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.

Lightening Round

Grand Illumination Night is a uniquely Martha's Vineyard holiday. A group of a couple hundred small Victorian cottages called The Campground (different than the campground we live at) all hang lanterns on their houses and illuminate them at the same time. We've done some homecare in these houses too - neat, weird little places.

Grand Illumination Night is a uniquely Martha’s Vineyard holiday. A group of a couple hundred small Victorian cottages called The Campground (different than the campground we live at) all hang lanterns on their houses and illuminate them at the same time. We’ve done some homecare in these houses too – neat, weird little places.

I’m going to do now what I do every time I get crunched for time and realized I haven’t posted in over a month, whip off a quick stream-of-thought blog about what’s been happening in my life recently out on the open road. Life right now is in a camper in Martha’s Vineyard, so it makes for pretty easy writing, but it will be a brief one. Don’t expect great grammar, don’t even expect good spellign.

Life has been fast paced and it’s been tough to keep up with the website. There’s been a lot of you reaching out on the discussion boards who are just getting into travel, and we have some good discussions going – so keep it up! I have a couple of half-written blogs for you, but they are posts that require a little more thought, so expect those in a couple weeks. The main thing keeping me busy has been this dang 1/2 Iron Distance Triathlon that I have been training for since I arrived here on the island 4 months ago. It is going to be held right here on the island in just a week and a half, so the end of this crazy, time-consuming training is near. I’m really looking forward to it. The 70.3 miles will cover the entire island and some beautiful vistas, but the training has been ridiculous, so I won’t be doing another one anytime soon.

Living in a camper has been great. I was kept very busy when we first moved in. There were a lot of little repairs that needed to be done. Water heater work, re-sealing some seams, and installing a screen room were the major low-lights of the work. After a few weeks of maintenance and finding out what it’s like to be a homeowner, we settled in and evenings after work have been filled with dinner on the deck and typically a campfire. There’s a lot of things I like about living in a camper, including being minimalist in my consumption of space and energy. The main attraction to the 5 months of camping is being outdoors. I have spent many, many hours on the deck and by the fire. There will a be a couple blogs soon related specifically to living in a camper, so I will digress for now.

Kate working wicked hard on the Vineyard. As I try to claim I've been too busy to write a blog....

Kate working wicked hard on the Vineyard. As I try to claim I’ve been too busy to write a blog….

Being on an island has lent itself to a lot of beach time. Sunday is the big beach day around here. We’ve been captured by friends who throw us in the back of their truck where we drive out onto the beach and create a wagon-circle-type caravan – except instead of keeping women and children in the middle of the circle for protection, there is various grilled meats. Not a bad use of the weekend, every weekend.

Kate and I are both working for a home care company out here. The expected productivity is reasonable, and, being on an island, the driving distances aren’t too bad either. Regardless, it has been BUSY at work. With the seasonal bump of tourists and residents work has been in high-season mode for the last 2 months – Martha’s Vineyard goes from a year-round population of 15,000 to an estimated 170,000 people on island last week! There are signs of the work load letting up a little bit soon. It truly has been a great job.

Just another Sunday on the beach. Great fun carting friends, games, and meats out to the beach for an afternoon of relaxation.

Just another Sunday on the beach. Great fun carting friends, games, and meats out to the beach for an afternoon of relaxation.

The weather has been just absolutely awesome here. We have had about 3 rainy days in the last 2 months – good news for us camper dwellers, and us beach goers. Despite the dry summer, the island life lends itself to insane humidity and with humidity, mildew. Not to wish the summer away, but I’m about ready for some cooler weather so I can stop washing the walls. The campground has really quieted down this week along with the rest of the island. Last night was hoody-weather, but I know we have another month left of solid summer as exhibited by the return of 80 degrees and muggy this evening (peepers peeping like crazy in the trees, love it!). With the change of the seasons, the campground will close and we’ll have to move into an apartment for one month before returning to the mountains of Colorado for the winter.

Expect some more thoughtful and thought provoking posts soon. Among my topics will be new grads traveling, how to select where you want to go as a traveling therapist, and, of course, #CamperLife.

Camper Life

The cold has finally broken me. I just went out to the trunk of the car, where our ski gear is stowed, opened up the bag, and grabbed my wool cap. Back inside the camper that we have been living in for almost three weeks, the oven door is open after dinner to help get whatever residual heat we can from it while the propane heater kicks on and off. When I thought of living in a camper on an island for a summer assignment, I tricked myself into thinking it was already summer in New England – just a couple more weeks and maybe it will be.

