Written by Travis Kemper, PT, DPT and Whitney Eakin, PT, DPT, ATC
When therapists are beginning to look into travel therapy, it can be hard to understand both a travel therapy contract and what the expectations are for you while working as a contracted travel therapist at a facility. For many, it’s difficult to learn how to appropriately advocate for themselves both during the negotiating period and while on contract. Unfortunately for us as travelers, not all companies, recruiters, facilities, and contracts are the same. We’d like to think that companies and recruiters have our best interest at heart, but sadly that is not always the case. Healthcare, including travel therapy, is a business. And as such, there are many factors at play, from the facilities we work for, to the travel companies we contract with, to our recruiters and the other staff members at the travel company. This is one reason it’s important to “interview” several travel companies and recruiters in order to find the best recruiter to have in your corner. And, it’s important to thoroughly “interview” the facility during your phone interview.
In our field, many therapists, bloggers, and companies are working towards making the industry more transparent to help new and prospective travelers better navigate the world of travel therapy, without having to worry so much about “looking out for themselves.” We hope that websites such as ours can help therapists to be more aware of the business side of things and instill confidence in their negotiating abilities and advocating for themselves as employees.
For those of you who may be just starting out, we want to share with you some “rookie contract mistakes,” as remembered from us as experienced travelers, as well as how you can avoid these same mistakes. Do bear in mind that each traveler may have different priorities, among which pay may not always be the highest. So while negotiating pay is a big part of this, there are also many other factors to consider in building a contract that suits you and advocating for yourself while on contract.
1. Overtime Pay Rate:
Everything is negotiable in your travel contract, including your overtime rate. We almost all made the mistake of not negotiating for a higher overtime rate in our first contract, but you can learn from our mistakes. While in general you will hear that most facilities don’t want you working overtime as a traveler, we have seen for ourselves that many facilities either don’t mind or will allow overtime when it’s really necessary. For example, if the facility is very busy and they don’t have any other full time or PRN staff, such as in rural areas, they would rather have their patients seen and pay you overtime than not have the patients seen. Jared worked over 400 hours of overtime in less than three years when starting out as a travel therapist so overtime opportunities are definitely out there! Also, as we will cover later, as hourly employees when you work past 40 hours, you should be getting paid overtime and not working off the clock. And we know for a fact that many if not most travelers work over 40 hours.
In my (Travis) and my fiancee Julia’s first contract, we had an hourly rate of $20 and overtime rate of $30 (time-and-a-half of the hourly rate). We ended up working a lot of overtime in that contract, and at $30 per hour, which isn’t even a normal hourly rate for many permanent physical therapists, it was not worth it to be working overtime. Personally, I really don’t want to work overtime. I am happy with my weekly pay. Money is not the number one motivator for me, and Julia is significantly less motivated by money than I am. But for some, having extra pay in the form of working overtime might help them reach their financial goals. But because it wasn’t important to us, in our second contract, we said no overtime at all. This also didn’t work out perfectly, and I don’t recommend it. Strike two. We will cover the problems with this strategy later. The third time is a charm, right? For our third contract, we decided that if we were potentially going to work overtime, we were going to make it worth the hours we put in. We negotiated an overtime rate of $70 per hour in our third contract. This is how we suggest you approach overtime rates in your own contracts to make the extra hours worth your while.
Where did I get this number? I talked to a permanent PT at the facility and found out that their hourly rate was $46.50, which would turn into nearly $70 in overtime. We probably could have gotten even more at this particular contract, but we were happy with the rate we negotiated.
2. Never work off the clock!
While not directly related to contract negotiation, we feel that it’s important to cover this topic here to make sure that other travelers and healthcare professionals in general are advocating for themselves. Not only is working off the clock unethical, but it is also illegal! Working off the clock can get you and the company in a lot of trouble legally. You need to be compensated for your time. If you are being pressured to work off the clock, you have to stand up for yourself, talk to your recruiter, and flat out refuse. This is where our second contract overtime strategy mentioned above failed us. The facility would not approve overtime, which caused Julia to feel pressured to work off the clock to get her notes completed. Don’t do this. If you are working, you need to charge the company for every hour you put in. Anything less is allowing yourself to be taken advantage of and disrespecting your personal time.
We have all seen so many travelers and permanent employees clock out and continue to work or do notes, or take notes home. While this may seem like it’s just “part of the job,” it’s not. If you are a traveler working as an hourly employee, you are paid for the number of hours you work. Of course, do not take advantage of this, and make sure that you are working as diligently as possible. But if the productivity expectations are unreasonable and you are not able to complete all work, including documentation, during your contracted hours, you should be compensated for the hours that you work beyond 40. If the facility is unable to compensate you for overtime worked, then your caseload or schedule needs to be adjusted accordingly so you can complete all required work during the 40 hours.
3. Productivity standards:
This is also an important point to cover when considering working as a travel therapist. Unfortunately, productivity standards are part of being a healthcare professional, and they certainly still apply as a travel therapist. Some report that productivity expectations have been more strict on a traveler, others more lenient, or others just equal to the permanent employees. When considering a travel position, you want to get an idea of the productivity expectations before signing a contract. This may be something you want to wait until toward the end of the interview to discuss. You never want to sound like you are not qualified to handle a caseload, but you also need to be realistic with yourself and the facility. Sometimes productivity is something that will actually be written into the contract and you will be held to, otherwise your contract could be terminated. Whenever possible, we don’t recommend you accept these terms. Most of the time, the productivity will be more of a verbal agreement and expectation.
