THE BEST Travel PT Job

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

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

Location

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

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

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

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

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

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

Clinical Setting

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

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

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

Pay

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

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

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

4 Island Travel PT Assignments

As winter comes to a close, you might be wishing you were on an island somewhere…. if you’re a travel PT, you may have that option on your next assignment. Here’s (more than) 4 opportunities that could have you living on an island soon. Lots of links included to articles from when I worked on and visited several of these islands.

Kate hiking down from the 10,000 ft summit of Haleakala on Maui to camp in the base of the volcanic crater many hours and miles later that night in 2014.

Hawaii

Let’s not bury the lead. Hawaii is a tropical paradise within the borders of United States. All the advantages of really getting off-the-grid without any of the hassles or insecurities of international travel. Within Hawaii, there is a wide spectrum of opportunities – from uber-urban living to the very rural – a little different flavor for whatever your taste is.

Oahu is the main island and generally a good place for anyone unfamiliar with Hawaii to start. Oahu is home to about 1 million people, many of whom live and work in Honolulu, a major city and international hub. Honolulu offers all the perks and culture of a big city with the world famous surf beaches of the North Shore a short 30 minute drive away. Traffic can be brutal on Oahu, so plan commute between home and a potential job appropriately

Maui and Kauai each have occasional assignments available and tend to be a happy-medium for the traveler seeking a mix of social life and rural island-living. Both islands have thriving communities and also places you can quickly get off the beaten path. Each island has grown a bit in recent years, but also have huge swaths of land preserved for their beauty and recreation. On Maui, much of that land is within Haleakala National Park. Haleakala is a 10,000 ft volcano with astronomy observatories on top and it’s flanks running straight into the ocean. On Kauai, few views on Earth rival those of the Napali Coastline – a stretch of steep cliffs and secluded beaches spanning the coastline between where the two ends of the road circling the island end. I really believe you can’t go wrong with any opportunities that arise on Maui or Kauai.

Mother nature hard at work creating more land on the Big Island through the eruption of Kilauea volcano and lava running into the ocean in 2016.

The Big Island, which is actually named “Hawaii”, has it all. The Big Island is about 70 miles across and boasts 13,000 foot peaks, an active volcano, some of the best scuba diving in the world, and a thriving biking/running/swimming community that hosts the Ironman World Championships each year in October. Kona on the dry West coast of the island, and Hilo on the Eastern wet side of the island are the two major towns – each have a pretty steady stream of revolving travel assignments available.

When finding a travel PT assignment in Hawaii, luck and timing play big roles. Sometimes, very few jobs are posted, while at other times, you’ll find many jobs. Waiting just a few weeks typically resolves any drought of jobs, but be cautioned that Hawaii assignments draw a lot of applicants, so bring your A-game to the interview. Also worth noting that pay in Hawaii can be low… but you’re working in Hawaii, so….

Martha’s Vineyard

On the beach below the Gay Head cliffs on Martha’s Vineyard in 2015.

Martha’s Vineyard, off the coast of Cape Cod in Massachusetts offers the true island-living experience. In the summertime, people are intent on fishing, beaching, and… outdoor showers? I believe that nowhere in the world is as passionate about outdoor showers than the people of Martha’s Vineyard. When assessing function and patient goals on my home health assignment on Martha’s Vineyard, it was not rare to have a primary goal for a patient to return to their outdoor shower. When Kate and I lived in a camper there, we caught the fever – although we had a shower in our camper, the campground opened a row of 6 outdoor showers, and we indulged daily, rarely, if ever, using the indoor shower.

Martha’s Vineyard Hospital and the Martha’s Vineyard office of VNA of Cape Cod often have openings because affordable housing is near-impossible on the Vineyard. Many of their permanent employees travel 45 minutes by boat everyday from The Cape for work. If you can figure out housing on The Vineyahd, you’ll have a great time. Also worth mentioning, the Cottage Hospital on Nantucket, a couple hours by boat from Martha’s Vineyard, also regularly seeks travelers.