It feels like I’ve been waiting forever to write anything of substance about the camper we’re living in. I guess, in reality, we’ve only been living in this camper for less than three weeks. I’d like to wait a few more weeks to write anything so that I have some firm conclusions on what life in a camper is really like, but it’s going to be a long process of adjustment. There’s another 5 months ahead to share all the other things that come up, so why wait… this is the first installation of a series of posts on camper life that I will be putting out this summer and into the fall.

Kate and I have lived in close quarters before. On my very first travel assignment, before we were married, I had a studio in Boston that is still the smallest place I have ever seen – at less than 6 feet in width, you could not lay down on the floor cross-ways without bending your knees. The length of the room wasn’t much longer. Just a twin bed, a shelf, and a very, very small attached bathroom. Later, we would live together in far Northern Maine on a travel assignment in a small one-room cabin. I think this was the first time we became aware of “tiny-living” through some blogs like tinyhousetalk.com. The tiny living movement has really caught since then and shows about tiny living appear nightly on HGTV, DIY Network, and the like – or so I’ve heard, since we’re living without TV.

The cabin we rented in Presque Isle, Maine. Fun fact, "presque isle" means "near an island." Presque Isle, Maine is land-locked and near no islands.

The small cabin we rented in Presque Isle, Maine. Fun fact, “presque isle” means “near an island.” Presque Isle, Maine is land-locked and near no islands.

Let’s address the no TV thing. I love it, I just absolutely love not having a TV. Last summer in Hawaii was the first time we went without TV, or at least without cable. The only thing I truly missed was sports. Last summer/fall we would go out for football games or sometimes miss them if the Pats weren’t being televised. For now, since we’re in New England, we’re able to catch our precious Red Sox on the radio nightly, and if we’re out some where, it’s always on TV. Last summer, without TV, completely ruined us for our return to Colorado during winter where we rent an apartment pre-supplied with cable. At first, TV was hard to watch. Having to tolerate multiple minutes of advertisements between brief segments of the actual show was infuriating, but, with passing weeks, the time the TV was on during the day began to grow and my tolerance for ads returned. I don’t think I ever fully got back to my pre-Hawaii TV routine, which I’m proud of, but I did continue to watch far more than I needed to. I’m really glad to be back to no TV. I’m getting more done in my life, relaxing with a book more often, and the radio is usually all that’s needed for a little entertainment, although the Sox need to pick up some slack if that’s going to continue to be the preferred programming. Occasionally, once or twice a week, we’ll treat ourselves to a movie or show on Netflix – a sensible amount of mindless TV.

That assignment in Hawaii last summer plays another interesting role in getting us into the camper this year. The Hawaiian Island of Moloka’i, where we were without the TV, was a very rural and uncomplicated place with a very straight forward life. After work, there was little that “needed” to be done. Life was simplified to working, getting some exercise, and relaxing. Relaxing usually came in the forms of going to the beach, reading a book, or watching the sun sink into the Pacific ocean from a lounge chair on the driveway. I think last summer was the first time I came to truly appreciate a more simplified life, with less going on, and more relaxation – this is the first thing I most appreciate about living in a camper at a campground. We frequently have camp fires and once the day’s work is done, nights can be pretty lazy, or least I expect them to become more lazy once we have settled in and have finished more of the projects that need to be done around the camper.

For now, I’m going to leave the camper talk at that. I realize I really haven’t said much about how living in a camper is going so far, but that will develop over the next couple weeks. As far a life in a camper to this point? I’m having flashbacks to episodes of Tiny House Nation and people talking about consolidating their belongings, coming up with inventive storage solutions, becoming more conscious of their water and electric usage, and having to be more organized on a regular basis to prevent living in total squalor. That’s all you get for now, but I’ll post more soon.

Today, I’ll leave you with the first video I have ever done for this site – a tour of our camper. Enjoy!

 

Your First Travel Gig

first traveling PT assignmentAfter being a traveling PT for 8 years, I sometimes forget that what now seems like a pretty routine process was very intimidating and complicated at first. This post describes what you can expect in the process of getting your first traveling therapy job. I have another page that you can link to under the “Getting Started” tab. There’s some similar information there, but with a slightly different focus. Here I have tried to focus on the details of your interaction with your recruiters and the order of how this should all happen to get your first job in traveling therapy. Here we go!

