Why Travel PT Exists… and Why It Shouldn’t

This is the dirty little secret of travel PT. Everybody knows it, why not say it aloud. Everybody with me now:

“Travel PT should not exist.”

…Nor should any other traveling healthcare profession, really. Don’t worry, no employers will take this message to heart like they should – a healthy travel industry will undoubtedly persist beyond this blog.

Why are we allowed the ability to travel all over the country to choice destinations while making more money than the hard working professionals that live and work there year round? We shouldn’t, but many employers are so buried in processes and organizational optimization that they fail to see the easy answer to their staffing issues; A classic case of not seeing the forest through the trees. Pay your permanent employees more and you will need less temporary staffing!

I have to back up just a minute. We couldn’t eliminate the entire industry, some travel assignments are available for exactly the right reasons:

  • Losing an employee who is a new parent to maternity/paternity leave for several months after the birth of their baby.
    • If only paternity leave were a real thing. It’s a unicorn, it doesn’t exist. I guess paternity leave is more of a narwhal than a unicorn, because it exists, but it is very rare and few have actually experienced it. More on what employers could do to keep employees later.
  • An employee suddenly quits. A thorough search for a long-term employee will happen, but the clinic needs help NOW. Good time to hire a traveler while the clinic finds an awesome permanent employee.
  • An employee is lost to an injury for an extended or unspecified length of time – this is a great time to hire a traveler!

The reason most employers hire travelers is not these good reasons. It is because they believe they can’t find consistent staff in their area. False! Wrong! Misnomer! STOP TELLING YOURSELF THAT!!! The reason you can’t find employees is because your compensation package is sub-par. If you would just pay more, people would rearrange their lives to work for you.

I’d like to present a case of one specific employer I heard about recently – actually a group of a couple dozen employers. These hospitals share market information within a group. All of these hospitals are in the same geographic area. They base their pay off of the “market rate” which is an average pay between all the hospitals they compare rates with. The numbers they are looking at are for full-time PTs. So, a full-time PT gets paid a competitive rate versus the other fulltime PTs in the region. If one facility increases their rate of pay, their increase is averaged against the other employers. The thought behind this model is as need for employees increases, the pay goes up in the market – employees must be paid more to meet staffing needs. I’m not so sure this model works like they think it works.

This example sounds fair-and-good until travel PTs are included in the equation – travelers are not included in the calculation. You have a group of hospitals hiring full-time PTs at one rate, hiring travel PTs through agencies for much, much more money, and then not including that rate into their calculation of pay for full-time employees. Effectively, the market system of comparing with other local employers keeps the pay down – no one actually raises their pay, because they all compare to the “market”. Meanwhile, these hospitals hire expensive temp workers and do not add that cost to the calculation. Infuriating.

This is why travel PTs should not exist. If employers would pay their physical therapists a modest amount more, they would not have to hemorrhage money out to recruiting agencies every month to fill their needs, but they do and the travel PT life is a wonderful opportunity for the therapist that can pull it off.

A few years ago, I was accidentally sent an email containing one single recruiter’s billing for a week. The bill was organized by each facility and contained amounts for each traveler provided. There weren’t that many facilities listed, maybe 15. Most of the bills were for a modest number of travelers – 1 to 3 travelers per facility typically. BUT, one particular facility had over $30,000 of pay for travelers in one week!!! I kid you not. (would I kid about this?) I think I could quickly fix that facility’s staffing issue. PAY YOUR EMPLOYEES MORE!

Now, I am not advocating for the end of travel PT. I must repeat that it is a wonderful opportunity. I certainly took advantage of being able to travel the country while working a professional job and think many others should exploit this opportunity as well. Traveling is so cool. GO TRAVEL! Travel all across this country, work in different settings, with different people, in many different places. But, if all the employers smartened up at once and started paying their full-time employees more, the travel market would instantly shrink to less than half its size.

Don’t worry. The travel industry is going to do just fine, I don’t see any big changes happening any time soon. I can only write this because it will make zero impact on any employer – they will keep marching forward keeping their full-time employee rates at just enough for most people to no quit. Take advantage, travel, and enjoy yourself doing it while making much more money.

….and shhhhh! Don’t tell the employers about what I said.

