PT Compact Update

Tennessee and Missouri share their borders with 8 states each, more than any other state in the nation. Both are compact states, and both are actively issuing compact privileges. Each has 6 of their neighbors in the compact, including each other. Tennessee has one advantage over Missouri – Tennessee’s neighbor, Georgia, currently has legislation proposed to adopt the compact later this year. Therefore, I hereby rule, Tennessee is the center of the PT Compact World.

You don’t need me to tell you where the center of the compact is. Just look at the most recent national PT Compact Map – you can easily tell we all revolve around Tennessee. Come on Missouri, “show me” I’m wrong. <— hehe, hope you caught the MO joke in there.

The compact has come a long way in the last year. 23 states have adopted the compact – 9 of those are active, issuing privileges to PTs and PTAs. If you’re in a state that has approved the compact already, but is not yet active, don’t worry. Most likely, if your state has approved the compact but isn’t active yet, they are actively working on making it happen.

As of March 15th, 2019

The compact is a scripted piece of legislature that states are individually approving into their laws. Each state has to approve the exact compact language. Any changes in the language would void the compact – essentially, it’s an agreement between states to accept licenses from other states – each state’s law has to match. So, if your state has approved the compact, but isn’t active yet, your state board is working to align its requirements with those of the compact.

It’s complicated, I get it if you don’t understand yet. A great example of an existing state compact is drivers’ licenses. Each state has the exact same language in their laws acknowledging every other states’ drivers’ licenses. That is exactly what the PT profession is trying to accomplish – license reciprocity among all states.

What I have heard about the actual compact experience is very positive. The people I have talked to have gone online, paid their fees, and immediately have license reciprocity! If anyone out there has had an experience, good or bad, with using the compact, lease post in the comments. I think it’s important that we start to collect some info on how the compact is doing in the real world.

There are 23 states onboard and another 5 are currently working towards adopting the compact. There is a very realistic scenario that we could have over half of the country on the compact by the end of the year – that is a very big feat in a very short time! As more states sign onto the compact, the states who are not onboard will find themselves being the odd-man out. States without the PT Compact will likely suffer staffing shortages. In a world where we are expecting PT staffing shortages through at least 2030, I can’t imagine why a state wouldn’t want to decrease whatever barriers it can for workers to come work!

That’s all I’ve got on the compact for now. Please do share any positive or negative experiences you have had accessing compact privileges. Ask any questions you might have. I’ll be replying and writing on this topic in the future as things progress forward.

Where Should I Work This Winter?

As pumpkins take over the world, traveling therapists begin to think about their next assignment that will last a good portion of this winter. Where do you want to be this winter?

Ocean, check. Mountains, check. Yeah, I could do San Diego. Does anybody know what San Diago means?

Ocean, check. Mountains, check. Yeah, I could do San Diego. Does anybody know what San Diago means?

On the beach? On top of a snowy mountain? Somewhere exotic and outlandish? Are you going to hibernate, or are you going to thrive? I’ve got you covered, here are some of the best places I’ve been in the winter and other places I would love to go in the future.

Southern California

I always wanted to do an assignment in San Diego, but somewhere along the way it fell off my list. It seems like it would be a great place to get a January tan. I know lots of people who have taken assignments throughout Southern California and absolutely love it there. Home care offers really good pay rates in SoCal if you’re willing to try out that setting. The only hitch to working in California is that getting a license can take 4 to 6 months, so get started now if it’s on your list.

Ski Country

Pop Quiz: Question: How does a snowboarder order a meal? Answer: "Hey Bro, you gonna finish that?" Question: 2 Snowboarders are in a car, who's driving? Answer: The cops.

Pop Quiz:
Question: How does a snowboarder order a meal?
Answer: “Hey Bro, you gonna finish that?”