Get a License

Do this first. Start working on a license for the state you want to go to as soon as you decide you want to travel. You can start this process after you start looking for jobs if you are still trying to figure out if you want to be a traveler (trust me, you do). But, if you wait too long, waiting on a license can delay the start of a job or prevent you from getting a particular job all together.

Contact a Couple Recruiters

This section was the impetus for this whole blog. I have heard more and more from people that their recruiters are telling them, “If I’m not your only recruiter, then I can’t give you my full effort.” If a recruiter ever says something like this to you, my suggestion is to hang-up and never talk to that recruiter ever again. Of course the recruiter wants you to work solely with them! It takes any competition or reason to hustle for you out of the picture. A good recruiter will understand that you are working with some other recruiters and will work harder to be the one to get you the assignment you want. Recruiters usually work on commission and get their pay from getting you a job. YOU, the therapist, are the commodity, without YOU, nobody gets paid. Seriously, if a recruiter says you have to work with them exclusively, they are playing you – ditch ’em!

Here are the reasons for working with multiple recruiters: First and foremost, talking with a few different recruiters should give you an idea of the going pay rate in a particular area which can vary wildly place-to-place. While different recruiters will have many of the same jobs available, there will be some jobs that are different between companies. Some companies have exclusive contracts with certain hospital systems – it all gets very complicated when you get into the details of how temporary jobs are posted and who they are posted with, but the bottom line is that having multiple recruiters working for you increases the number of potential jobs available to you. Also, when you do get ready to accept a job, having several irons in the fire will give you more leverage in negotiating better pay.

Get Submitted

When you are “submitted” for a travel assignment, it means that you have heard of a job from a recruiter, and you want your resume to be put in the applicant pool for the job. Some jobs will have dozens of applicants, while for others, you might be the only applicant. The number of applicants for an assignment has very little to do with the job itself and likely has more to do with the location of the job and how the facility chooses to post their available position with agencies.

Once submitted for a job, you cannot be submitted for the same job by a different agency – this is where having more than just a couple agencies working for you can trip you up. Early in our traveling, my wife, Kate, and I had 6 different companies we were working with, it got complicated. We had multiple agencies submitting us to the same jobs and arguing with the facility that that each had submitted us first. It was embarrassing – don’t let it happen to you.

Different agencies will vary in how they handle the process of submitting you. Some agencies will want all your information right away, I prefer not to give them my info (references, resume, etc.) until they have found me a job to be submitted for. So, if you can, delay giving a company all your details until it’s time to be submitted – but, some companies just won’t have it and want your info before they do anything for you. Some recruiters may ask if they can submit you for jobs without contacting you first – basically, they find a job that meets your criteria of location and setting, and they will submit you without hopping on the phone to notify you first. If you are working with just one recruiter that you trust, this is fine. Also, if you are searching in an area where there are many people looking, like Hawaii, and want to be one of the first people to apply, then this can be a good strategy. But other than those two situations, I have a hard time justifying giving my recruiter a “green light” to submit me for whatever, whenever. By having the recruiter check in with you, you are keeping control of what jobs you are applying to and where your resume is being pumped out to.

Interview

If a facility you have been submitted to is interested in you, your recruiter will arrange a phone interview for you with the facility. Simply remember that this is your chance to interview the facility as much as it is their chance to interview you. Ask questions, but come into the interview knowing some stuff about the place you are interviewing with. Usually, at the end of the interview, you and the interviewer will report back to the recruiter separately to let them know how the interview went.

The Job Offer

If the interview has gone well, you will receive a job offer. If your recruiter does this verbally, ask that it be sent by email also so that you have it in writing and can crunch some numbers. Swiftly move along to the next step.

Negotiate!

Therapists. We are really bad at this step. But, if the pay seems low compared to what you’ve been hearing through other recruiters, or if there is a benefit that you want that isn’t included in your package, ASK! It never hurts to ask. Don’t underestimate your ability to name a price and see if it can be matched. Remember, YOU are the commodity!

Accept

Don’t get so wrapped up in your negotiating and getting every little bit out of your contract that another therapist signs their contract first and takes the job. Sure, negotiate, but do it swiftly.