Travel PT Resources

Travel PT Resources

Social media is full of trash, absolute junk. Physical Therapy’s twittersphere and facebook groups are mostly a flaming pile of garbage. Now, don’t get me wrong. Most of the people running groups on facebook and moderating discussions have pure intentions and deep knowledge – for the most part, they are true experts. It’s everyone else who gets involved that ruins it. Social media has leveled the playing field so that everyone’s opinion counts equally. There is no rating to show that one person may have in depth knowledge and experience while another is just a know-it-all crackpot. Vetting info and figuring out whose advice you can trust is more important now than it has ever been.

travel PT tax home rule

There was a particular post on a travel PT Facebook group with a series of completely false answers that led me to write this piece. Someone asked the often-asked question, “How far do I have to travel from my tax home to get a tax-free housing stipend.” Let the wrong answers pour in: “50 miles!” “60 minutes!” “100 miles!” ….people with such confident, concise answers. The correct answer is: “a taxpayer must be on a trip that requires the taxpayer to stop for sleep or a substantial period of rest.”^ …and there you have it, non-specific, open to interpretation, and totally typical of the IRS! That’s not an easy answer, is it? That is not easily repeated, typed into a social media thread, or understood. So, we get repeated, false answers like “50 miles!”

I’m done with the griping part of this blog, let’s get positive. I only share the example of awful information on Facebook pages to illustrate the point that you need to dig a bit deeper to find good resources – there are some fantastic resources out there!

  • There’s a number of blogs out there (like this one, of course!) that offer great travel advice. Rather than going fishing for a correct answer on a Facebook page, reach out to myself (James.Spencer.PT@gmail.com), or any other one of the many great bloggers – we all love to help people discover travel PT. Look around a little bit and you’ll find a blogger that has similar interests as you, like independent contracting, international service work, traveling with kids, traveling with pets, living in RVs – it’s all out there*. If you find a blogger that you identify with personally, you will have found a great mentor.
  • Ask a friend. Surely you have known a traveling PT, or you have a friend from PT school who knows one – or ask a professor at school who likely has a former student that is a traveler. These personal connections are important in finding your way as a traveler. Having someone you can confide in and trust their advice is very valuable.
  • If you have a great recruiter, they will be your greatest advocate and resource. Now, how might you find a great recruiter? Again, there’s some really bad resources for this online bought and paid for by the industry – The advertisers in the margins of this post are not just advertisers, but also companies I have traveled with and trust greatly. If you post on the HoboHealth Discussion Board topic Travel Therapy Companies, I’d be happy to email you with the names of the recruiters I use and trust. Also, I give some more generalized advice on picking a recruiter here: https://hobohealth.com/wordpress/traveling-pt/your-first-travel-gig/
  • Finally, I would be doing myself an injustice if I didn’t self-promote a couple more of my own resources that I think are fantastic:
    • Travel Essentials – these are the best blogs I have written over the past 12 years. You will find the answer to most travel PT questions within.
    • The Media page contains a whole bunch of interviews that are all about the same topic – traveling physical therapy.

Happy travels out there. Please don’t listen to any ol’ know-nothing on the interwebs when it comes to travel PT… or when it comes to any other topic. You’re better than that, and there are great, easy to find resources out there that have the answers you need.

^Sourced via traveltax.com: Tax Court Small Tax Cases (Archive), Daniel P. and Glenna J. Marple v. Commissioner., U.S. Tax Court, T.C. Summary Opinion 2007-76, (May 21, 2007)

*Some bloggers that I think put out great information:

Minimizing for Travel PT Assignments

The ‘ol Accord. Fully loaded, ready to roll.

When I was a traveler, everything I owned fit in or on my Honda Accord. Now, just 2 years departed from travel, I have all this stuff. Most of it has a function, the things that don’t definitely have sentimental value. Regardless of it’s use or sentiment, all of this stuff is… here. In my house.

As I get ready to move from my current home to a bigger house with additional free space (which I’m sure I can fill-up quickly), I am reflecting on everything I own and how it came to be this way. I had great joy living in a camper for 5 months on Martha’s Vineyard. I lived out of 2 suitcases in Hawaii for 6 months – multiple times. A 5×5 storage area once contained all my wintertime equipment and toys – now they spill forth from every closet, rack, and corner.

As I lament my minimalistic-demize, I’ll share these tips with you for down-sizing and keeping small as you transition to your next travel assignment. Come on, Marie Kondo, hugging all my belongings? Ain’t nobody got time for that.

Rent Furnished

This one is easy. If you rent furnished apartments, you won’t need furniture or appliances. This simplifies everything as you move place-to-place. Simple.

Airbnb, Craigslist, and HomeAway make it easy to find furnished housing for the short-term. I always had good success in the local classified papers finding things like inlaw apartments above garages (Skowhegan, Maine for that one). Just hop on the interwebs and find the local paper for wherever you are headed and you should be able to access their classifieds online. There remains this percentage of people who haven’t discovered the ease of online buying and selling – you will find apartments in the local classifieds that aren’t listed anywhere else.

