Travel Therapy During the COVID-19 Pandemic

Information as of April 1, 2020Unfortunately not an April Fools joke

This is a difficult time for the entire world amid the COVID-19 Pandemic. Unfortunately, the world of travel therapy is also affected as a result of this global pandemic. This hits at an unfortunate time for PT’s, OT’s, SLP’s, PTA’s and COTA’s, because our job market has already been reduced the last 6 months or so due to recent Medicare changes (PDPM & PDGM).

Many of you who are current US travel therapists or who are considering starting travel therapy may be wondering what’s going on with travel therapy and what you should do in response. Here we will provide some information and insight on what we’ve been seeing in the travel therapy job market, as well as some recommendations on how to proceed during these tenuous times.

The Big Picture

Unless you’ve been living under a rock, you’re undoubtedly aware of the increasing numbers of cases of the COVID-19 virus in the US, as well as the nationwide response resulting in many “shelter in place” or “stay at home” orders. This has had a big impact on our economy and overall job market, with millions of Americans applying for unemployment in the last couple of weeks. While the need for certain healthcare providers (such as ICU and ER nurses, physicians, respiratory therapists, lab techs, etc) during this pandemic is soaring, other healthcare providers are dealing with layoffs and facing unemployment themselves.

Why is this? We have to consider the big picture of what a “stay at home” order does to our other healthcare settings. For example, many “non-life saving” medical offices have had to close or stop seeing patients, including primary care physicians, dentists, and even outpatient therapy offices. In addition, elective surgeries have been put on hold to help clear out hospitals, which has “downstream” effects on therapy with less post-op patients being seen in the hospitals, SNFs, and outpatient therapy departments. For those offices that are still open, there are less clients due to the public staying at home, which leads to a reduction in caseload, and reduction in staffing needs. Also, with schools closing, there is a decrease in job openings for school therapists. All of this has led to less overall job availability for both permanent and traveling PT’s, OT’s, SLP’s, PTA’s, and COTA’s.

Who’s Been Most Affected?

As alluded to above, outpatient therapy and school therapy jobs have been most affected, for both perm and travel positions. Some school positions have been saved by the ability to do teletherapy, and some outpatient positions are trying to utilize teletherapy as well where able. Overall this has meant a lot of cancelled contracts for traveling therapists in outpatient and schools, and layoffs for perm therapists in these settings. It also means we’re not seeing hardly any new job openings in those settings, which is a big hit for those therapists who primarily take jobs in these settings.

Of the therapy disciplines, PT, OT and assistants have been the most affected, with the SLP job market still staying fairly strong.

So far, SNF, home health, and hospital jobs have been the least affected. In some cases, we’ve seen that hospital-based outpatient has been spared, because the hospitals are able to keep this staff and float them to other departments where they can still assist and stay employed. However, for travelers, this can actually backfire where the hospitals are trying to keep their perm staff employed, so they cancel travelers in both the outpatient and the inpatient side to be able to use their outpatient perm staff in other departments.

Cancellation Clauses & Honoring Contracts

Unfortunately during this difficult time, we have seen that many travel therapy contracts are not being fully honored. Many facilities are terminating travelers on the spot or with less than a week’s notice. Many are not honoring their 14 or 30 day cancellation clauses, meaning they are not allowing them to work out the notice period or providing additional pay after the termination date. In addition, many facilities are not honoring minimum guaranteed hours that are written into contracts, and they are cutting therapists’ hours without providing compensation. This is putting both travel therapy staffing agencies and travelers in terrible positions financially. The travel agencies are trying to assist the travelers however they can, and in some cases are able to provide compensation to make up for the guaranteed hours or early contract cancellation. But, some of them are not able to provide any compensation due to massive lost revenue from so many cancelled contracts.

Why not? Don’t we have any protection? The reason for this is that the facilities themselves are not paying for the hours, so the staffing agency isn’t receiving money to pay the traveler, and therefore they would have to pay for this out of funds that they just don’t have. This is cause for significant frustration among travelers, but unfortunately the facilities and staffing agencies could go out of business if they have to pay out every employee when there is no money coming in from clients. This can be very difficult for travelers to swallow, and we understand the frustration. Unfortunately there is generally an “Act of God” rule written or understood in the industry, and a global pandemic does fall under this category where the contract is basically void. To understand this further, we recommend you read this article about bill rates to learn how the travel agency gets paid in order for the therapist to get paid.

Travel Therapy Job Outlook

Because of how the overall therapy job market has been hit as outlined above, we now have an over-saturation of therapists looking for jobs, including: perm therapists who’ve been laid off, travel therapists who’ve had contracts cancelled, not to mention travel therapists coming off of a normal contract looking for their next one, therapists who were planning to jump into travel therapy this Spring/Summer, and recently graduated therapists. This all leads to a problem with supply and demand. There’s a low supply of jobs as we discussed, and a high demand for those jobs due to all the therapists currently out of work and searching!

To give you some further insight about how badly the therapy job availability has been hit, here are some stats/rough estimates for total travel therapy jobs open now.