 

That’s probably more details than you really need, so I’ll stop here. I’ll again refer you to the “Getting Started” page that is somewhat redundant to this post, but offers some other details including a link to what benefits you should expect or ask for. Happy job searching, I’ll say something here that I don’t say nearly often enough: I love being a traveling PT. If you have the itch to get out there on the open road, you should do it now, because life is a funny thing, and you don’t know how long this opportunity to travel will last. Happy travels!

Preview of Coming Attractions

Matha's Vineyahd

The Cape and Islands

So much to talk about. There is a lot going on in our world right now. The normal hecticness of finishing up the assignment and end of ski season parties has been compounded by actually knowing where we are going in May. Usually at this time of year, as the winter season wraps up in Colorado, we’re discussing where we would like to go for the spring and just starting to get some leads from our recruiters. But, this year, we locked down our May to November assignment in March, a true luxury. Normally, 2-4 weeks ahead of an assignment is good lead time to get everything set for the next assignment, but we have been graced with a full 2 months to get ready for our summer doing home care on Martha’s Vineyard. There seems to be a lot of confusion about exactly what and where Martha’s Vineyard is.

I grew up nearby around the Boston area, so I do know that Martha’s Vineyard is an island off the coast of Cape Cod – Nantucket’s next door neighbor. There once was a man from Nantucket…. um, nevermind. Anyways, Martha’s Vineyard is an island, there is no actual vineyard that I am aware of. I’ve only ever been there for one day as a kid – I seem to remember it being a fall day with pretty lousy weather – Kate has never been there. An unknown adventure awaits!

Housing is coming together pretty well for us despite running into a few challenges along the way. We originally were looking into houseboats for the summer, but there’s a lot of logistical challenges to how long you can stay in one harbor, what to do when a storm comes, and whether you are actually allowed to live on your boat at all in certain places. Basically, if you plan on working a 5-day-per-week job on land, it gets really challenging logistically to live on a boat. So, we shifted our focus to finding an apartment. At first glance on Craigslist, apartments looked very reasonable for rent – unfortunately, all the rent rates I was seeing were weekly rates. It quickly became clear that finding a reasonable place to live without having half a dozen other roommates was going to be a real challenge.

Dear Champ, Hey there Champ, Kate and I need to talk to you about something. We had some great times out there on the road - some of our more memorable times in all our years of traveling. But, well, it's time for us to move on and get another camper - something newer, something sleeker, something a little more "liveable." I know you'll understand, we'll think of you often. - James

Hey there Champ, Kate and I need to talk to you about something. We had some great times with you out there on the open road – some of our more memorable times in all our years of traveling. But, well, it’s time for us to move on and get another camper – something newer, something sleeker, something a little more “liveable.” I know you’ll understand, we’ll think of you often. – James

Kate and I have long dreamed about living in a camper since riding around in our old RV “Champ” every weekend during our assignment several years back in Anchorage, AK. It turns out that Martha’s Vineyard has one campground and we have locked down a campsite for the summer. The only problem is, we don’t own a camper yet. Our main logistical problems will be 1. Finding a camper small enough for our SUV to tow, but big enough to live in for 6 months. 2. Reserving a spot on the ferry to the island not knowing the exact size of our camper yet. 3. Figuring out how to watch as many Red Sox games as possible without cable!

I’m really looking forward to the adventure of living in a camper this summer. At some point we’ll have to make a decision whether to sell the camper at the end of the summer or keep the adventure going. I guess whether we keep or sell the camper depends on how much we like it. In the meantime, the end-of-season parties are wrapping up here in Colorado. Work parties, ski mountain parties, and just party parties will keep us busy over the next 3 weeks before starting the road trip back “home” to New England. The first leg of the trip going back East will be to head West for a dry needling course in Salt Lake City! After that, I hope to grab a couple baseball games in random stadiums along to route and couch-surf with a few old friends from the road.

Stay tuned! Lots of adventure and fun ahead!

Licensure Tips

hobo licensure tipsI find myself coming back to the topic of licensure a couple times every year. Licensure is the great challenge and barrier to a much more free travel life. If licensure was centralized in one place, we could go where ever we wanted, when ever we wanted. Nurses have co-ops between states that allow transfer of licenses across state lines in particular states, but PTs are at the mercy of each individual state’s licensure office to grant access into the state in a timely manner. There are plans in the works to improve reciprocity between states, but it will be several years before we see any of these changes.