St. Thomas

The US Virgin Islands are part of FSBPT. Like any state, you can apply for a license in the Virgin Islands. St. Thomas is the main island and has historically had good availability for jobs. The Virgin Islands are definitely for the more adventurous traveler, or, perhaps, for the traveler who wants a tropical experience, but doesn’t care for the long distance to Hawaii. Most people on St. Thomas speak English, but Creole or Spanish may be primary language of some patients. I have read about concerns of safety, but travelers who have worked there tell me that if you are smart about your surroundings and company, then it is safe…. and highly enjoyable – basically like any major US city.

Hurricanes Irma and Maria may have changed the travel experience on St. Thomas. Largely overshadowed by the destruction in Puerto Rico, the Virgin Islands got hit hard as well – in fact, the roof ripped right off the hospital in St. Thomas during Irma. As best I can tell sitting at my computer in Colorado, it appears there is still an ongoing need for travel PTs in St. Thomas – it also appears there are many volunteer opportunities to continue helping with hurricane recovery. It’s worth mentioning that Puerto Rico is also under the umbrella of FSBPT, so you might consider volunteer work in Puerto Rico as well.

Alaskan Islands

With more coastline than the entire rest of the US, there are many way-off-the-grid island opportunities in Alaska, but here are a few standouts.

Looking across the town of Sitka at Mt Edgecumbe, a dormant volcano. Also, I remember Sitka having a great brewery!

Kodiak Island currently has travel PT needs. Kodiak is 100 miles long and has a population under 14,000 making it a true outdoorsman’s paradise. Kodiak is best known for the Kodiak Brown Bears, which alongside polar bears are the largest bears in the world. Kodiak has ample fishing, hiking, hunting, and anything else you can imagine outdoors. Though, it is not for the faint of heart – no one is around to bail you out if you get yourself in trouble out in the wilderness. But for the therapist looking for a truly rugged off-the-grid experience, Kodiak could be a dream assignment.

Sitka, on Baranof Island, was the capital of Alaska back when the state was a part of Russia. On our way back from working in Anchorage, Kate and I stopped off to visit a PT friend there and quickly fell in love with the community. Sitka is a vibrant town with architecture reminiscent of it’s Russian past. Our friend took us down to a park to watch for whales, and sure enough, we quickly saw a pod of Orcas swimming by in the bay. Sitka has excellent access to the outdoors both in the mountains and on the ocean. Compared to most of the rest of Alaska, Sitka is relatively Southern and therefor more temperate.

If you are willing to make a longer-term commitment (starting at 2 years) in Alaska, there are opportunities to make substantially more money in the form of student-loan repayment. These opportunities are available both in private and government facilities through a government program called SHARP. When working for large health systems in Alaska, there can also be opportunities to take small planes out to remote bush towns reachable only by sea and air. PTs fly in to provide rehab to the residents for a couple days at a time. While I don’t think a typical 13  traveler in Alaska is likely to be sent out to the bush, it might become more possible to make these trips after extending a contract for a longer period.

Mendenhall Glacier in Juneau Alaska, 2012…. not technically on an island, but you can only get there by boat or plane.

There are many more islands all over the country where you can find work as a traveling therapist. Jobs exist off of Texas, in the Northwest corner of Washington state, off the far Northeast coast of Maine, and down in the Florida Keys. If you look, you will find the island that suits you fancy. Happy travels, and good luck turning those island dreams into your real life.

 

Does Travel Therapy Really Pay Better?

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

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

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

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

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

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

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

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

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

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

Traveling Therapist Q&A: Considering Travel

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


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

Housing/Insurance

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

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

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

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

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

Taxes/Reimbursement

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

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

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

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

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

Cancelled Contract

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

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

Recruiters

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

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

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

Overtime

Can you sign up for overtime?

