Category: Unique Traveler Stories

Travel Therapy With a Spouse Who’s Not a Healthcare Professional

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Guest Post by Ryan Eldridge for Travel Therapy Mentor

We often get questions from healthcare professionals who want to travel, but they are unsure if it’s feasible for them due to having a spouse or significant other who isn’t a healthcare professional. Fortunately, we know many travelers who have made it work traveling with their partner or family. Everyone’s situation will be different, but there are many options to explore to allow your partner to join you on your travel healthcare journey. Some travelers are in situations where their partner may not need to work and can come along for the journey, but many are interested in learning how their partner can still work and earn income while on the road. We asked our friends Kayla and Ryan to share their story on how they have been able to make remote work possible for Ryan, a software developer, while Kayla, a Physical Therapist, takes travel contracts around the country! Check it out below to see what Ryan has to share!

Traveling for work is such a rewarding lifestyle. Life can’t get much better than being able to see the world and having amazing adventures while still earning a living. Whether you’re a solo healthcare traveler, or traveling with a friend, a significant other or a family, you get the opportunity to have these incredible, unforgettable experiences. In our case, we are a married couple that travels together, and we feel very fortunate to be able to share these experiences together.

What We Do for Work

I am a software developer and my wife, Kayla, is a traveling Physical Therapist. We started traveling about a year and a half ago in late 2020. It was a fairly easy transition for me as I fortunately have a job that allows me to work remotely, so that I was able to travel with her without having to figure out an alternative solution.

After working for my company for a few years, more and more people started to leave and work from home, so I took advantage of this and did the same. Initially, it was just to save on time and money from the commute, but it worked greatly in our favor since we decided to start traveling.

Suggestions for Finding Remote Work

Try going remote at your current job

The easiest solution to finding remote work is to try to work your current job remotely. This doesn’t apply to every job, but if you think your job can be done as well remotely as in the office, then I have a couple of suggestions.

Before asking your boss, get prepared. Have concrete examples and actual numbers. 

Try researching the topic. I particularly enjoyed the book “Remote: Office Not Required” by Jason Fried. This can help you come up with good examples of the benefits of remote work that you can share with your boss.

Develop a communication plan

Lack of communication is oftentimes the reason why bosses may not want their employees to work remotely. Propose a solution ahead of time, such as daily updates in emails, or short meetings, or maybe a weekly catch up meeting to go over goals and how things are going. Having suggestions ahead of time shows you’re serious and are willing and able to make it work.

Leverage time or status at company

If you’ve been at the company for a long time, or have an important job that is tough to fill, make sure to leverage that. Let them know you’re serious, and if they don’t let you work remotely they could lose a valuable employee. However, be prepared to walk away from the job if they disagree.

Look for a new job

Even if you’re trying to keep your current job, it may be beneficial to look for new jobs in the same position that hires remote workers. You can use them as leverage and show that other companies are doing it, and you can get a head start on finding a new job if modifying your current job doesn’t pan out.

Can’t Work Remotely?

If you’re looking for new work opportunities, there are many options out there. Keep an open mind and maybe try a few different ones to find what works for you.

Work Camping

Some campsites, National Parks, and RV parks offer Work Camps where you can do seasonal work for them. This can be a great option for those that travel in an RV. Oftentimes this means you can work for a few months right at the park where you are staying. This could include cleaning and maintaining the park, or being a full camp host that stays on site to help out guests and manage reservations. Keep in mind that if they offer you to stay on site at no cost, you are still required to pay duplicate expenses to meet tax home requirements if your significant other (travel healthcare worker) is receiving non-taxable stipends, so be sure to factor that thought into your plans.

Seasonal Work

Seasonal work options could include painting houses, landscaping, shoveling/plowing snow, theme parks, and Amazon or other shipping warehouses especially around the holidays.

Apps

Driving jobs through Uber, Lyft, Doordash, etc are another option. These work better if you have a fuel efficient vehicle. There are also some lesser known apps out there for things such as Pet Sitting, Dog Walking, or random tasks like putting together furniture from TaskRabbit.

Freelance Work

If you have a skill that you can monetize, you can try freelancing. You can start a career in freelance web development, graphic design, UX design, writing, and much more by building a couple solid pieces of work and networking. You could try doing your freelancing through sites such as Upwork, but I’d suggest only using it to start building a portfolio and networking, as it’s infamous for people taking reduced pay from cheaper cost of living countries. You could also create and sell products on Ebay or Etsy.

Other options

There are many other options out there you could explore for either remote work or temporary work at your travel locations. Do your research and see if there is an option out there that could work for you!