Yesterday, I was speaking with some other travelers who are just wrapping up their first travel assignments and looking to move onto other states, but struggling with licensure. I realized I have taken for granted the jaded nature with which I view getting new licenses that has developed from years of being repeatedly disappointed by state licensure offices. Here’s my advice, from my acquired jadedness, that should help your transition to your next state go much more smoothly.

Start Early

Getting a license in another state is going to take longer than you think. Get started as early as you can. The more state licenses you already have, the longer you should plan for. For instance, Illinois takes 6 weeks to process anything, so if you applying to another state and have an Illinois license, you’ll need to get a verification from Illinois and this will add 6 weeks to whatever estimate you have for the time it will take to get the new license.

Snail Mail Verifications

Most states require you to have each state you have ever held a license in to send a verification by mail (yeah, real mail). Additionally, many states require you to send a written letter to them to get a verification. Does it make sense in 2015 to have to send a letter by mail to a state office to get them to send a letter to another state by mail? Absolutely not, but get over it, it is exactly what you have to do. Fortunately, there are a small number of states that are now accepting online verification – they will let you go online, print out that page that shows you have a license in good standing, and fax it into them. But, unless you have spoken to someone in the state’s office that says they will accept online verifications, do not count on getting away with this. The majority of states still require the pony express to get involved.

Follow Up!

When you request verifications from states, follow up by phone to see if the verification was ever sent. I have had checks cashed for verification by states that never actually sent the verification. 2 weeks after I send out my verification requests, I will typically call the state I am applying to to see which verifications they have received and which they have not. I will then call the states that they have not received the verifications from yet. This can be very time consuming, but it prevents me from waiting around weeks for verifications to arrive that will never be sent.

California

Build in at least 6 months to get a license from California. I’m not sure what you’ve heard, or exactly what the state of California is telling candidates for licensure, but it takes 6 months to get a California license. There is a finger printing process, there is a juris prudence exam, and there is no lack of bureaucracy. If you need to be in California in 3 months, you are too late, Just build in 6 months for California – add six weeks if you already hold an Illinois license. 😉

 Don’t Fret

The licensure process is there to protect the public from the worst of the worst, but the system is far more cumbersome than it needs to be. Don’t get all flustered by all the changes that need to be made to the system. Just know that with some patience and a little bit of paperwork, you will eventually get that state license you are chasing. The more level headed and methodical you can remain through the whole process, the less stressed you will be.

These are just a few simple tips on licensure. There are a few states that stand out from the pack that are better than others to get licensed in, but do know that your typical state licensure office is understaffed and will take weeks to do anything. I picture a cyclone of papers swirling around every licensing professional. If you want more info on licensure, click in the search box at the top of this page and type “tag:licensure”. Good luck!

What’s Next?

If you’ve read this blog over any sort of extended time, you should notice a pattern: May to November, really good at writing frequently; December to April, really infrequent writing. I came into the winter this year with a head full of steam and several partially-written blogs. I had desires to reach out to more Occupational and Speech Therapists, and I also had the intention of voicing my strong opinions of PT-specific topics. But, as usually happens in December and January, I’ve had too much damn fun in Aspen and haven’t written a damn thing.

The mountains of Aspen have kept me aptly distracted from writing this blog.

The mountains of Aspen have kept me aptly distracted from writing this blog.

So, it hasn’t snowed a meaningful amount in several weeks, I got a quick ski session in this morning that was reminiscent of my days back skiing on the blue ice of the Northeast, and I’m left with a full afternoon to produce something meaningful for you. After procrastinating a couple hours by clearing a couple items out of my Netflix queue, I’ve sat down at the computer to write. In my mind, I’ve abandoned the two possible topics I had intended to write about and have forgotten what my partially-written blogs from November are even about. This will be stream of thought entry, proof-reading may be marginal, and I’d like to just get some of my current thoughts out to you. In these ramblings, I hope there’s something useful about being a traveling therapist that can be a take-away for you. If not, I’m sorry – at least my blogs are short.