It was just awesome living in the camper. I was so connected with nature that summer and had so little with me. Less is more.

9 Month Rule

You’ve got this car full of stuff that you’re dragging around the country. Some stuff is seasonal in nature – for me, ski gear^, but 9 months should account enough for the change of seasons and activities. If you haven’t used something in 9 months, you don’t use it enough to justify bringing it from assignment-to-assignment. Ship it home, send it to a friend, or consider establishing a gear cache (below).

Ditch the Electronics

There is so much you’ll be tempted to bring that you don’t need. You don’t need a better TV. You don’t need to bring video games with you. Leave the DVDs behind. Eliminate all the stuff you might see as a nice luxury for downtime. Your furnished apartment will have an adequate TV. With subscription services, you can order up whatever you want for entertainment while you are on assignment. Besides, hopefully, you are going somewhere awesome that will keep you out of your home most of the time. Maybe with less in-home distractions, you’ll go on more outdoor adventures and make more friends while on assignment. Games, TV, movies, Facebook – it’s all a giant time-suck that doesn’t enhance your life.

One In, One Out

Once you have pared down your belongings to a reasonable amount, you must maintain that small volume. Don’t accumulate! It’s easy to let stuff start showing up and staying – you will regret it the next time you have to move, which may be sooner than you think in the world of travel. Follow the simple “one in, one out” rule – if you bring something in, something must go out!

Need a new shirt? That means one has fallen out of favor in the rotation. If you’re going to buy a new shirt, you have to throw one away. Of course, the more stuff we can keep out of the landfills, the better – always resell or donate. The same goes for anything else you want to buy – want a new book? Then something comparable has to leave. Easy peasy. You’ve been living just fine with what you have. If you get something new, something old must go.

Gear Cache – A place to keep some stuff

I can’t tell you where this lean-to is, but it seemed to have everything I ever needed to live a fulfilling life.

Some stuff you want for “someday,” but you just don’t need it on assignment. Maybe you’ll want it when you’re not traveling anymore and are more “settled”. I have this waist-high gold colored box that I just moved to the new house. I haven’t opened the box in years, but I can’t bring myself to toss it either. The box has old baseball cards, pictures from high school, a class ring… things of that nature.

There’s some stuff you’re going to want to keep, but absolutely can’t travel with. You need somewhere to stash it. Maybe there’s a space at your tax home where stuff can stay, or maybe you need to rent a small storage area. It doesn’t matter where your extra stuff goes, but hopefully it’s cheap in case it stays there for a long time. And, hopefully it’s accessible in case you decide you need something from your storage.

For traveling, you have to lighten your load. Otherwise, transitions between assignments will become overly burdensome. Ditch the stuff you don’t need, travel light, and happy Marie Kondo-ing if you have the spare time.

^Footnote:
My first time up Aspen Highlands Bowl in 2008 – nearby where I live today. A truly inadequate ski selection that day. I was about 4 pairs short of an acceptable ski-quiver.

I believe every avid skier should have at least 5 pairs of skis for a variety of conditions and activities:

  • Rocks ski for the early season and questionable conditions.
  • Everyday ski for you standard mid-season, good-coverage ski day.
  • Powder ski for any epic pow-day, this ski should only be used with the correct combinations of conditions and skill-level.
  • A.T. Set-up – Alpine Touring for back country skiing, traveling to snowy places by foot, or just to earn your turns.
  • Cross Country For exercise when you can’t be on the hill.

This list is meant only as a bare minimum of the skis one should own and is no way meant to limit ski possession. ….perhaps this might explain something about my gradual fall from minimalism…. but what am I going to do? Give away my Powder skis!? Blasphemy.

Interview a Travel PT Recruiter with Anders Group

Last month, at APTA CSM, I got together with Stacy and Melissa, two recruiters from Anders Group to discuss travel PT. The premise of the conversation was getting into some of the “next level” topics that recruiters and travelers never get to discuss together.

At just under 40 minutes long it’s a good listen for your next run, commute, or road trip. Either stream it right now or hit the three dots on the right to download it for later. Happy listening!!!

I’m very happy with the conversation we had and hope all the things we discussed will help you find the assignments you want!

Many thanks to Stacey, Melissa, and Anders Group for taking the time out of a VERY busy conference to chat.

A Year of Firsts

2018 was my first full year living a settled life – not as a travel PT.