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

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

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

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

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

Tax Time, Again

Crunch time. Taxes are due very, very soon. No matter how much I work throughout the year to be prepared for tax season, it still takes hours to get everything organized when April rolls around. Don’t let me fool you, Kate’s the one who handles the finances around here – very smart of her. But, every year, I hope taxes will be painless, they never are. It is an awful, dreadful process, and being a traveling therapist does not help simplify the matter. I hope you’ve filed your taxes already, but if not, here are a few tips that will help make your tax season a little less painful:

Hire someone who specializes in taxes for travelers

An actual bill I received from the IRS in the middle of writing this very blog…. apparently we made a mistake two years ago. Whoops, my bad.

Having someone do my taxes who understands health care travelers and their financial arrangements is priceless – actually, it’s only $300. A traveler’s taxes are complicated. I work in multiple states each year, have a rental property in Maine, live in Colorado, occasional work as an independent contractor, and receive a lot of tax-free money each year. In my first years of travel, I tried using TurboTax, which charged me a lot of money for all the extra forms I needed. I also tried using someone at H&R Block – he said he could handle my taxes, but clearly had no idea what he was talking about when it came to travel stipends and reimbursements. Hiring a professional who can handle all the moving parts of travel therapy is money well spent.

A quick Google search will find a long list of people who specialize in taxes for travelers. Searching for “travel nurse tax preparation” yields the most results. A tax professional who specializes in travelers should also be able to help you answer all the questions you likely have about your tax home. A good tax-guy/gal should also be able to advise you of the things you can do in advance to help secure your tax home status in the event you are eventually audited. Speaking of which, make sure you ask any potential tax preparer what their responsibility is in the event you are audited. A few tax professionals warranty their preparations so that an audit is done on their time, others will charge you an hourly rate to defend your audit on their preparation.

Track your mileage

It’s easy, but few actually do it. Just keep a memo-pad in your glove box and write down any mileage that pertains to work – for 2016, you can deduct 54 cents for every mile you drive. It’s that simple.

Mileage you can include in your deduction:

  1. Mileage driving between assignments.
  2. Any driving between clinics or other work locations.
  3. In home care, all mileage between the office and patient visits can count towards your deduction.
  4. People living in permanent places commuting to permanent jobs are not allowed to deduct their commute mileage. However, because a travel work-place is temporary, I believe we are allowed to deduct the mileage on our commutes. That mileage can really add up! (You may want to see what your tax professional before committing to this one.)

The exception to the above categories is if you are already reimbursed for your mileage, you cannot claim it as a deduction on your taxes. For example, if an agency reimburses you specifically for your mileage to relocate, you cannot then deduct that mileage from your taxes. Similarly, if you are paid per mile in home health (which I recommend you do negotiate into any home health contract), you cannot claim that mileage. Although, with a federal deduction of 54 cents per mile, if your job reimbursed you less than 54 cents you can claim the remainder. These little bits do add up to a deduction that could make difference over the course of a year.

Keep track of your tax deductible items throughout the year

We have a big envelope that we put receipts in throughout the year. We keep track of the costs of various trips, the price of continuing ed courses, the price for APTA membership, and anything else that could be tax deductible. Frequently we make notes right on the front of our large tax-envelop so when tax season rolls around we aren’t spending hours trying to find the prices we paid for deductible items – this is where the majority of tax-prep time goes in our household. If you can truly be disciplined and keep track of your work-related costs throughout the year, tax preparation is far less painful when tax day comes.

Keep your tax records available to you, wherever you are

We have a fire-resistant file box that always traveled with us. It had everything important in it including our old tax records. The firebox is really heavy, maybe 20 pounds when empty… 35 pounds when full. It never fit quite right behind the front seat of the car on roadtrips. It basically has always been a pain to manage.

In the age of online data, it makes much more sense to scan all of your tax documents into the computer and store them online. If you ever have your taxes questioned in the future, you’ll be glad you have a readily accessible copy of your tax return. There is nothing worse than receiving an unexpected bill or audit from the IRS and having your tax returns back home, hundreds of miles away. When you need proof of your returns, you want it quickly. The general rule is to keep tax records for 7 years, but if it’s all online, I see no downside to keeping them longer… indefinitely.