The football playoffs started out with a lot of different potential outcomes for me. As a Native New Englandah and now as a Colorado Resident, the prospect of a strong Broncos’ team scares the heck out of me. It seems that in most of recent history, the Pats inevitably meet the Broncos in the playoffs – rivalries are fun, until it pits you against everyone around you. This year, we snuck by, the Broncos were eliminated early and my friends and co-workers (sorry, guys) were silenced. Crisis avoided. Then, two weeks ago, I realized my Pats were up against the Indianapolis Colts – Indy is also the home of this year’s CSM conference which is to be held 3 days after the Superbowl. If the Colts got past the Pats and went on to win the Superbowl, I would be in Indy for the victory parade…. Not a pleasant thought. Luckily, the Pats have prevailed beyond the Broncos, beyond the Colts, and are on to play in the Superbowl against the defending champions, the Seattle Seahawks. The NFL has once again stirred up controversy to make a good-guy/bad-guy scenario: Last year, the terrible Richard Sherman was portrayed as an out of control brute who can’t control his emotions, this year he is the intelligent tough-guy who will be playing through injury to take on the New England cheaters. I imagine by the time most of you read this, the NFL will have cleared the Pats of any wrong doing – it was trumped up controversy, folks, the NFL choreographed the whole thing to make you care about the Superbowl, just saying.

::segue coming::

The current center piece for our living room. A Hawaiian coconut painted with the Patriots logo. Below that, a series of books from Colorado, Hawaii, and Alaska.

The current center piece for our living room. A Hawaiian coconut painted with the Patriots logo. Below that, a series of books from Colorado, Hawaii, and Alaska.

Anyhow, let’s move along to the topic of therapy and travel. Did I mention I would be in Indianapolis for a conference next week? For those of you who may not be in Physical Therapy and may not know, CSM is our biggest conference each year, it moves from city-to-city each February, and over 10,000 PTs, PTAs, and students attend. Everytime I attend a conference, I come away incredibly motivated and excited for the future of our profession. I’ve written in the past about the need to gain knowledge and continuing ed while traveling (Traveling Doesn’t Have to Mean Professional Sacrifice – 4/11/11). Attending this conference accomplishes learning at a very high level and so much more – hanging out with old friends, meeting new colleagues/friends, discussing the future of our profession, meeting other travelers, and having a good time.

In the past, I have felt like the opportunity of being a traveling Physical Therapist may be some sort of compromise. Traveling frequently from place-to-place has limited me in creating real traction to move forward to the next stage of life (whatever the hell that is)! The approaching of CSM and some recent conversations with friends has brought this thought of the balance between travel-life and being established to the front of my mind again. This thought apparently comes to mind frequently around this time of year (Community Chest – 3/1/14). I was speaking with a co-worker, who is also a travel PT, and she was wondering what is “next” for herself. For me, “next” usually comes in the form of a 3-month plan that my wife and I spontaneously put together over a couple beers in mid-February. (Perhaps back home to New England for a few months? (and maybe catch some Red Sox games?)) (Who uses parentheses within parentheses? (Weird.)) But, this traveler I speaking with was asking the bigger question, “What’s next in her CAREER?”

Oh man, the “C”-word for travelers: “CAREER”. This word is only surpassed by the “S”-word: “Settledown”.

The life chosen as a traveler is unconventional. Kate and I, my wife, have chosen to roam fancy-free and mostly without any agenda other than to see as many different, awesome things as we can. We’ve been at this for 8 years and aren’t done yet, but it seems that through our meanderings, some sort of career-traction is being established. 1. I have had several requests for meetings at CSM this year, mostly about and due to travel (the total of all requests for meetings in previous years is zero). 2. I’ve inserted myself into conversations legislatively about licensure issues which has opened some big doors in the last couple of months. 3. Traveling just feels good to keep doing – after all, it’s what everybody does once they are retired and no longer hindered by their work schedule. Could it be possible that a career could be made traveling? Just writing down the words makes me feel uneasy, you’d think there would be some stop to this crazy travel-life. Who knows. For now, I’m excited for the Superbowl, CSM, and the next three months – but I should come up with a solid plan for the following three months soon. The three months after that? Not important, I’m doing jobs that I like, where like, with people I like.

Whoa, well I certainly got on a roll there. Hope it wasn’t too manic for you and sorry for blabbering about the Superbowl, be thankful I didn’t go on-and-on about the Rob Gronkowski dream I had this week. I’m just glad I finally got around to the topic of travel therapy. Have a wonderful winter and I promise I have more poignant topics soon.