Logistics of Remote Work

RV vs. Short Term Housing: Workspace & Internet Access

After determining the job situation, you have to decide how you want to travel. We decided to buy an RV, and one consideration with this decision was that it needed a good workspace. We found an RV with a mid-bunk room that I was able to modify and turn into my office.

The bunk room did not have enough space for a normal desk because the slides come in during travel, so I designed and built a desk that swivels out when we are on location, or swivels in over the built-in cabinets during travel. 

Another option is removing furniture in the living room or dining room to build a workspace. If you don’t need the extra monitors, keyboard, etc. many people just bring their laptop to the kitchen table. But personally, I wanted a separate work space from my living space to improve my work-life balance.

One of our challenges was figuring out what to do for internet. Getting consistent internet is a big can of worms coming from an RV perspective. RV parks have spotty internet and are rarely reliable enough for full time work. We’ve found that using mobile hotspot data works the best. Having multiple plans with multiple carriers ensures we always have a connection no matter our location. You can put those plans in phones, hotspot devices, or what we use is a mobile connected router that can take multiple SIM cards and creates a WiFi connection you can use just like you would in a home connection. Plus it gives the ability to connect a robust antenna to get more range than you would from just a hotspot or phone.

If you need to have video conference meetings frequently, another great option would be a tablet plan. Most carriers have plans for unlimited data on tablets that may require digging to find but are actually quite affordable. Then you can use your tablet for video conferencing without worrying about data limits. The downside is that it is harder to boost the connection as you can’t attach an antenna, but you can use a signal booster.

Signal boosters are different from a mobile router and an antenna as they can boost the signal of your phone or tablet wirelessly. It also boosts the signal of your phone allowing better reception for calls and hotspot data. The downside is they are less reliable and will often show no benefit. 

If you’d like to read more in-depth about how we set up our internet on the road, check out our blog post on mobile internet strategies here!

The cost of set-up depends on your needs. It all depends on how much data you need, where you plan on going, and how reliably you need to stay connected.

If you choose the short-term housing route, this could be simpler. Make sure your short term residence has a comfortable workspace for you. The internet may already be set up and included in the cost of renting. Sometimes it is not and you have to set it up yourself, but don’t forget to cancel it when you leave. If you don’t use much data, a simple data/hotspot plan and tablet plan could be a good option since short-term housing will likely be in areas where you won’t need advanced antennas and boosters to pick up a signal. This means you won’t have to get it set up again every time you move.

Transportation

If you travel with two vehicles, transportation won’t be a problem. We only have one vehicle, which is our truck that we tow our fifth wheel with, which Kayla usually drives to work, so I am usually without a vehicle during the day. We try to stay within walking or biking distance to her work so we can share the truck more easily. When we cannot stay close to her work, and I need the truck for the day, I will drop her off and then find a place to work from close-by. I usually work from a library, a coffee shop, or sometimes her workplace has a room they are willing to let me use for the day. I have also used the bus systems in town for transportation when needed.

Time Off Between Contracts

Kayla will usually take time off between Travel PT contracts before starting her next contract. So far she has only taken 1-2 weeks off, but this summer she will be taking 4-5 months off so we can go on a road trip!

If she was traveling alone, she would have to figure out a plan for her health insurance between contracts, but since she is on my employee plan, she is covered during this time, which makes things easier for her.

One downside of her taking this much time off is that I am not able to take the same amount of time off with my job. Since I am not able to take that much time off, I try to utilize my work time as efficiently as possible so that we can still have most of the day to go out for adventures.

When we’re traveling from one location to another, Kayla does most of the driving while I sit in the passenger seat working. This works well for us because Kayla enjoys driving and has no issues with towing our fifth wheel, plus it allows me the time I need to do my work.

We have run into some issues though, mostly towards the beginning of our travels when we were getting accustomed to this lifestyle. Kayla prefers to take the scenic routes whenever possible, but this often means losing signal en route and I am unable to work. We have a signal booster to help with these instances, but when driving through the mountains we still don’t get enough reception, so we have to stick to interstate driving to avoid this issue.

I always inform my job ahead of time that we are moving locations just in case the signal cuts out. We try to plan our travel days/times around when I have meetings so that I don’t accidentally miss something important at work. We also try to visit places and get some hikes in while traveling between contracts. Oftentimes this means working at odd hours either at night or on weekends so that we can explore during the day.

Is Traveling Feasible for You?