Good luck, may this tax season be easy on you!

The Big Settle Down

Kate driving our first camper, “Champ,” through Denali National Park. Champ was awesome and had so much character. I think our new camper, “Mabel” (named before us), will give Champ a run for his money.

Kate and I were travel PTs for over 10 years. We had a good run – no, “good run” doesn’t begin to describe it. We have lived all over the country, driving to both the East and West Coasts most years. We have lived in a camper on Martha’s Vineyard, explored Alaska, found serenity in rural Hawaii, and have accumulated over 500 ski days each in Colorado. We have had a great run.

We’ll be having a kid in about 4 weeks. When we decided we wanted to have a child, we weren’t sure if it would end our travel careers. Until even a couple months ago, we had a backup plan that included the three of us living in a camper taking short contracts all over the Western US – it seems a single traveler salary could stretch further than most permanent salaries. With travel pay, one of us could work while the other home-schooled the little one. We remained very undecided about whether we would stay in Colorado following the baby’s birth or see just how far we could take this traveling thing. We have a couple friends here in Aspen who are raising a one-year-old between Asheville, NC in the summer and Aspen in the winter – sounds pretty awesome, and with an established life in each place, very manageable. We had visions of a similar life… seemed reasonable.

So what gives? Life as a travel PT really has been living the dream. We never made a formal decision to stay here in Aspen – it just happened.

Over the years, we began returning to Aspen for winters yearly. We have long said if we were to settle down, it would be here. Over the years, we’ve casually looked at properties with a friend who is a realtor. About 3 years ago, we took snowmobiles to check out some land on the back of Aspen Mountain. It would have been awesome. (It would still be awesome) But, it would be expensive, and we would have to snowmobile to our house through avalanche terrain every day in the winter – not the most practical set-up. There’s been a couple other things we’ve casually looked at over the years. Within days of showing up in town this December, our realtor friend insisted, “Hey, there’s this house you should really check out.” We dilly-dallied, didn’t pay much attention, and again, “Hey, there’s this house you should really check out.” Within 2 weeks of returning to Aspen this winter, we were under contract on the house and have been working to buy it since.

Our first winter in Aspen, 2007. We figured we’d live slopeside, because “You only live in Aspen once. Right?” This was one of the many on-mountain fireworks shows that first year when we could stroll out our front door and watch. We certainly don’t live slope-side anymore, but we’re close enough.

It just happened. There was no conscious decision to stay in Aspen, but here I am sitting by my cozy wood fire typing, in my house, trying to process the fact that I’m not a travel PT anymore. The longest job I’ve held in the last 11 years was my first travel assignment that I extended out to 10 months. Before that, my entry-level PT program at Northeastern University was structured so that we were constantly rotating between a few months in class and a few months in clinic. The last time I did one consistent thing for over a year was high school! But, I guess it’s time to settle-down. All this came together and happened so naturally that I have to believe the timing is right and that it’s meant to be. I honestly see a lot of advantage to being in one place. There are definitely areas of my life where I’ll gain traction and finally be able to make some headway. Don’t get me wrong, traveling PT has been a dream-life and I can’t picture doing anything different with the last 10 years. One sign of more stability is that I’ve already committed more time to the Colorado Chapter of the APTA. My first project is getting the PT licensure compact to pass here – clearly travel-driven idea.