I love skiing, so I do the opposite of the snow birds. I love living in the mountains with skiing right outside my front door in the winter. There’s a lot of places to find jobs near skiing, but to actually live and work in a ski town is an experience that every avid skier (or snowboarder) should have.  most hospitals in the Colorado Rockies hire directly (without staffing agencies) and you’ll need to pick up the phone and call or go check the hospital’s website for employment opportunities. You might have more luck around Salt Lake City which has more employment opportunities and all the world-class skiing you could dream of within a 30 minute drive. Wyoming and Montana offer more rural settings with great back country access and beautiful, pristine landscapes. New Hampshire, Vermont, and Maine all have quick access to big mountain skiing – some of the best skiers (and snowboarders) in the world come from New England – Bode Miller, Ted Ligety, Simon Dumont, Jeremy Jones. If you’ve wanted to see the Northeast and you’re a fan of winter sports, winter can be a great time with a lot of job opportunities and decent access even as far south as Boston.


Hawaii, idyllic for any traveller anytime of year. Plan ahead, lots of people want to go to Hawaii and jobs are competitive.

Hawaii, idyllic for any traveller anytime of year. Plan ahead, lots of people want to go to Hawaii and jobs are competitive.

I love my time in Hawaii, but I am never here in the winter time due to my aforementioned affection for skiing. Although, the summit of Mauna Kea at over 13,000 ft does offer enough snow to ski on in depths of winter – so there’s that option. During the Hawaiian summer, the surf is more calm and better for swimming – the summer brings less rain too. But the winter is when Hawaii really displays its beauty. Migrating whales visit Hawaii by the thousands in the winter. The increased rain brings deep green colors to the hillsides that are brown and parched during the summer. And the surfing world gets together on Oahu’s North Shore to hold competitions on the best waves in the world during the winter months. If you want to go to Hawaii, you have to be flexible – a lot of people want to go there, so finding an assignment or getting your resume in ahead of other people can be hit or miss. I normally recommend making sure your recruiter presents jobs to you before letting them submit you. But Hawaii can be competitive enough that getting your name in first can be a real advantage – when it comes to Hawaii, you may consider giving your most trusted recruiter the green light to submit you to any job that fits your criteria.


Huh? Antarctica. Hang with me here for a minute. Our winter is the southern hemisphere’s summer. The University of Texas Medical Branch staffs the 3 US research stations in Antarctica with contract workers. Each year they look for, “Licensed Physical Therapists who have a strong clinical background and a taste for adventure.” I think both of those qualifications need to be strongly met. In a position where you may end up being a fairly solitary clinician with limited resources, you must know your stuff, and you have to be able to improvise with whatever is available to you. A “taste for adventure” states it lightly. I have heard this job is essentially like working on a submarine except that you get to go outside occasionally. My understanding is that you rarely get off base, and when you do, there is NOTHING (except hungry polar bears)… but, you’re in Antarctica and that is pretty cool. I have also heard about the “Race Around the World” – A 5K race in a loop around the South Pole – that’s just hilarious and awesome.

US Virgin Islands

Did you know the US Virgin Islands are a part of FSBPT, the same body that all US states belong to for PT licensure? Oh yes. It is as easy to transfer your license to the Virgin Islands as it is to any other US state. There are jobs available in the Virgin Islands, it’s easy to transfer your license, and they are a short flight from anywhere east of the Mississippi. I’ve talked with a couple people who have worked there, and they’ve loved it.

On a side note, while FSBPT is in the conversation – if you are a traveling Physical Therapist or recruiter and you are unaware of the Physical Therapist Licensure Compact, educate yourself now. PT licenses between certain states will be reciprocal within the next two years – very exciting, make sure your state is included!

Choose Your Own Adventure

Don’t be limited by these 5 options. Choosing where to go as a traveling therapist is as personal choice as you could make. There’s all kinds of opportunities available in the Southeast and the Southwest – great, warm places in the winter. I’ve seen and heard wonderful things about Lake Havasu in Arizona and San Padre Island in Texas – I just know nothing about them, so they aren’t mentioned here. Why not make an adventure. Try finding an assignment in the Florida Keys. Don’t let any list limit you, go out and find the place YOU love, that’s what traveling therapy is all about.

