Now that it’s over, I have no revelation, I have no great take-away message, I have no feeling of great accomplishment from living a minimalist life. It just feels… I don’t know, it’s like I’ve simply lived in a small apartment that I really liked.

Our main kitchen for the summer. Cooking indoors will never be the same. The kitchen sink was a garden hose.

Our main kitchen for the summer. Cooking indoors will never be the same. The kitchen sink was a garden hose.

There are a few appreciable improvements on life that are worth mentioning. I spent the vast majority of this summer outdoors. We had a great screen room and deck that was where we spent all our home time – 3 months went by where I didn’t cook a single meal inside. Meal prep happened on our outdoor stove top, grill, and fire pit. All this outdoor cooking and campfiring left me wondering about whether my carbon footprint was really improved by living in a camper. Originally I had thoughts of buying solar powered generators to be really minimalist in energy usage, but our very shaded campsite put the kibosh on that very early on. Our entire electric usage for the summer was about 750 kilowatt hours, my understanding is that for 5 months, that’s a relatively small amount of electricity. I figure with all the campfires we had, that we broke about even on our carbon production – sorry, Earth. I did find myself a little more in-tune with nature through all of our outdoors time. Most days, I could tell you the sunset time within 15 minutes, could tell you whether the moon was waning or waxing, and could describe any recent changes in the flora and fauna surrounding our campsite… so that was pretty cool.

People have been asking, “How’s living in a camper?” It’s fine, it really hasn’t been much of a change from how I like to live. It’s cool that I’ve lived minimally and mildly increased my connection with nature, after all, these are two things I have been looking to enhance in my life. So, if you’re wondering if living in a camper is for you, go for it. Hopefully you’ll have a very pleasant and unsensational experience like mine. Although, now that I think about it, maybe my blasé experience says less about the experience of living in a camper than it does about me. Maybe it didn’t affect me because I’m built for this. Me and a camper fit together so seamlessly that I barely noticed it. Let’s latch home onto the back of the car and keep moving – maybe I could be a traveler forever.

See you on the road.

The New Grad Dilemma

new grad therapist travelNote: I have included a lot of links in this piece and there is a ton of information beyond this article through those links. If you are a new grad therapist looking into travel, take the time to explore these links. Some are other pieces about new grads traveling, some are about professional development, and some are conversations on the discussion board that are pertinent. Note 2: I’m going to write this post using “Physical Therapist” language, but I believe this topic applies to speech and occupational therapists as well. I feel passionately about this particular post and found myself getting bogged down in language trying to be more inclusive of all therapists – so, forgive me, I really mean all therapists, but as a PT, I just write more gooder when I can write in the terms most familiar to me.

In the last couple months, I have written and spoken with quite a few new grad physical therapists who are going straight to traveling after graduation. With several of these new grads, I have had the opportunity to give my typical schpeel:

I do not believe you should travel as an immediate new grad therapist. I believe you need at least a brief experience as a PT with your own patients and own license alongside other experienced therapists to get to know yourself as a clinician and what life as a professional in a good clinical setting is like. That way, when you run into employment, management, or ethical red flags on assignment, you can recognize them and react appropriately. As a student PT, you have gained great knowledge that is more up to date and in depth than many currently practicing clinicians. You have also likely managed your own patient case load and treated a wide variety of cases. But, you have never done this without a safety net – with everyone expecting you to be the person with the answers. Do you need to be an expert clinician to be a successful traveler? Absolutely not, but I recommend you have some sort of professional experience, because there is frequently less support around you as a traveler than there would be in a more stable environment. I do not think you should travel right out of school, but if you are determined to, I would like to help you down the path to a better traveling experience.

So, in summary: Don’t travel immediately out of school, but if you do, I’d like to help you along the way.

What has my experience with giving this advice been? Failure. Despite my advice, just about every new grad physical therapist I talked to this summer is already working in a travel job or currently traveling to their first assignment. I have lost them to the awesome, kick-ass world of traveling therapy. Can I really blame them? No, being a traveling PT has a lot of benefits and upside, but I hope I can still save a few of you who haven’t signed travel contracts yet. I plead with you, just get a brief stretch of experience as a therapist before you travel.

I’ve written a lot on this topic in years past. I’ll try not to be redundant and instead, as mentioned above, link out to the things I have written in the past. If you are a new grad considering travel PT, earnestly consider whether traveling therapy is the best thing for you right now. Maybe it is, life changes fast and your window to travel may be closing soon, but if you can delay travel for 6 to 12 months, it will improve your experience. What follows is a mixture of “why you shouldn’t” and “if you do” advice.

With the new grad therapists I have been talking to, the most prevalent challenge I have been finding is predatory recruiters who don’t care who you are and who you want to be as a professional. These recruiters are only motivated by the fact that they get paid if they place you in a job. I’m generalizing, but the more predatory recruiters tend to be in the really big recruiting agencies that are staffing-factories. Finding a recruiter as your “employer” is the same as if you were looking for a permanent employer. You would want a clinical employer that allows you to spend solid one-on-one time with each of your patients. Likewise, you want to find a recruiter who has the time to get to know you and give you some personal attention. When working with a recruiter (and I recommend you work with 2 or 3), ask yourself these questions:

1. Does this recruiter know or remember anything about me personally or professionally?
2. Does this recruiter care if I get placed in a good job?
3. Am I steering the conversation of where I am going to work? (or is the recruiter?)