So what now? I guess I’ll keep writing about traveling and the path-less-taken by therapists. I’ve learned a lot about traveling over the last decade and will continue to share what I can for as long as I can. I recognize that my knowledge and advice probably have an expiration date, maybe a couple years. You’ll likely start to see me taking on more generalized PT and rehab topics, but travel PT will stay central for now. In life, traveling is not even close to done. We recently bought a 1970 Shasta camper that we are going to put some serious miles on this summer driving through the mountains and into the desert. The mind-set in Aspen affords a lifestyle full of continuing adventure. Many of our coworkers routinely take 3 week international vacations – many of our coworkers and friends are of international origins themselves. I’d eventually like to see a large chunk of the globe, but Australia, Japan, Iceland, and much of Europe stand out as places that I need to get to more immediately. A steady job affords the opportunity to increase participation in global-health projects and international service learning for which there are many opportunities in healthcare. Aspen has exchange programs with several sister cities (Bariloche, Argentina; Chamonix, France; and Christchurch, New Zealand to name a few of our sister cities). I’m not really sure what having a child, owning a home, and accepting a permanent job means, but it definitely doesn’t mean the end of travel.

Stay tuned, this is the start of a new adventure. A very different, new adventure.

Must-Visit Outdoorsy Communities

The best places to live are those that mix a life surrounded by the great outdoors with a great community. Many of the places that offer endless opportunities outdoors do not have the support of vibrant communities, and many great communities are far from the great outdoors – the places on this list offer the best of both worlds. These are smart, cultural places that center around outdoor recreation – consider seeking them out on your next road trip… or even for a travel assignment if you consider yourself lucky.

Boulder, Colorado

Up playing in the hills surrounding Boulder – easy to get off the beaten path fast.

The ol’ Colorado standard. Set just West of Denver, some consider Boulder America’s Biggest Mountain Town. Boulder is inhabited by a huge number of the world’s elites in skiing, rock climbing, cycling, and triathlon. Boulder is close enough to almost any-kind of outdoor recreation you could crave while also having a large enough community to find the creature comforts you need just outside your door.

Boulder’s outdoor community centers around the Flatirons – a series of 5 jagged peaks jutting out of the ground. The peaks are around 8,000 ft from sea level, of course town itself is a mile high. The bigger mountains are less than an hour away in Rocky Mountain National Park and there are 14,000 foot peaks nearby in almost any direction. For entertainment, Red Rocks Amphitheatre is close by and brings in some of the biggest names in music to play concerts each summer. The venue is highly unique – the amphitheatre is open air, naturally formed, and set within several large crags of red rock. If you need the big city, Denver is only bout 45 minutes away.

Bend, Oregon

Downtown Bend, Oregon in the shadow of the Cascade Mountains. Industrious people self-making everything.

I recently visited Bend, and it blew me away. Bend is surrounded by huge (HUGE) mountains. Mt Hood looms in the distance at over 11,000 feet (7,707 ft of prominence from the surrounding land). Mt Hood is home to six separate ski areas including year-round skiing on glaciers (available limited time only, while supplies last). While Mt Hood is the pinnacle of outdoor activities in the area, Mt Bachelor is closer and more accessible to Bend – it offers much of the same recreation on a slightly smaller scale. Many of the mountains in the area are volcanic and, therefor, dramatic in their look – steep slopes that standout from much of the surrounding high-desert.

Second to the impressiveness of the mountains, is the very impressive local beer selection… I’ve never seen so many different beers in my life. Breweries abound – many brands you’ve heard of, many you haven’t. But beer isn’t all that Bend makes. If the end of our society came today, Bend would go on. These people are self-sufficient in making everything. Coffee, bread, gluten-free dairy-free bread, locally-sourced everything, local clothes companies, Hydroflask water bottles – you name it, Bend makes it. I definitely see the appeal of Bend.

Lake Tahoe, California/Nevada

I’ve never been to Tahoe (hence no photo), but I hear it’s awesome. Suddenly, I have about half-a-dozen friends living around Lake Tahoe. I personally equate Tahoe with skiing – there are 12 ski resorts in the area with Squaw Valley and Heavenly being the two biggest. But Tahoe, being a huge lake, offers many summer-time opportunities that other mountain communities don’t have. Boating, wind surfing, and everything else you can do with miles of open water. But Tahoe’s greatest strength might be its location and ease of access to everywhere else. Heading West, you’ll end up in Sacramento, wine country, and San Francisco. East will send you into Nevada with quick access to Reno and Carson City. South shoots you straight into the Sierra Nevadas and with a few hours of driving, Yosemite Park. If you’re spending time in Nevada or Northern California, make sure your next ski trip or summer lake trip includes Tahoe.

