• Feature

    Greetings From PTs and PTAs Who Travel

    Traveling isn't for every physical therapist, but for many who do it, there's no looking back.

    Travel PTs

    A little more than 3 years ago, Dylan Callier, PT, DPT, was in the same position that thousands of physical therapists (PTs) before him had been. About to graduate from PT school—he attended Maryville University in St Louis—he soon would begin work at a new outpatient clinic in the town of Farmington, Missouri. The practice had been launched by a friend, and it wasn't far from where Callier had grown up. "It was a great opportunity," he says. "Something I felt like I shouldn't miss."

    Still, he had second thoughts, mainly because a staff position wasn't in his plans. "I had always wanted to be a traveling PT, and I'd assumed that was the path I'd take right away. 'Hometown boy goes off to see and travel the world.' That was the way I'd envisioned it."

    Despite his misgivings, Callier took the job. And while says he "absolutely loved it," the travel itch was back less than a year later, and this time he decided he couldn't ignore it. "I still remember that very first contract—packing up my stuff, leaving early in the morning, and driving off to California, where I'd never been before. It was that feeling of getting locked into a roller coaster: like, 'Okay, here goes! There's no turning back now.'"

    When he arrived at his assigned clinic in Palm Desert, a city east of Los Angeles and a haven for retirees, he had no idea what to expect. Callier's first morning began with a 2-hour orientation—"to learn their documentation system and take a HIPAA [Health Insurance Portability and Accountability Act] quiz"—and then he was off to see his first patient. "That day I had 6 evaluations, and 4 of my patients were Spanish-speaking-only, but I don't speak any Spanish." Fortunately, others at the clinic did. "They helped me out and translated, so it wasn't too bad—I made it through the day," he says, "and it got easier after that."

    The contract, like most in travel therapy, called for him to remain at that site for a total of 13 weeks. Nine weeks in, however, when the facility's workload shifted, the clinic manager decided to let him go early. "That's something a lot of new traveling therapists don't realize, and I myself didn't know could happen," Callier says. "There are cancellation clauses in every contract, so there's no guarantee they're going to keep you."

    In this particular case, the staffing agency that helped him secure the job found him another in Oakland, California. "They paid me for that lost week of wages, and I didn't have to switch housing or anything. Overall, I'd say my experience at both sites was enjoyable. Everything worked out well."

    An Evolving Path To Practice and Partnerships

    Ask traveling PTs how they got to where they are today, and you're nearly guaranteed to hear a good story. In Callier's case, a year and a half after that somewhat bumpy start, he's still traveling. His most recent contract was with a home health agency in California's Silicon Valley. Callier also hosts a popular podcast for health travelers called the "The New Medical Nomads."

    In addition to wearing those hats, Callier is the chief operating officer of Nomadicare, a traveler-focused business for therapists, nurses, radiology technicians, and others that bills itself as a "recruiter matchmaker." That role has been especially rewarding, he says, because it gives him a chance to help other traveling providers avoid some of the mistakes he made when he was starting out.

    "The way the business is set up," Callier explains, "you have your facility in need of a traveler and then you have a traveler. There are many middlemen between those 2, but the main players are the staffing agencies or recruiters."

    In the past, it wasn't uncommon for recruiters to take advantage of the therapists they signed, he says. "They might take your resume and submit you for a job without your permission, for example. Or, it wouldn't be clear how much an agency was charging for a therapist compared with what that therapist was earning." Traveling therapists who didn't know any better might be pressured into taking jobs that weren't a good match. And they'd often be paid less than were others with equal skills and experience because they didn't know they were allowed to negotiate.

    "Those kinds of scenarios are less common now because there are a lot more resources available that enable travelers to learn from their peers," Callier says. Nomadicare, for example, only connects therapists with recruiters it has thoroughly vetted. "We tell people: If your recruiter isn't offering a win-win relationship, that's not good practice. Go to someone else."

    One traveler who has listened to such advice is Sarah Munella, PT, DPT, a recent graduate of Daemen College in Amherst, New York. Less than a month after finishing school in 2018, Munella and her boyfriend, Alec Courtney, PT, DPT, committed together to take 2 temporary positions at a hospital-based facility in Indianola, Mississippi. It was the first job that came up, she says, "but it checked every single one of our boxes, as far as what we wanted and were told we should look for."