Places in Time

I was listening to NPR on the way home from work today and heard a segment that caught my ear. I grew envious of the author in the piece who had lived on a remote Alaskan island for two months to study the island’s history and write a book about it. I thought, “Man, I wish I had a job I could just take around to a cool places like that.” I then laughed hysterically at myself, because I do have a job that I can take where ever I want – if that remote Alaskan island ever needs a PT, I’m there.

I hear about peoples’ travels to far out and cool places and immediately want to be there. The only problem is that I can only be in one place at one time. Working typical 13 week travel contracts, a person can only see four different places in one year max. When I first started out traveling eight years ago, I had a short list of places I absolutely had to live in – Hawaii, Alaska, and a ski town. Three assignments, you figure you can chisel that out in nine months, right? Wrong. It took me six years to get to those three places.

We took 4 weeks off for our wedding and honeymoon including this zip-lining in the Dominican Republic. You're absolutely free to take whatever time off you want between assignments, but no PTO.

We took 4 weeks off for our wedding and honeymoon including this zip-lining in the Dominican Republic. You’re absolutely free to take whatever time off you want between assignments, but no PTO.

There’s so much time in travel PT that people don’t account for. If a three month contract is going well, it’s not unusual to negotiate a contract extension (typically another 13 weeks at a time*). Sometimes, particularly in home care or far-off places, the facility will request that the contract be six months instead of three. Usually a contract is longer when there are anticipated costs to the facility like an extended training process or extra relocation expenses. Living life 13 weeks at a time can get really manic, so most of the travelers I know who have traveled for a while have found a way to slow the pace of the constant 13 week shuffle. For instance, those of you who read often know that my wife and I spend half our year returning to the same seasonal jobs in Colorado. Returning to the same jobs provides us a little stability  while leaving 7 months each year to be true traveling therapists. Other travelers I know make a habit of extending their contracts whenever they can – their typical contract is not three months, but more like six or nine after extending their contract a time or two. One thing to know about extending contracts is that you do have a year cap on how long you can work somewhere before giving up your “traveler” status. I’m honestly not sure what determines this, but I do think it has to do with the IRS, tax home, and not being able to continue to receive tax-free per diem and housing.

*If you do negotiate a contract extension, always ask for a raise, even if it’s a small one.

In addition to extended contracts, the other place I’ve lost a lot of time over the years is between assignments. When I say I’ve “lost time,” I only mean that I’ve completed fewer traveling assignments because of all my time off. Most agencies don’t offer paid time off (PTO) unless you’ve done a few consecutive assignments with them. The bad news is you likely won’t get paid for your time off. The good news is that nobody else has a stake in your time off, and you can take as much time as your bank account can tolerate. I spend a lot of my time between assignments visiting family and friends back home, but I also use the time between assignments for some of my best adventuring. There were a couple years where I was ending up with 10+ weeks off per year! Luckily I’ve reeled that in a bit and tend to only have a week or two between assignments.

So far, I’ve talked about two positive things that can account for unanticipated time – prolonged assignments and vacation time. The third way your next travel assignment can be delayed is because you can’t find a job. I’ve written recently on the discussion board about staying flexible as a traveler. The more flexible you are, the less likely you are to remain unemployed. The only times I have ended up unemployed are few and far between – and I’ve never been more than a week without a job. Should you ever find yourself in a position where the job you want is just not popping up in time, re-evaluate and see what your other options are – other adventures await! There are great opportunities available in travel rehab, the only reason you would ever remain unemployed for a sustained period of time would be your own stubborn solidarity to a particular city or a particular practice setting.

Arriving in Juneau on our boat/roadtrip back from Alaska in 2012. One of the coolest uses ever of two free weeks between assignments.

Arriving in Juneau on our boat/roadtrip back from Alaska in 2012. One of the coolest uses ever of two free weeks between assignments.

As you plan to take on traveling as a career, or even for just one year, there will be many places you’ll want to see. You can’t see them all at once, so allow time to get to where you want to be. There will be positive experiences that keep you in areas longer than you intended, and there will be obstacles to getting exactly where you want to go. But, with a little patience, you can turn  traveling therapy into one of the greatest life opportunities ever.