If the answer to any 1 of these 3 questions is “No,” find another recruiter. Don’t worry, there are over 300 Joint Commission accredited recruiting agencies, you’ll find another recruiter. Your recruiter should be WORKING FOR YOU to put you in a situation that best fits your needs and sets you up to grow as a professional. The predictable next-step with any predatory recruiter is a low-ball offer to work at a facility with no other PTs but likely an ungodly number of support staff for you to supervise. In this conversation going on at the discussion board (which I highly recommend you read), one new grad mentions a job offer where he would be the only PT at the facility with 3 PTAs. Which brings another three questions to my mind:

1. If the facility needs a traveler, who is supervising the PTAs now?
2. Does a therapist supervising 3 assistants actually get to treat any patients of their own?
3. How unbelievably bad is this facility that they are willing to hire a new grad they have never met in person to be their only therapist?

Forgive me, I’m just a worried big-brother-PT trying to keep his siblings out of trouble. I know you guys are all (mostly) super-intelligent people and see the red lights flashing on this job offer, but I want to assure you that you have choices and should never-ever under any circumstances work for a recruiter who offers you a job like the one described above – pass on it, this job can be somebody else’s nightmare. I got really lucky with my first assignment, but took time looking for a recruiter that was willing to hold my hand throughout the process. Because I was working at a permanent job, I had the luxury of taking my time to research staffing agencies and search for a job. When I found the recruiter I would eventually take my first assignment with, we searched together for a job that would allow me to work in outpatient and would have other PTs around for my mentoring and growth. It took a few weeks of patience, but that assignment eventually came up. I interviewed and accepted the job, and I extended my contract there twice to ultimately stay 10 months because it was such a great fit for me and satisfied my need for growth as a new therapist – this, ideally, is what your experience should be as a new grad exploring travel therapy. Your recruiter should be some sort of a cross between a teacher and companion who can appreciate what you need in a job and what strengths you have to offer a potential employer. Here’s an older discussion board thread discussing travel as a new grad and selecting your first job.

Let’s talk about why a facility needs to hire a traveler, because I think it is central to why some travel assignments are better than others and why you should have some experience before you travel. A facility hires travelers because they are understaffed. A facility can be understaffed for a number of very benign reasons – an employee is out temporarily for illness or maternity leave, the geographic location is difficult to attract highly educated professionals to, the business has recently expanded or gone through a structural change and is spread thin on staffing, or the area doesn’t have any PT programs nearby so there is a chronic shortage. If you’re discerning, patient, and lucky enough, these are the jobs you will take consistently as a traveler. These facilities generally care about their patients, and, because they care, they will be expecting you to bring a certain established skill-set with you to hit the floor running and start treating patients confidently soon after you start. If you approach the job selection process with little care of where you work and no experience to demonstrate any specific skill set, you’re more likely to find yourself in the facilities that have staffing issues for the other, more sinister reasons – these places are willing to hire any warm body with a license. Facilities can have staffing issues because management is awful, productivity expectations are too high, or the business is unethical. The therapists that put themselves in the situation of working for the clinics with the worse kind of staffing issues are not going to have a good professional life. They will experience stress and burnout, and these are the people you will meet who are cynical about therapy and healthcare business in general. With a little bit of effort and patience, you can dodge lousy assignments – when the red flags go up, pay attention to your gut. If it sounds like a lousy situation, it is. If you can get yourself a year or even just a few months of experience before traveling, your marketability improves dramatically and the quality of jobs available to you will grow.

The reason I feel the need to warn you all about the dark side of traveling as a new grad is because I care greatly about our profession. We are uniquely situated to do great things in healthcare. We are primed to heal patients conservatively without medication or surgery, to heal and promote health in many different venues, and to prevent pain and disease in the first place. All of these things save patients and insurance companies a great deal of money versus other treatment options and will ultimately be our golden ticket as everyone continues to age. In order for our profession to best seize these opportunities, we need to cultivate the best clinicians, and I don’t think starting out as a traveler with zero professional experience will make you the best clinician and ambassador of our profession that you have the potential to be. Just a little time before you travel will get you grounded and set a baseline for your future experiences. There are great advantages professionally and clinically to being a traveler – if you travel for multiple years, you will eventually work in more settings than you ever dreamed of. You will treat patients of more different backgrounds and cultures than you could never imagine, and you will be one of the most well-rounded clinicians with more diverse clinical and world experiences than any of your non-traveler colleagues. Without experience in the setting you would ultimately like to work in, you are more likely to aimless drift from lousy assignment to lousy assignment without gaining a good foothold on who you are as a clinician when you are at your best. As a traveler, professional growth is a solitary experience, you really need to be on the right path when you start. Please, I beg you, travel, it is a fantastic experience, but get just a tiny bit of professional experience first – in the long run, you will be more successful in your travels and you will be a better representative of our profession to your patients and co-workers.