    Munella had taken an online class for new and aspiring travelers through WanderlustPTs.com, and had talked to the site's cofounder, Jess Renzi, PT, DPT, about Renzi's traveling experiences. "I remember calling Jess and freaking out, telling her, 'This job seems perfect, but it's the first one we got. What are we supposed to do? Shouldn't we look around?'"

    The facility, Munella says, was a good match for their interests. She'd be in skilled nursing while Courtney would be in outpatient orthopedics. The housing market in the area was good, and she was particularly comforted by the city's low crime rate. And most important, PTs at the facility were happy to serve as mentors. "Jess said to take it: 'You've done your due diligence; this is travel—your feet are in the water.'"

    They started at the facility soon afterward, and when the contract concluded 13 weeks later, they extended it by 3 months. After that, they took some time off and visited their families for Christmas. Then they moved on to their second assignment—another hospital-affiliated clinic in Sierra Vista, Arizona.

    "This clinic is a traveler's dream," Munella says. She and Courtney are practicing with a number of PTs—a vestibular specialist and an osteo- practor among them—who together have decades of experience. And as they did in Mississippi, Munella and Courtney are learning new skills every day.

    "We're getting these golden pearls from everyone we work with," Munella says. "In Indianola, there was a PT who had a phenomenal shoulder protocol, and his total knee rehab also was good. Now we're getting exposure to neuro, manipulation, taping, and everything else—all these different approaches to patient care." Meanwhile, Munella believes the perspective she brings to a clinic as a traveler can be beneficial to its permanent staff. "In most places, everyone knows each other—they're used to collaborating, and they know their different strengths. But when we come in," she notes, "we can share what we picked up at our previous site. We can learn new things from them, but maybe we can teach them, as well."

    Challenges and Rewards

    With the many traveler blogs that now exist—replete with picturesque photos showing PTs standing on mountaintops and walking pristine beaches—it's easy to get the sense that life as a traveling PT is something close to perfect. But ask Stephen Stockhausen, PT, DPT—who blogs at ptadventures.com—to describe what traveling is really like, and he's not afraid to tell it like it is.

    "It can be amazing, but it's not always easy," concedes Stockhausen, who travels with his wife,Ellen Stockhausen, PT, DPT. Both Stockhausens are board-certified clinical specialists in orthopaedic physical therapy. They're traveling with their toddler daughter, which presents parenting challenges on top of the other tolls that come with constantly being on the road.

    At one point they took jobs at separate sites in Alaska, assuming the dozen miles between their temporary home and Ellen's clinic would be manageable for her to drive daily. "Well, we hadn't seen Alaska in the winter," Stephen Stockhausen says. "There were times when it took her an hour and half to get to work."

    Another hurdle they've had to overcome involves the very nature of traveling. "A real disadvantage of traveling is the lack of community that can easily creep in if you're not purposeful about making friends at every contract," he says.

    The Stockhausens have traveled together for about 5 years—they previously each held staff positions for an employer in Durango, Colorado. For the first 3 years they rarely wanted to socialize. "But then we both fell into this kind of funk, Stephen Stockhausen says, "where it seemed like something was missing from our lives. I think part of it is that we're mostly working in home health, where you're pretty much autonomous all day long. In a setting like that, it can get lonely."

    Their solution was to start a Meetup group with other travelers and to attend similar gatherings—whenever they were hosted by local recruiting agencies—in the cities in which they worked.

    Traveling, Stockhausen says, "isn't for everyone," and even he and his wife anticipate settling back in Colorado within the next few years. He adds, though, that, to him, the perks associated with traveling make it a difficult option to resist. "If you don't have a good reason for staying put, and especially if it's early on in your career, I don't see any reason not to travel."

    Economically, he says, traveling often makes sense, "because you can earn a lot as a traveling physical therapist."

    The compensation benefits begin with the pay rate. According to one placement agency, "Typical travel physical therapy jobs can pay 15%-20% more on average than permanent positions."Add to that benefits which often include insurance (health, life, dental, and vision), licensure reimbursements, a housing allowance, travel reimbursements, referral bonuses, and a bonus for completing a 13-week assignment.In addition, some of those benefits—including per diem funds for meals and incidentals and the housing allowance—aren't taxed.The bottom line, according to one traveling PT couple, is "It's not unrealistic for new grad travel therapists to make up to 2 times as much as they would if they took a full time permanent job right out of school."3

    In addition, Stephen adds, the sense of adventure can trump the relative insecurity of traveling. "We've been able to see the country," he says. "We've lived in places in which we'd only hoped someday to vacation. And we've been able to enjoy these areas and get to know them on a deeper level than we ever would have if we'd only been vacationing."