When my wife and I started traveling, we thought we’d travel for two years. We eventually saw everywhere on the original list of places we wanted to see, but haven’t shaken the travel bug yet. Eight years later, we still think two more years will do the trick. Yeah right! Maybe we’ll find our way to that remote Alaskan island someday.

The Journey of Stuff

Supply chain. It’s something so basic that surrounds each of us every day, yet most of us go on completely oblivious to its existence. The supply chain is what brings us every material thing we have ever come in contact with.

TravelPT - longest wharf in Hawaii

Kaunakakai wharf, the longest wharf in Hawaii. The barge lands here and the pipes at the right of the picture are the gas lines that bring fuel from delivery to the big tanks in town.

The first time I ever thought about the supply chain was on a travel assignment in Chicago. I rented a room in this guy’s apartment who was a higher-up for one of the major shipping companies in their “supply chain management” division. You might ask, “What really is supply chain management?” I did ask. He explained that he was in charge of all the shipping for an electronics company – ALL the shipping. Let’s say that the electronics company wants to make and sell some phones, they first must receive all the parts or materials for the manufacturing of the phone. After assembling all the parts, the completed phones may need to be shipped to a different plant for distribution, from there they ship out to stores and customers. I had never, ever thought of all these steps that go into the making of absolutely everything we buy, and I have rarely thought about the supply chain since.

Living on a rural island has again pulled back the curtain on the path things take to get to us and also the path they take when we are done. Molokai’s supply chain relies on a barge that comes two times per week – Mondays and Thursdays. If you hit the grocery store on a Sunday night, before the barge arrives the next morning, you are likely to find the selection of meats and other perishables has been picked over and doesn’t offer much. Timing your grocery trips with the arrival of the barge offers greater selection, and greater crowds. I learned several weeks into my stay on Molokai that the gas prices will drop just before the boat comes in that refills the island’s gas tanks – a handy tip for purchasing another commodity that I rarely ever considered how it got to me. Everything ever manufactured has taken a trip to its final owner – this trip is just far more visible on Molokai.

Up at the Molokai Dump, the bulldozer gets ready to turn trash into a mountain.

Up at the Molokai Dump, the bulldozer gets ready to turn today’s trash into a mountain.

On the other end of the supply chain is my weekly trip to the dump. I try to be very environmentally conscious, recycle everywhere, limit the plastics I use in every way I can, but had never personally had to take my trash to a dump. Every week, I go to the dump and head up the steep dirt road to the top of the hill where I throw my trash in a pile. Up on top of this mountain of trash (pu’u opala  – loosely, trash mountain in Hawaiian), there is a bulldozer driving around, flattening the trash and occasionally adding dirt. As I return to the dump week after week, the area where I throw my trash has shifted slightly to a different part of the hilltop. Week-by-week, on Saturdays before 2:30 PM, I do my part in building this mountain of trash one bag at a time. With only 8,000 people on the island of Molokai and only locally owned businesses, I get to see consumer waste and disposal slowed to a more easily observable scale and managed by one guy in a bulldozer. Over 13 weeks on Molokai, I have been unable to tell how much higher the mound has gotten, but on my last trip to the dump, I saw one clear sign of the accumulation of trash – a crew was beside the hill rolling out huge layers of black plastic to prepare for the next layer of the hill to be built of new trash.

In my time on this small island, I was able to watch the boat come in weekly with supplies, buy those supplies from the store, take the refuse of those supplies to the dump, and watch that refuse get flattened into the ground by a dude in a bulldozer. Seeing this much of the supply chain in full display has strengthened my efforts to recycle and, more importantly, to just. use. less. If a small island of 8,000 is able to build a mountain out of trash, what can a city of millions do?

From this point, I could preach on-and-on about how I feel regarding our culture of consumerism and how wasteful small bottles of water are. Instead, I’m going to stop here and only remind you that with every product you buy, you are in some way contributing to a mountain of trash somewhere. Indulge this Thanksgiving weekend, take advantage of deals for holiday shopping, but do consider where goods come from and where your waste is going.

Update 8/27/2016 – On our return to Molokai pu’u opala has noticeably grown. Several weeks ago, a group of 200 people collected 12,000 lbs of trash from a 3.5 mile stretch of coastline. This trash is in many languages and comes from allover the Pacific. Reminder: Trash on land goes to the ocean, trash in the ocean lands on a faraway beach…. when animals don’t eat it first.