Montana, The Big Sky State

Montana is huge. The mountains are huge, the lakes are huge, the sky is huge. This is in Glacier National Park in far Northern Montana.

I don’t know how they’ve done it, but the sky is truly bigger in Montana. I have rarely seen landscapes as majestic as your average commute in Montana. My only experience with Montana was a roadtrip that entered in the south through Yellowstone and exited North to Canada through Glacier National Park – every single mile between felt like I was still in a national park. We stopped at Chico Hot Springs, just outside Yellowstone, and enjoyed their massive outdoor pool fed by natural hot spring water – the stars at night were perhaps the most I’ve ever seen (on account of the sky being so big). In the past, the hot springs were a spa for the sick in the early 1900’s. I couldn’t help but think that there is something special about that place and that the water does indeed have to be healing. We stopped into Bozeman for a quick meal while on the road and found it to be a fun, happening college-town. Other small cities in Montana have their own unique personality and have a lot to offer as well – Missoula, Billings, and Whitefish all offer outdoor recreation in the wilderness that stretches out in every direction. Get to Montana where the Wild West is alive and well – you will not be disappointed.

Experience Before Travel PT vs. New Grad Travel PT

new grad traveling therapy

James of HoboHealth worked in private practice before going into traveling PT and believes gaining professional experience is the right move to make before traveling.  April of The Vagabonding DPT has had professional success and happiness through becoming a traveler immediately as a new grad. These two traveling Doctors of Physical Therapy from different personal and professional backgrounds have connected to provide you diverse perspectives on travel PT.  This is their first blog post together of a series of topics.

What are the advantages of being a New Grad PT vs. being an Experienced PT then going into Travel PT?

 

headshot-square-finalHoboHealth:
Professional Experience – I only worked for six months between graduation and starting as a traveling PT. The brief time I worked in private practice before traveling did a lot to shape who I am as a clinician today. Getting just a little bit of experience as a clinician allowed me to become grounded in a healthy work environment before setting out into the less predictable and less stable world of traveling.

Personal Marketability – I believe the little bit of experience I had in private practice prior to traveling gave me a leg-up on other candidates looking at the same jobs. My first traveling job was (primarily) outpatient in a community hospital outside of Boston with other therapists around to help continue my mentorship and growth. Without a little experience, I don’t believe they would have taken on the risk of hiring a near-new grad. Six months in private practice, followed by 10 months at my first travel assignment with strong mentorship set me up for 10 years of positive traveling assignments. Bottomline, if you get a little experience before travel, better employment opportunities are available to you as a traveler.

Vagabonding DPT:april-fajardo-headshot
My life was as compact as possible.  I already had sold all my furniture and everything I owned fit into my Honda Civic. I was as mobile as I ever would be.  If there was any opportunity to travel and explore, now was my moment. I had just spent my 3rd year completing my clinical rotations in Oklahoma City, OK; Salt Lake City, UT; Springfield, MO; and Dallas, TX. I was moving about every couple of months.  In essence, my clinical internships provided me the opportunity to live the life of a travel DPT as a student.  I was used to learning at a rapid rate and had to learn to adjust to a new city and clinic every few months. Because of this, It was quite an easy transition to go from a DPT student on clinical rotations to a DPT on the road for work.

You have “less” responsibility. As one begins to settle into their career and life (in general), the natural progression is to get settled into a specific location, get married, buy a house, have children or furry kids, and/or take care of ill, elderly parents.  Although I think it is absolutely possible to travel with all the aforementioned circumstances, these factors require far more extensive benefit/cost analysis. For myself, I wasn’t married, I didn’t have a house, nor did I have children.  So I made the personal decision to take the plunge straight into travel PT for further domestic exploration and adventures!