It has definitely been a transition – a transition that I might not be fully appreciating until now. Friends often ask, “Do you miss traveling?” I answer quickly, “Yes”. But, as I reflect, I realize all the things that have gone on in the last year. A lot of the things that I accomplished could only happen once I was done with the travel lifestyle. I loved my life traveling for work between ski slopes and beaches, but this year has been pretty special.

Violet charging around in the backyard of our family cabin in the foothills of Pikes Peak

This is the first year since 2004 that I have lived in one domicile for an entire year. Kate and I bought a house out here in Colorado almost two years ago. After months of DIY jobs and decorating, we are finally feeling a sense of home. Previous to this, we had briefly worked as permanent PTs before our 10-year stint as travelers. Before that, we had each traveled state-to-state for clinicals our final 6 months of PT school. …and prior to that, lived in a potpourri of apartments scattered across the segment of Boston inhabited by Northeastern University students.

I finally lived in Colorado long enough to get acclimated to the altitude. Many say it takes 2 weeks to get acclimated, I insist it takes more like 6 months to truly feel strong. I had grown up outside of Boston, but visited a family cabin in Colorado at 8,000 ft for just a week or two most summers. On most trips, someone got altitude sickness. Whether it be me, a family member, or a friend I had brought along, someone would puke intensely for about 24 hours, and then be fine for the rest of the trip. Now knowing what I know about altitude sickness, we might have approached acclimation a little more seriously.

This sign put up near an aid station about halfway up Pikes Peak made me laugh out loud. A bunch of rescue workers and volunteers were camping out around that part of the mountain… with a helicopter, just in case.

When I was a kid, my family trips to the cabin were usually during the last couple weeks of summer before heading back to school. We were often at the cabin during my birthday which is the same week as the running of the Pikes Peak Marathon. On most trips to the cabin, my family would drive up the “Pikes Peak Highway” to the 14,110 ft summit of “America’s Mountain”. On more than one occasion, we were at the top during the marathon to watch runners tag the 13 mile mark of the race, barely pause, and head back down. We all thought those guys were a bunch a psychos – who would want to do that? At some point along the way, I decided that I too was a psycho who wanted to do it – probably intense nostalgia and just a bit of hypoxia influencing that desire.

This year, I got to check the Pikes Peak Marathon off my bucket list. I was extremely excited and motivated during the whole process of training and through the marathon’s completion. The race went great! I took a relaxed approach and spent time getting food and water at each checkpoint. After resting a few minutes at the top to shoot some pictures, take in fuel, and have a small internal celebration, I soon realized many people were blowing past me to head back down to the finish line. I quickly rejoined the psychos for the 13 mile plunge back to the bottom. I am so happy to have had that experience. I don’t think I’ll do it again… but who knows.

Half way done. Feeling great taking pictures at 14,110 ft while this guy in the purple shirt and lady in the blue jacket both casually pass me and head back down.

I feel like staying in one place and stopping traveling finally let me make some headway professionally. I knew this would be a part of stopping travel, and it’s one small solace in losing several months near the coast each year. When I left my patients every 3-6 months, it was hard to find any sense of professional momentum. Now, working in one place for almost 2 years, I finally feel like I have some personal connection with my patients. I have people who come back every time they have an injury. I have malingerers who are constantly hurt and seem to never leave. I have doctors who expect me to be there for their patients. Most importantly, there is continuity – I get to see all patient cases to their end, and that has helped me grow tremendously as a clinician.

I still frequently joke about going back to travel, if only to make my co-workers uncomfortable, but let’s be honest, I have a house, I have a life here, and I have a kid – I am stuck!

Which brings about the greatest and best addition to my life – this has been my first full year with a kid. I can’t describe the happiness our daughter has brought. It’s a wild experience. At 1.5 years old, I’ve already been strapping her into skis in the backyard. She enjoys it for about 2 minutes, which is probably enough skiing when you’re one year old. People around here typically get their kids on the mountain in this first year – but I’m not so sure we need to be so aggressive about it. It will probably happen just before her 2nd Birthday, but only if the timing is right, and if it’s fun.

The whole fam damily.

I just remembered one other great thing from this year: my Boston Red Sox winning the World Series…. again! The Red Sox winning the World Series this year was the cherry on top of an already incredible year. Just had to mention that. GO SOX!

That’s it for now, but another year of adventures and firsts is just beginning. The whole family will head to CSM in Washington DC to kick off the year, and we’ve been brainstorming other potential air and road trips for the summer. Other APTA conferences have me busy zipping out of Colorado for 2-3 days at a time throughout the year. Hang on, it’s going to be a wild ride, and I’ll keep you updated as we go. Happy New Year!