My Landlord is a Clown

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

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

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

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

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

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

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

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

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

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

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

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

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

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


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


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


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

10/22/15 – PM

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

Two weeks later… 11/4/15

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

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

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


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

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

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

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


Watching football on the camper's big screen.

Watching football on the camper’s big screen.

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

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

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

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

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

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

See you on the road.

Lightening Round

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

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

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

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

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

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

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

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

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

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

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

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

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

Preview of Coming Attractions

Matha's Vineyahd

The Cape and Islands

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

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

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

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

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

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

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

Stay tuned! Lots of adventure and fun ahead!

At Least It Wasn’t In Boston

Hang with me. I’m amped, I motivated, I’m psyched, I’m downright manic – and I only have a short time before this feeling fades to make as much progress as I can, including pumping this blog out to you.

Actually the weather when we left Denver, but Indy was very similar upon our arrival. The weather bothered a lot of people, me too actually, but at least I was used to and prepared for it.

Actually the weather when we left Denver, but Indy was very similar upon our arrival. The weather bothered a lot of people, me too actually, but at least I was used to and prepared for it.

I just got back from CSM (APTA’s Combined Section Meeting) and I have the same feeling I always do after one of these conferences – I need to make an impact, and I need to do it now. For those of you who may not be familiar with CSM, it is a 4 day conference held annually that brings together over 10,000 PTs, PTAs, and students for some high level education. Well, education is the pre-text, I find myself more drawn to the social… excuse me, “networking” events. The reunions with old classmates, professors, colleagues, and friends are totally priceless. These people, automatically by being at the conference, are also all jacked up about PT and what we need to be doing to make it even better. So, while I indulge heavily in the social “networking opportunities,” I look forward to the conversations all year: Conversations about the research friends are engaged in, different practices in different clinics around the country, and what every individual therapist is doing to improve PT and all of healthcare in their communities and nationally. Don’t get me wrong, I found the actual, formal programming fascinating too and have several clinical-pearls to bring back to the clinic an implement immediately, but I just love getting together with everyone.

Lots of education, meetings, and receptions at CSM. Luckily many of the meetings come with ample networking and a cash bar.

Lots of education, meetings, and receptions at CSM. Luckily many of the meetings come with ample networking and a cash bar.

CSM is an ultra-boost, one of the highest forms of motivation, but not everyone can or needs to go to CSM. BUT! Everyone should do something to get a similar charge. As travelers we can exist very isolated in our individual silos unless we make a concerted effort to expand our horizons and take in some new information. There’s a certain stereotype of the traveler out there that just simply doesn’t apply to the vast majority of travelers – let’s give this stereotype a name, how about “Clint” – definitely just a random name, yeah, random. Clint is a lazy slob. Clint hasn’t had a meaningful continuing ed experience in 4 years. Clint is at work to survive the day and definitely not to excel. The thing about Clint is, I’ve never met a traveler like him. Travelers are generally insanely fascinating people who have the motivation, gall, and cajones to drop convention and get out on the road. A seasoned traveler can be dropped into a clinic on Monday and be completely indiscernible from the permanent staff by Wednesday – a true chameleon. In PT these days, autonomous is a hot word. If there’s anything more autonomous than loaning your services out for 3 months at a time to the flavor-of-the-month employer, I haven’t seen it. A traveler is truly autonomous, highly resistant to the negative influences that colleagues, bosses, and referral sources can build over time. The hyper-autonomy of the traveler’s life, moving from place to place and determining your own path, can be isolating. We must seek out education and motivation if we don’t want to end up like Clint. There are tons of great options out there: Courses offered locally during contracts, courses offered at a distance on a road trip between assignments, state meetings of your professional association, and more long-term certificate and specialization courses. We must make sure we get out there and get supremely jazzed-up by interacting with other professionals and finding out what else is happening beyond our small sample of personal experiences. There’s nothing worse than seeing a new traveler show up to a job with all the confidence in the world that they know everything there is to know. A traveler will learn over several assignments that while there are great things about the way they have been taught to treat already, there is much, MUCH more to learn. Let me be clear, mastery of treatment and skills does not come from one clinic or one model of treatment, it comes from exposure to a great expanse of different treatments and styles over years (another advantage of travel).