Money
Although I believe that this shouldn’t be your primary reason for going into traveling therapy.  It definitely doesn’t hurt. Students are coming out with a tremendous amount of debt and this is definitely a great way to pay down those student loans.

What are the disadvantages of being a New Grad PT vs. being an Experienced PT then going into Travel PT?

 

HoboHealth:
When I first thought about this question, my gut reaction was, “There’s no disadvantage! What could be wrong with having more experience going into a job?” …but then I thought of the hardest day of my PT career – the day I had to quit my first job. The day I told my mentor and friend that I wouldn’t be able to work for him anymore was a really stressful day. Quitting a job, especially one that you like, is hard. I can see how someone with the intention to travel could go get a steady job and never end up leaving it. While I do believe strongly in getting experience before traveling, I can see how you risk getting “stuck” in a permanent job. I remember the phrase one of my professors told me to make quitting professional and simple, “It’s an opportunity I can’t pass up.” Remember that phrase, it’s a good one.

Also, the traveling lifestyle is only available to those in the right life situations to have the flexibility to take short-term contracts. Sometimes you have to strike while the iron is hot – waiting to take a permanent job, get several months of experience, and then quitting can shift you into a phase of life where the idea of travel isn’t as easy as it once was. New family obligations, meeting a significant other, and simple logistics like year-long rental leases can obstruct your path to the open road.

Vagabonding DPT:
Mentorship:
Off the bat, one’s initial thought may be the lack of mentorship.  There are some travel companies that may market mentorship opportunities.  I challenge you to ask them what exactly this looks like.  Just being in the same clinic as other physical therapists does not constitute as mentorship.  This can be countered by building an army of mentors while being a student.  Based on my interests, I’ve inadvertently built an army of specialists from Neurologic PT to Global Health to Nonprofit Leadership.

Mentorship does not have to be limited to our profession. There is something to learn from everyone.  Quite frankly, our patients become our first mentors.  If you learn to listen intently, they will lead you to the answer.  In addition, a firm understanding of other disciplines such as occupational therapy and speech & language pathology can help us maximize our role with a focus on patient-centered rehabilitative care.

Lack of Experience:
James touched upon this and it is true.  There will be some jobs that will require that you have more experience than what you have had. However, I secured my second job assignment by highlighting my strengths and experiences in that setting.  I applied for a position in inpatient rehabilitation that required 5 years of experience.  So during my phone interview, I discussed my experience.  I worked for two years as a PT aide in outpatient PT, then did an additional two years as a rehab aide prior to even applying for physical therapy. I also completed two clinical rotations in inpatient rehabilitation. I felt I was more than qualified for the position at hand.   I’m glad that the rehabilitation manager was pleased with my response as well because she essentially hired me for the position. I’ve extended my contract since then.

Being a traveler can isolate you from the typical learning and professional development paths that may be available in more traditional PT careers. What have you done or do you plan to do to continue your professional development?

 

HoboHealth:
Board Specialty
Shortly after completing my transitional-DPT, I soon felt ready to pursue my Orthopaedic Clinical Specialty (OCS). I spent more than a year reading every piece of ortho research I could get my hands on and reading a couple comprehensive ortho books cover-to-cover. The constant studying kept me focused on a fixed goal for quite some time. Specialties through ABPTS are available in variety of practice areas. A couple supervisors on travel assignments have told me they hired me specifically because of my board specialist certification. In total, my tDPT and OCS combined filled the first  4 years of my professional life with a structured, focused learning path.

Some universities are offering post-doctoral learning paths that culminate in sitting for (and hopefully passing) the specialist exams. My alma mater, Northeastern University, offers a Certificate of Advanced Study in Orthopedics. Essentially, you take 5 online classes focused on advanced orthopedic practice, earn college credits, and become more prepared for the OCS exam. Programs like this can help you keep a structured learning schedule that can otherwise so easily fall out of priority while working as a travel PT.