If it’s a SNF asking for 90% or greater productivity for an evaluating therapist (PT, OT, SLP), consider if and how that will be manageable. Is there a therapy aid to help with transporting patients or other appropriate tasks, or are you going to be transporting patients, cleaning your work area, etc in addition to patient care? Is there a set schedule for patients to receive therapy, or will you have to find the patients yourself and deal with patient refusals, interrupting other staff duties, etc? Is a laptop or tablet provided to allow for point of service documentation, or are there only computers and wifi in the therapy room? If the facility operations are not conducive to your success and productivity, then a 90% expectation is undoubtedly unrealistic as an evaluating therapist.
Similar cases can be made in other settings including home health, hospitals, and outpatient clinics. It’s important that you understand what is a realistic productivity expectation for you and the setting. You should also get an idea of whether there is leniency on the productivity during extenuating circumstances. For example, one week your caseload may be higher than another week. Is the manager understanding that your productivity may fluctuate based on the clinic flow? It’s important that you discuss this with the facility prior to accepting a position. Many travel therapists will get themselves into a bad situation with unrealistic productivity expectations because they are afraid to speak up, which results in many therapists feeling pressured to work off the clock. Don’t make that mistake!
4. The difference between guaranteed hours and weekly pay:
On your contract, you may have a “guaranteed hours” line which may be 32 hours, 35 hours, 40 hours, etc. Realize that your quoted pay from your recruiter will be for 40 hours. If the facility and/or travel company is only able to “guarantee” 32 hours, you are better off to calculate your numbers based on the guaranteed hours so you can budget more effectively.
For example, if you’re expecting to make $1600/weekly after taxes if you work 40 hours, but you are only guaranteed 32 hours, you may only be getting a paycheck of $1280 some weeks if you only work 32 hours. Ask your recruiter for more specifics on how they calculate your paycheck if you only work the 32 hours. For example, do they deduct your full hourly pay and stipend pay, or just the hourly pay?
On the other hand, if your company guarantees a full 40 hours, make sure you understand how this works. Normally, this means that if you are unable to work the full 40 hours due to low census or the facility calling you off, then you will still get your full paycheck. However, if you do not work 40 hours because of illness or asking off for an appointment, going out of town, etc, then you do not get paid 40 hours if the time off is not the facility’s responsibility. Likewise, some companies don’t pay the full 40 hour guarantee if the facility is closed for a holiday or inclement weather, but some do. It’s important to ask your recruiter these questions so that everyone is on the same page!
5. Understand that per diem (stipend) rates can be based on hours.
We alluded to this above, that stipends can be based on the hours that you work. This is a subject that seems a little sketchy because these rates are supposed to be for your housing and meals, but a lot of companies will tie these reimbursements to the number of hours you work. This means they can decrease your per diems (stipend money) if you work less than the required hours stated on your contract. A lot of travelers get angry about this, and we see their point, but at the same time the travel company only gets paid if you work. Make sure to discuss this with your recruiter and read the fine print in your contract to understand how many hours you are expected to work each week.
6. Get time off requests written into the contract in advance.
Travis and Julia have taken time off in the middle of every contract so far. Some reasons they took off were to go to the APTA NEXT conference and to hang out at Universal Studios. Others may need to request time off for a wedding, a family vacation, or for holidays. It’s important that you clear these requests with your recruiter and especially with the facility before you sign your contract. You want to make sure the dates off are agreed upon in advance and written in black and white. Sometimes the facility may not be able to approve your request, but it’s much better to know that up front. If you have a wedding to attend, and the facility needs you to work those days, you may have to pass on that contract altogether.
What if something comes up and you need time off once you’ve signed the contract? Things happen, and most facilities understand this. For example, you may be sick, or a family emergency could arise, or you may need to schedule a routine medical appointment during your contract but don’t know the date in advance. If you know that you’re going to have something like a routine medical visit during your contract, but don’t know the exact date, try to discuss this with the facility at the beginning of your contract. Let them know you need one or two days off during the contract, but will have to let them know the date later on. Usually they are going to be understanding and allow you to take the day off, unpaid of course. Or, depending on the facility hours, they might be able to let you shift some hours during the week to make up for that time off. For example, work a weekend shift and take a day off during the week. But it all depends on the facility and is not guaranteed.
In the case of illness or family emergency, neither you nor the facility have much choice in this matter. Hopefully the facility will be understanding, and the travel company can just deduct or adjust your pay accordingly. Sadly, there have been cases where the facility was not accommodating, and in rare and serious cases, some travelers have terminated their contracts due to a family emergency. Do know that these are circumstances where it may be completely reasonable for you to end a contract. On the other hand, if you have personal matters that cause you to miss too much work that was not previously agreed upon, the facility does also have the right to terminate your contract in that case.
These are a few key points that we wanted to cover about contract negotiation and self advocacy as a travel therapist, from our personal experiences as travelers as well as the problems that other therapists that we have talked to have encountered. If you have questions about a contract, the negotiating process, or self advocacy as a travel therapist, please feel free to reach out to us and we can offer advice based on our experiences!