Sunrise in the Indy airport after the last night of CSM. As you can see, the weather did get better, it was actually pretty nice by the end of the conference.

Sunrise in the Indy airport after the last night of CSM. As you can see, the weather did get better, it was actually pretty nice by the end of the conference.

So, go find your own CSM. Whatever gets you excited about your PT, OT, or SLP career, explore it in more detail, get exposed to all the different tangents that surround it. Put yourself in groups of other therapists and talk about what you do – more importantly, listen to what others do. I’m psyched, I’ve got video gait analysis techniques to implement, new post RTC repair techniques to use, emails to send to old friends to tell them how nice it was to see them, and emails to new friends to ask them to tell me more about their projects and passions. While out exploring the country, get invigorated, don’t get isolated in your own silo, don’t justify the stereotype of Clint.

What’s Next?

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

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

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

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

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

::segue coming::

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

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

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

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

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

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

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

The Journey of Stuff

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

TravelPT - longest wharf in Hawaii

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

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

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

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

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

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

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

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

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

Two Weeks of Shampoo

The last few weeks around this blog have been a little too serious for my taste. Time to stop taking on all the problems of the world and get back to the nonsense and fun about being a traveler.

Things are winding down on this assignment. 11 weeks are gone and only 2 remain. In a non-traveling life, I think months and years would start to blend together for me, but the constant change in job and location helps to keep my memories of events organized. If I lose track of when something happened, all I have to do is think about where I was living, and instantly I know when it was. When did the Red Sox play the Rockies in the World Series? I was living in Colorado Springs, so it must have been 2007 – Go Sox! This constant change also creates constant deadlines – projects must be completed before any big move, i.e. Christmas cards must be sent before this assignment is over, otherwise it will be mid-December before I’m situated and organized again.

The sun set a couple weekends ago. This has been a great assignment and moving on will bring more adventure but is bitter sweet.

The sun set a couple weekends ago. This has been a great assignment and moving on will bring more adventure but is bitter sweet.

As the time has gone on with being a traveling PT, I’ve become very good at estimating time in unusual situations. For instance, it takes about two weeks for me to memorize the light switch arrangement in a new apartment. Until two weeks has passed in a new place, I am likely to be found late at night, in the dark, feeling my way around the walls trying to find the right switches. I realized recently that I’m constantly thinking of all kinds of bizarre things in terms of time.  A Costco trip at the beginning of each assignment will be filled with estimations about whether each package is big enough or too big for the whole assignment – I’ve gotten good. Two large jugs of maple syrup (32 oz each) will last 3 months. We somehow ended up with too much maple syrup on this assignment, now we’re really having to eat/drink a lot of the stuff – woe is me. 🙂

Now that I think about it, this assignment has been a tricky one for managing the amount of products we have. We’re really isolated here on the island of Molokai, and there’s no major chain stores (except for Ace Hardware). The barge comes in only twice a week with supplies and most of the stores are locally owned and small. Most of the things we’ve been buying are limited in selection and you have to buy what’s available whenever you need it. I thought I was going to run out of body wash and spotted some on sale a couple weeks ago. I jumped at the opportunity to get a decent price. As the days tick down, the original bottle is still managing to hang on and I’m realizing that with a little conservation I probably could have made it through without the new bottle. Now, with all this extra body wash, the inclination is to try and burn through the bottle fast, make every shower a super-soapy-sudsy event. But, that’s not sane, I’ve really had to step back, use the normal amount of body wash, and realize that it’s alright if I leave a couple bucks worth of soap at the apartment when the assignment is over. Man, I thought my powers of soapy-estimation were better than that. Luckily, we’ve just learned that the travel PT starting the week after us will be moving into our apartment, it makes me feel better about leaving some extra supplies behind.

Time for me to run, we’re having hamburgers tonight, gotta start to eat down the beef supply in the freezer. I’ll write again next week before this assignment is done – the deadline is approaching fast.