    On top of that, Stockhausen says, he's found—as does Sarah Munella—that life as a traveling therapist can be professionally rewarding. "Many people ask me if the clinical work is challenging, and it definitely is. But the rewards are great. There are regional differences in the way providers approach care. Your coworkers all have different interests and specialties. You're seeing a hands-on technique that's new to you here, an exercise that's unfamiliar to you there. You can't help but add to your skillset anywhere you go as a traveling therapist."

    New People, New Adventures

    That also was the case for Jess Renzi, the traveler and founder of WanderlustPTs.com. "In the beginning, I didn't want to travel at all," she says. "I was a homebody. I didn't want to leave my friends or my family. But my boyfriend at the time said, 'Look. Let's just try it for 13 weeks. If you don't like it, we can go home.' I thought, 'I can do anything for 13 weeks.' So off we went, and that was it."

    Nine years later, that boyfriend is her husband, Gabe Renzi, PT, DPT. They're still traveling—most recently for an assignment Gabe landed on Martha's Vineyard in Massachusetts. "The decision to travel was the best we ever made," Jess Renzi says. "It just required me to step outside my comfort zone."

    Prior to traveling, Jess had worked as a staff PT for a little over a year. It was her first job after graduation. She was the practice's only PT and she had relatively little support. Renzi says. That made it slightly easier for her to make the move to life as a traveler. But the couple's first assignment—in 2010— also was far from perfect. "When we interviewed, they told us their productivity standard was 90%. We had no idea what that actually meant, or what it would take for us to be successful." They got through it, Jess remembers, "but it was a challenge—and not one that I would wish upon anyone."

    Among the many things Renzi says she quickly learned as she adjusted to her new professional track involved the licensing requirements for travelers. PTs must be licensed in every state in which they see patients. Historically, any PT who wanted a new license applied through the state board. "It's paperwork, fees, and time, and you need to understand the scope of practice in that state."

    At this writing in May 2019, however, 13 states are participating in the Physical Therapy Licensure Compact. Under the compact, a PT or physical therapist assistant (PTA) who holds an active license in 1 participating state can seek "compact privileges" to work in any of the other participating states.

    Many other states have seen compact legislation introduced, so the number of participating states will grow in the coming months and years.

    "If you aren't licensed in states where you're applying for jobs, clinics could be less likely to call you for an interview because they know you need to go through the licensing process," Renzi says, "and without the compact, that could take anywhere from 2 weeks to 4 months." She and her husband are based in Florida, which is not a compact state, but they each hold 6 active licenses, which Renzi says is "plenty" for them to find work.

    "My advice to anyone who wants to travel is to contact a recommended recruiter and find out what the market supports at the time that you're looking," she says. She also recommends "educating yourself" and talking with seasoned travelers about the how-tos of the business. And if you'd like to work in states such as Colorado or Utah (both compact), or California or Hawaii (non-compact), know that they're very popular and may not have as much work available as some other places.

    No matter the state, facilities that are looking for travelers tend to do so for the same reasons, Jess says. "I'd say that for 80% of travel positions, they're actually seeking permanent staff, but they haven't been able to fill the need for one reason or another." Those who do only want people on a 13-week contract—the standard length in the industry because most temporary housing leases require 3-month minimum stays—usually are seeking fill-ins for staff who have gone on maternity or medical leave, or they may be supplementing their teams to accommodate seasonal fluctuations in their patient population.

    "Either way," Renzi says, "a lot of places are looking to hire—and if you get there and you like the position, and they like you, there's a good chance they're going to offer you a permanent job." She and her husband have received such offers "pretty much everywhere we've been," she says. They've never accepted—she doubts they ever will—but they do often agree to contract extensions that allow them to remain for an additional 3 months.

    Today, Jess says, the thought of being settled in 1 spot for longer than 6 months is an "uncomfortable concept." She likes the sense of "newness" she feels in each position, and she loves meeting new people and trying new things. She has had to fight feeling lonely at times, but she's found success by saying yes to opportunities that her younger self probably would have skipped. She and her husband joined a kickball team while at one travel job, for example, and they've both learned yoga while traveling and now are certified instructors. Before they became travelers, Renzi had never hiked or camped, but she says she and her husband now have hiked in 21 national parks and have their own camper van.

