I had another conversation with Jimmy McKay of PT Pintcast. We discussed things to do in Denver around APTA’s CSM conference expecting up to 18,000 attendees this year. We also talked about my history of travel PT, new endeavors into concierge PT, and my full time gig as a slope-side therapist in Aspen, CO.
For other Hobohealth appearances on Podcasts and recorded presentations on travel PT: https://hobohealth.com/wordpress/media-appearances/
In this piece, The Vagabonding DPT and HoboHealth are teaming up for the 3rd time to present to you the major red flags we look for when choosing a staffing agency or when choosing to accept a specific travel assignment. These red flags shouldn’t be treated as absolute no-no’s for taking an assignment or using specific recruiters, but they should make you pause and think, “Is this what I want in an assignment?” If you run across these red flags, your antenna should perk up and you should be asking yourself if it is the right situation for you.
Red Flags for Recruiters
We may use recruiter and agency interchangeably. The recruiter is your main point of contact who also represents the agency. So, if you are working with a recruiter that starts checking the boxes on several of these red flags, move along. There is enough options for agencies that you shouldn’t be working for one that employs any recruiters with shady practices.
- One of the most egregious red flags is if your recruiter ever tells you that you can only work with them and not for any other agency. “If you don’t commit to me, I can’t give you my full attention either,” is usually how this is presented. The thing is, that is EXACTLY the role of a recruiter: To give you their full attention, to work as hard as they can to find the best job for you. If a recruiter can’t find you a job, they don’t make money. A good recruiter should be going above and beyond to win you over. YOU, the therapist, are the commodity. YOU hold the power, not the recruiter.
- When searching for a job, your recruiter should stay in touch with you often and actively search for jobs. Many agencies are passive in their job searches – they sit and wait for jobs to be posted to them through subscriptions to staffing databases. If your recruiter isn’t in touch with you often and communicative about the process of finding you a job, they may be solely relying on these databases. There are recruiters and agencies out there who will do the footwork of getting on a phone and calling around to clinics to look for jobs that match your priorities. You should feel like your recruiter wants to find you a job that meets your needs.
- As we’ve mentioned, constant communication with your recruiter is essential for your success as a traveling therapist. An excellent recruiter will disclose all aspects of your contract including the cancellation clause. All contracts include a cancellation clause in which the facility reserves the right to cancel your contract in the event that they hire a full-time therapist or therapist assistant to take over your position. This clause will typically give the traveling therapist either a 2 or 4-week notice prior to terminating the contract. Many new travelers may not even know about this until their contract gets cancelled. If it isn’t obvious in the contract, ask questions of your recruiter. While having a contract cancelled isn’t extraordinarily common, it does occasionally happen and you should know what the process is in case it happens to you.
- Some red flags may take a couple assignments with an agency to reveal themselves. If you find yourself in a situation where a company is refusing to pay referral bonuses you earned by referring colleagues, or if situations develop where previous pay is being reclaimed for questionable reasons – it’s probably time to start looking for a new agency. When things of a financial nature begin to creep up that don’t seem completely above-board, it is usually a good indicator of where the agency’s priorities are – in their own bottom-line, not the wellbeing of their travelers.
Red Flags for Facilities
The phone interview is typically your only chance to interview a facility. These red flags below come from questions you can ask on the interview to reveal what you really want to know about a facility. The interview isn’t just your chance to convince a facility that you are right for them, it’s also your chance to learn if the clinic is right for you! Ask the right questions on your interview, search for these red flags, and you may never have a bad assignment.
- During your interview with the facility, you must ask about productivity expectations. Skilled Nursing Facilities are notorious for unrealistic productivity expectations of 95%. This means that they expect you to have direct patient care for 7 hours and 55 minutes leaving you less than 5 minutes each day for chart review, documentation, team meetings, progress notes, re-certifications, discharge summaries, etc. Home care companies can also vary wildly in their expectations, it makes a huge difference whether you are expected to see 5 or 7 patients daily and whether different types of visits (i.e. Start of Care visits that can take multiple hours) are credited on your productivity as more than one visit.
- Ask the facility if they’re caught up on documentation. At times, SNF’s with staffing issues may have PTAs or COTAs running the facility and have a PT or OT off-site, which means that they may be behind in clinical documentation. If they are behind, you may be placed in a position in which they will ask you to update documentation for a time period before you were hired. This is a RED flag. Don’t ever risk your license.
- Listen intently to the flow of your conversation with the person interviewing you. Is it curt? Do they ask you about your experience, skills, or interests? We’ve both had interviews, which were brief with little insight to the work culture and dynamic. Our patients thrive when we are immersed in a collaborative environment that supports us as clinicians. Don’t be afraid to directly ask, “what is the work culture like?”
- If you’re interviewed by a regional director who does not work onsite, ask to speak with someone who does. If they say no or try to dodge this, then that should be a red flag. You want to speak to someone who can attest to the daily challenges of that facility. A regional manager, who lives in a different state, will not be able to provide you a realistic picture of those challenges. You will have a direct clinical manager, this person should be available for a conversation.
- Ask why the facility is short-staffed. Is it location? Is a therapist on sick leave or maternity leave? Have they recently expanded? It’s important to know what kind of staffing need you are filling for a couple reasons. If you would like the potential to extend your contract longer than the initial 3 months, it’s more likely to happen if the staffing need is ongoing rather than only for an employee’s temporary leave of absence. Chronic staffing needs occur for a variety of reasons. Some reasons for long-term staffing needs are completely reasonable, like being in a location far from any PT schools – these clinics often have staffing needs. Another reason that a clinic may have ongoing staffing needs is because they are, frankly, a lousy place to work. Asking more questions about the clinic’s staffing needs may help you discern between clinics with staffing needs for good reasons and clinics with staffing needs for bad reasons.
- If you are working in a stand alone clinic, ask who the owner is. In all other situations, it’s at least practical to know who your direct supervisor is. This seems like an innocuous question until it isn’t. James once didn’t ask this question and the owner and clinic supervisor was an unlicensed Chiropractor from South Africa. Ask this question, if the answers get weird, it is worth asking more questions.
- Find out who you’ll be working with. How many therapists and of what type? How many therapist assistants? How many other kinds of care extenders (ATCs, Massage Therapists, Techs/Aides)? An abundance of Assistants is a big red flag and a good indicator that as the therapist you will be spending more time doing evals and discharges than actually carrying out treatment. These questions can also help paint a picture in your mind of what a day in this facility looks like.
If you try to suss-out these red flags with your recruiters and during interviews, and if you are willing to walk away when the red flags stack up, you are likely to have a successful, enjoyable travel career. Failing to ask the right questions and have a meaningful dialogue on the interview can set you up for a frustrating time as a clinician and traveler. Good luck out there!
If you’re a traveling therapist and have any additional advice feel free to comment below.
April Fajardo, The Vagabonding DPT can be found on her blog at https://thevagabondingdpt.org/
I spoke with Jimmy McKay of PT PintCast about life as a Travel PT:
87 – James “Hobo Health” Spencer – Talks Travel PT