Traveling for work can be tricky, but if you’re creative anything is possible. This experience has been so worthwhile. The number of places we’ve been and the experiences we’ve had in just over a year of traveling is far more than what either of us had anticipated. We initially thought we would only travel for 1-3 years, but after experiencing how incredible the lifestyle has been, we don’t see ever staying in one place again!

We definitely encourage you to look more into this way of life to see if it’s right for you!

If you would like to hear more about our specific experience including how we made the decision to travel, buying our truck and RV, and the places we have been, visit our website eldridgeexpedition.com or follow us on Instagram or Facebook @eldridgeexpedition.

Written by Ryan Eldridge
Guest post for Travel Therapy Mentor

Working as a Physical Therapist in Europe (Belgium)

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We get a lot of questions about working internationally as a therapist. While we don’t personally work internationally, we’ve had the opportunity to talk to many therapists who have. Most of the therapists we know who have done this go overseas more long-term, not short-term. But nevertheless it’s interesting to hear their stories and the processes they went through to be able to work abroad as therapists. We’re excited to share American PT Britni’s insights on moving to Belgium and becoming a physiotherapist there.

My name is Britni Keitz, and I have been a physical therapist for over 4 years. I previously worked as a Travel PT in California, Washington state, and Florida, until I moved to Belgium permanently! I got married last year to a Belgian national, and we both decided it was easier career-wise for me to move to him than vice versa, so now I am working as a physiotherapist/kinesitherapeut (aka “physio” or “kine”) here in Belgium! I’d like to share some information about the process of moving here and being able to work as a physio/kine!

The Licensing Process

This process of getting licensed to work in Belgium is fairly easy, but took very long for me due to the pandemic and delays, including summer holidays where nobody works. Typically this should take up to six months, but it took me ten months. It should be known that the process I’ll describe is for Belgium only. It is going to be different in every country throughout Europe.

My process for getting licensed to work here was slightly different because I am now considered a permanent resident because I am married to a Belgian. If you are not, you would have to apply via the work visa route. I just skipped that step and waiting period because I got my residency card instead.

Once you have your work visa or residency card, then you have to apply for a degree recognition through NARIC Vlaanderen. This is to make sure our degrees correlate with theirs for the specific job. Since our physical therapy degree is a doctorate program, there is no problem because here it is a master’s degree. (Also, little Belgium is very complex with two separate governments within this country- the French side and the Flemish side- Wallonia and Flanders). So, when you apply for your degree recognition you have to decide which process you will go through. I was told the Flemish one is faster and easier, so I chose that route. I had to submit a whole list of things such as diplomas, official transcripts, course description of every course you took that includes undergraduate and graduate courses, work history (resume), work license, state license, passport, background checks, etc., along with an application. It took about four months to get everything back and receive my degree recognition for my Master of Science in “de revalidatiewetenschappen en de kinesitherapie” (rehabilitation sciences and physiotherapy).

After that, I had to apply for what’s called a “visa,” but this is different than a work visa, it’s for insurance here. You apply through the Agentschap Zorg & Gezondheid. You have to submit basically all the information again plus the degree recognition. This took the longest because it had to go through so many loops of signatures within the healthcare government here, and they only meet once or twice a month, so that was a very long wait. Five months later, I received the green light to proceed, and that was submitted to the healthcare insurance here. Then I received my INAMI number, which is basically my insurance practicing number to work here as a kine/physio. This also allows me to give my patients a receipt for their visit to submit to their insurance and receive a reimbursement for their session. I started this whole process in February of 2021 and was officially able to work in December of 2021. Because of this long process, I would generally only recommend going through the process to be licensed in Belgium if you plan to work here for a longer period of time, not short term.

Job Hunting and Working

This process was actually not bad at all, but it took a lot of research and contacting places. I knew the year before that I was going to move to Belgium, so I started early and just asked around about what I found online. I got EXTREMELY lucky, I should add, because I connected with a therapist here who is actually from the US and moved here over ten years ago and started her own practice. She was a life saver because she helped me with the whole process of being able to work and was able to send me the direct links on where to go. We kept in touch that year, and when I moved here I reached out again and we were officially able to meet in person. She took me in and has helped me so much! I am beyond grateful for this woman!

It’s important to know that working in Belgium is different from the US. Here, all therapists are independent contractors basically, and you pay a certain percentage per month to the facility where you rent out space. So, I rent clinic space from the therapist I mentioned above, and I pay her a monthly percentage of my earnings. The clinic is fully stocked with supplies just like any clinic in the US. Getting patients here is from physician referrals only. There can be direct access, but if they go through direct access, they will not get their insurance to cover it or get reimbursed. So, the majority of patients get a referral from their general practitioners for physiotherapy, and it’s typically for 9-10 sessions (similar to the US), unless it is post-op, then it’s more. You can always get more sessions just like in the US with medical necessity and more paperwork after 18 sessions. So, in order to work here, you will need to meet and network within your area of physicians or specialists in order to get patients.