    It's the many therapists and others she's worked with, "and how they've inspired me to change as a person," that Renzi says she appreciates most about being a traveling PT. "Most PTs, no matter what setting they're in, are just happy to be doing what they're doing—physical therapy is a rewarding career to begin with. I think what sets traveling apart is that you're always moving on to new experiences and challenges. For me, it's a new adventure every time."

    Chris Hayhurst is a freelance writer.

    References

    1. Travel Physical Therapy Jobs. Club Staffing. https://www.clubstaffing.com/allied-careers/travel-physical-therapy-jobs/. Accessed May 20, 2019.
    2. Physical Therapist Salary. American Traveler. https://www.americantraveler.com/physical-therapy-salary. Accessed May 20, 2019.
    3. Casazza J. How Much Money Do Travel Therapists Make? Travel Therapy Mentor. https://traveltherapymentor.com/2018/10/21/how-much-money-do-travel-therapists-make-the-comprehensive-guide-to-travel-therapy-pay/. Accessed May 20, 2019.

    Traveler Types

    Many traveling therapists start early in their careers, but that doesn't mean it only works for younger PTs. "I've seen a number of therapists who were empty nesters, or were nearing retirement, who decided they were ready to travel," says Matthew Michuda, PT, DPT.

    An ex-traveler himself, Michuda in 2012 launched a placement agency called ProTherapy Staffing, which he runs from his home in Indiana.

    Among the more seasoned would-be travelers with whom Michuda has worked are recent divorcees "who want to get away" and PTs with preschool children. "And then I've had travelers who aren't happy with their current jobs or living situations and see traveling as a way to test out new places before they commit to a major move," Michuda says. Some older, soon-to-retire therapists have taken contracts that allow them to be near their grandchildren. "They'll take a 32-hour-a-week job that gives them plenty of freedom, and they spend as much time as they can with their families."

    One of the great things about traveling, Michuda says, is the exposure it can offer to a variety of practice settings. "I've had several people come to me who'd done outpatient ortho their entire career and were thinking about trying something different. If you take a permanent job and 3 months later you decide that you don't like it, that's not good. But if you travel, you can try anything you want. Nobody's feelings are hurt when you move on."

    Focus on Doing the Job

    Don't assume that traveling work will be easy, says Tracey Duke, a division manager with recruiting agency Cariant Health Partners in Omaha, Nebraska. "You have to understand," she explains, "that facilities need travelers because they're short-staffed. If you walk in there thinking, 'I'm going to get the best patients and all the best cases, and everything is going to be hunky-dory,' I think you're setting yourself up to fail."

    Every traveler will have some "fabulous" assignments, and some will have great mentors and other perks. But more often, Duke says, travelers are going to find that they've been hired for 1 reason: "To go in, be a good therapist, and take care of your patients." Duke tells the PTs she places that it helps to keep an open mind. "If you're dealing with staffing issues, or have staff with difficult personalities, stay focused. It's best just to zero in on doing your job."

    APTA Resources

    APTA.org

    Physical Therapy Licensure Compact

    www.apta.org/StateIssues/InterstateLicensureCompact/

    APTA Student Pulse Blog

    "The Adventure-Seeking PT"

    www.apta.org/Blogs/Pulse/2018/7/TravelPT/

    "I Didn't Choose to Be a Travel PT, It Chose Me."

    www.apta.org/Blogs/Pulse/2017/2/TravelPT/

    "The Wanderlust PTs"

    www.apta.org/Blogs/Pulse/2018/8/TravelNSC/

    PT in Motion Magazine

    "Stepping In: Traveling PTs"

    www.apta.org/PTinMotion/2008/2/Feature/TravelingPTs/

    Other Resources

    Wanderlust PTs

    wanderlustpts.com/

    The New Medical Nomads

    www.newmedicalnomads.com/

    The Federation of State Boards of Physical Therapy

    Physical Therapy Licensure Compact Home Page

    www.apta.org/StateIssues/InterstateLicensureCompact/

    National Center for Interstate Compacts

    www.csg.org/NCIC/default.aspx

    Council of State Governments Webinar on Interstate Compacts

    www.youtube.com/watch?v=B7OkX8WQ__0

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