Travels Well With Others

Physical therapists find ways to live this crazy travel-life in a bunch of different ways and have to overcome a variety of obstacles to find the flexibility in their lives that can allow them to up-and-go to different jobs at any time. People travel with their friends, with their spouses, with their pets, and with their families. Any of these obstacles adds a little complication to travel, but by no means should these be reasons not to travel.

Traveling in an RV has always seemed to me to be the best way to overcome housing struggles. Having your own, mobile space solves many of the difficulties of shuttling kids around from state-to-state or finding a short-term apartment that will allow pets. In 2014, we lived in a camper on Martha’s Vineyard to solve the issue of not being able to find affordable housing. The camper was a major part of what made that one of my all-time favorite travel assignments. There are pieces of our lifestyle that summer that I wish I could make more consistent staples of my everyday life. If Kate and I ever did continue to travel with our daughter, it would be in a camper again – like the Partridge Family of Physical Therapy.

Travel PT Camper Martha's Vineyard
Our pretty sweet set-up on Martha’s Vineyard.

A couple resources:

  • I have been enjoying reading PT Adventures and some of their recent posts on traveling with a baby – some on traveling with a dog too.
  • Highway Hypodermics is a facebook page for healthcare travelers living in RVs. The page has over 5,000 members and is definitely the best resource if you have any questions about living the travel life in a camper.

Travel PT With a Significant Other

If I know anything, I know how to find two travel PT jobs at once, because Kate and I were travel PTs together for about 10 years. I can’t think of a time that we weren’t able to travel to where ever we wanted because we couldn’t find two jobs – though, we did have to be flexible and inventive at times.

Travel PT Kona Waipio Valley Hawaii
One independent contract I worked was in Kona, Hawaii. This is from a day trip out to Waipio Valley. That was a great summer.

Normally, our first line of attack would be to find two jobs close to one central town. This approach would typically work. We never put any effort towards trying to work in the same clinic, but often a recruiter would find us two jobs at the same workplace. The agency would present us as a “travel team” which is advantageous for a facility trying to fill multiple positions – one stop shopping for multiple therapists. This easy solution was sometimes nearby where we wanted to be and not necessarily exactly where we wanted to be (i.e. commuting to work in communities just outside a major city we wanted to live in).  The most frequent settings we would find work together in was in smaller community hospitals (CAH) or working for a home care agency.

Even if you’re not romantically involved with another traveler, you might consider traveling with a friend. Two travelers working contracts together can be a great way to get ahead financially – getting two housing stipends and having only one rent is a great way to keep some more cashola in your pocket.

In the rare occasions that we couldn’t find two jobs in the same area, we would start calling around the area to private practices looking for independent contracts. One of us would have the “official” travel job with benefits, and the other would find an independent contract. Here’s a more detailed post on the process for finding an independent travel PT contract.

Living with a significant other who isn’t a Physical Therapist should not be the lone reason not to travel. I have met many couples along the way who have figured out how to make travel therapy work for them. One good friend (PT) met a Speech Therapist while traveling. They eventually got married, settled down, had kids, the whole nine yards. But, for a while, they took year-long travel assignments – her as an SLP in schools, him in a variety of settings as a PT. Additionally, I know several PT/OT couples who have had the same positive experiences we did – there’s a lot of facilities out there looking for PT/OT teams. I’ve also met many couples traveling as a PT with a non-healthcare worker (even one PT/recruiter couple!). If the non-therapist doesn’t have an easily portable job, he typically has to be more flexible in his work – odd jobs, seasonal work, Ridesharing driver, Amazon delivery, etc. With a little determination to get on the road, it’s easy to work odd-jobs for a few months at a time in many regions of the country.

Traveling when you have add-ons (family, pets, etc.) ultimately comes down to the final conclusion that so many things in travel therapy do – flexibility helps! The more flexible you can be with where you’re willing to travel, what setting you’re willing to work in, or what you’re willing to live in, the more opportunities you’ll have. A little flexibility goes a long way in finding happiness through traveling therapy.

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.

Careers in Travel PT with Regis University DPT Students

I had the opportunity to talk with Regis University DPT students. We covered a whole lot of topics in just 30 minutes – housing, tax home, finding a recruiter, searching for assignments, independent contracts, PT compact and licensure, health insurance…. and a lot more.

The presentation and Q&A were video recorded and are here for your enjoyment!

Travel PT Assignment Red Flags – With the Vagabonding DPT

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

Red Flags for Recruiters

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

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

Red Flags for Facilities

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

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

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

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

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

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.