In Belgium, you have the option to be “convention” or “non convention” status. When you select “non convention” status, this allows you to bill and see patients for how long you would like, versus having to stick with the government’s rules of only billing patients 22 euros for a 30 minute visit. Whatever you charge, the patient pays you directly and you keep that amount. Then, after 9 -10 visits or sooner, we write them a receipt with certain codes like in the US with an initial evaluation code and then a general treatment code. (There are no different codes and costs for TherEx verse TherAct vs. NMR, etc). Patients will submit the receipt to their insurance and get reimbursed, but the amount of reimbursement varies based on their insurance. Most of my patients and clientele work for the European Commission, and they have separate insurance here compared to everyone else which pays for everything in full. Everyone else that does not work for them will get a smaller reimbursement back.

For example, I charge 65 euros for initial eval (45 minutes) and treatment sessions I charge 55 euros for 45 minutes. Patients would usually get back around 18-20 euros back per session from their insurance. That part doesn’t affect me; I keep the full 65 or 55 euro. If I was convention status I would be only allowed to charge 22 euros per visit. So, for some people they don’t want to pay my rate because they don’t get back as much money as if they went to a convention status therapist. So, that could be challenging. But, I always try to provide the best quality of care and information for my patients to make it worth while, and it’s working.

Documentation

Documentation is AMAZING here. It is not strict, because we don’t submit anything to the insurance company. We just write a ticket/receipt with certain codes for pathology and treatment, and give it to the patient. Then they have to submit that plus their prescription to their insurance for reimbursement. So, it is very laid back in terms of documenting! I continue to do a SOAP note format with abbreviations for myself, plus goals. There is no set number to my goals or anything, it is just specifically depending on the patient and their baselines.

Language and Culture

The official languages of Belgium are French, Dutch, and German. Also depending on where you work, there could be a further language barrier due to other ex-pats moving to Belgium from other countries. But, in many cases you’ll luck out with ex-pats who are English speaking. I would recommend taking an intense language course of French if you plan on working in Brussels or the French part of Belgium, and Dutch if you plan on working in the Flemish part. Again, I am extremely lucky again where I work because my clientele is pretty much all English speaking with the European commission and ex-pats. I have taken four months of French classes and began Dutch classes recently, because the prescriptions and everything else are either in French or Dutch depending on where the patients went for their general practitioners or specialists.

The culture here is similar to the US with treating patients. I do 45 minute evaluations and treatment sessions. It is a similar structure to what we learned from school. There is no change with that. There are also continuing education classes and specialties available here as well to further improve your skill set, but it is not required like in the States with CEUs.

Where I Am Now

I am officially working here and loving it! I have more freedom as a physio here and create my own schedule. I am working in two locations, one in Brussels near the European Commission (https://berlaymonthealth.eu/) and one outside of Brussels in the clinic where the therapist from the US took me in (http://lvwphysiobrussels.com/)!  I also work for an international school here that is English speaking only, and I am the sports physio for the school and go to their games. There I have connected with athletic trainers through the international school system. Because of all of her connections, the therapist I mentioned has introduced me to this school as well as a midwife/lactation consultant company who is based out of the UK and Belgium now. There is much more to happen for me in the future, but I am beyond grateful for this woman I met who has helped me every step of the way.

If you have any questions about working in Belgium, I would be more than happy to help you as well!

Britni Keitz, PT, DPT

Britni is an American Physical Therapist who now lives and works in Belgium. She received her Doctor of Physical Therapy degree from Clarkson University, and is originally from Armada, Michigan. She enjoys anything outdoors and active. She loves hiking, climbing, backpacking, snowboarding, fishing, dancing, and soccer. Before moving to Belgium, she did US travel physical therapy immediately after graduation and absolutely loved it! Britni traveled all along the west coast and in Florida. Now that she is getting situated in Belgium, she and her husband enjoy exploring and hiking (yes, there are some good hikes/trails in Belgium). They both love to travel, and now living in Belgium and being so close to everything, she plans on spending some time in Italy in the Dolomites for hiking and backpacking sometime in the summer! You can find her on Facebook or on Instagram @britni3. You can reach her by email at: keitzbritni@gmail.com.