Certifications
Generally, I am skeptical of programs focused on one clinical belief system and the alphabet soup that comes along with them. Courses that all come from a single guru will help you dive deeply into a treatment strategy, but are typically lacking in variety outside of that one strategy. However, as a way to provide a structure for learning towards a final goal, they can be very useful. I currently am about to set out on earning my certification in Dry Needling. Over the next year, I have my learning laid out for me and a fixed goal to be certified in Dry Needling and Cupping by the end of 2017. There are some other great programs available that offer several courses on different topics culminating in a single certification – do be discerning, not all certs are created equal.

Vagabonding DPT:
With the constant change, rapid rate of learning, and high productive expectations expected as a Travel PT, you can get burnt out and/or apathetic as a PT.  It is pivotal that you “Be fearless in the pursuit of what sets your soul on fire.”  Since graduation, I have done exactly that through social media, leadership positions, national PT conferences, and continuing education courses.

Social Media
I didn’t understand Twitter.  I didn’t get the point.  However, a few years ago, I ran for the position of APTA Student Assembly Director of Communications and thought that I should get one in the event I got elected and had to manage one. I’ll be honest.  I had no idea what I was doing.  With the Twitter mentorship of Matt Debole, PT, DPT, OCS and Stephanie Weyrauch, PT, DPT, they opened up a world of passionate students and clinicians from all over the country and the world.  I started utilizing pound signs…I mean hashtags and twitter handles in my tweets.  A few years later, I had the pleasure of engaging with these professionals virtually and in person.

If you don’t have a twitter account, get one.  The best way is to just dive in and follow a few hashtags such as #ChoosePT, #DPTstudent, #SolvePT, #FreshPT, #PTFam and/or #TravelPT, just to name a few.

Still don’t get it? Start one, follow me, then tag me @AprilFajardoPT in your first tweet! Be part of the conversation.

PT Conferences
National Conferences: Have you ever been to National Student Conclave, Combined Sections Meeting (CSM), or NEXT?  It’s how the kids say, “lit?”  Yesss, LIT!!!! Everyone comes to this conference to learn, but one of the most important aspects of these conferences is the opportunity to formulate connections.  If you’ve been active on social media, meet some of those you follow on Twitter at one of these conferences.  You get to attend a multitude of receptions based on your interests and involvement from Alumni events to Section events.  The exhibit hall is equipped with the latest physical therapy gadgets and with recruiters from every corner of the US.  The

International PT Conference: This coming year, I plan on attending the World Congress of Physical Therapy on July 2nd-4th in Capetown, South Africa.  I look forward to the opportunity to learn from and engage with physiotherapists around the world.  Sounds enticing, doesn’t it?  Well, the early registration deadline is November 30th.  Join me and check out their website at http://www.wcpt.org/congress.

Professional Leadership
I’ve been on the go as a traveler; however, I’ve stayed engaged through the pursuit of my passions in professional development, engagement, APTA membership, global health, and service.  I currently serve as The Academy of Neurologic PT’s membership and public relations committee member, an Early Career Team committee member, and the PT Day of Service’s Global Affairs Chair.  My role in all these leadership positions has been location independent.  If I can do it, you can too!  Not sure where to start?  Fill out the APTA Volunteer Interest Pool at http://www.apta.org/VolunteerGroups/ or email the APTA Executive Director of the Section you want to get involved in at http://www.apta.org/Sections/.

Continuing Education Courses
Every state has a different set of requirements for continuing education courses.  However, I’ve found that the most helpful courses have been those developed by a specific section of the APTA.  I’ve taken a continuing education course on Parkinson’s Disease developed by the Academy of the Neurologic PT.  Terry Ellis, PhD, PT, NCS of Boston University  and Lee Dibble, PhD, PT of University of Utah taught the course through the integration of the evidence and its clinical application.  So if there’s a specific topic you want to learn about, check out what courses are provided by the appropriate APTA section.

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!