  • Currently, we are hearing from staffing companies that there are between 20-40 Travel PT jobs; 15-25 Travel OT jobs; 200-250 Travel SLP jobs; and less than 10 Travel PTA/COTA jobs open at any given time in the entire country.
  • To compare, this time last year we would’ve been seeing 300-500 open travel jobs across the country for PT’s, OT’s and SLP’s (each!) and a little lower for assistants but much higher than the single digits! This means there’s been a massive reduction in available jobs.

In regards to pay, we have seen pay rates remaining relatively stagnant, but in some cases pay rates going down for therapy jobs. This is a natural occurrence due to supply and demand in any market. Many therapists were hoping we would see “crisis” job rates, such as those we have seen for nursing and respiratory therapy. However, we unfortunately are not seeing these crisis rates for PT/OT/SLP because our disciplines are not in demand as much as nursing and respiratory therapy right now due to the nature of the virus.

Are States Waiving Licensure Requirements?

There has been a lot of talk of states putting out emergency statements that they will waive licensure requirements for “healthcare workers” who are crossing state lines to “respond to the COVID-19 crisis.” Therapists have been hoping that these rules will apply to them, in order to make it easier for therapists to quickly pounce on travel jobs as they tend to come and go very quickly, and they could be in states where the therapists don’t currently hold a license. However, at this time, it’s very unclear whether these waivers apply to PT/OT/SLP or assistants. The statements put out by the states are generally vague and don’t specify which healthcare professionals qualify, and what positions qualify as “responding to the crisis.”

We have seen at least one state, Connecticut, with a specific statement issued to include PT, but not OT or SLP, among their list of healthcare professionals who qualify like nurses, physicians, etc. We’ve also seen at least one job posting for a position in Maryland which stated that Maryland state license was not needed, however we have not seen an official statement from Maryland to state that the licensure requirement was waived.

Overall, what we are hearing from recruiters is that most jobs are still requesting active state licensure for PT/OT/SLP jobs. This may be due to the fact the state hasn’t put out a clear guideline, or also that the hospital/facility has its own specific rules and compliance guidelines.

In general, at this time it seems working without an active state license is not really an option for travel therapists. While there are some vague statements out there, in practice it seems that the job listings are asking for licenses, and even if there was an opportunity where they would consider waiving licenses, it’s more likely that there will be a candidate who is already licensed who they would choose for the job rather than the unlicensed candidate, due to the high competition for jobs right now. So the bottom line is that we would not bank on being able to work across state lines without proper licensure at this time.

Our Recommendations

So, what now? The job market is terrible, the world is ending, and we should all just give up? No – it’s not that bleak. There are options, we just need to be patient right now and do the best with what we’ve got.

These are our recommendations for travel therapists and those looking into travel therapy during this time:

  • Work with multiple recruiters: This cannot be overstated at a time like this! It’s vital that travel therapists are working with 3-4 different recruiters at different companies so they can have the most the job options available to them. To learn more about how this works, check out this article. If you’d like help getting in contact with reputable recruiters to add to your team, please contact us and we’ll help you.
  • Have your profiles ready to go: Along with working with multiple recruiters, we recommend having your profile fully set up and ready to go with your recruiters, so when a job pops up, they can present it to you right away, you can say yes, and they can submit you right away. Otherwise you will miss out on jobs because other applicants beat you to the punch. While job boards such as our hot jobs list are a great way to find out about open positions, the challenge in a market like this is that if the job is listed with another company you’re not set up with, it may take too long to get your profile ready to even have a shot at the job once you express your interest.
  • Don’t be picky: Unfortunately now is not a time to be picky about job options. In order to line up a travel therapy job, you need to be as flexible as possible on setting, location, pay, hours, reimbursements, start date, and all the other nuances that go into a contract. This is not a time to play hardball on negotiating for pay and extra incentives. If you’re presented with a job offer, you need to accept or decline right away, no waiting around a few days to weigh your options, because the facility will move on to another qualified candidate very quickly. Some of these jobs are getting 50+ submissions right now which means a lot of competition!
  • Apply for another license: It’s important to be licensed in a few states to have the most job options. For those who normally rely on applying for a job then getting a license later, there isn’t time for that right now. As we discussed above, the jobs will likely get taken by another candidate who’s already licensed. The few jobs that are open are getting a ton of submissions, so it’s unlikely that these jobs are going to wait on you to get licensed. Go ahead and start working on a 2nd, 3rd, or 4th license so you’ll have it in hand to be able to submit to other jobs in other states.
    • However do keep in mind that licensing times could take longer than usual in some cases due to decreased staff available at the licensing agency, the school for transcripts, the government department for background checks, and if there’s a test required- well the testing sites could be closed completely!
  • Advice for travel pairs: Sadly this time is even more challenging for pairs. It’s very difficult to find jobs right now, period, much less two jobs together. We feel your struggle, as we’ve traveled together as a pair for many years and know how hard it is sometimes to find two jobs together. We normally don’t recommend submitting for only one job, but in times like these, that’s all you can do unfortunately. So right now we do recommend you just go for one good position, then if you can get one, try to look for something else in the area (including travel jobs or PRN jobs). Even if you can’t find a second job, at least one of you will be working, which is better than neither of you working. If you are a friend pair, or a couple that would be willing to do so, consider splitting up locations if two different jobs present themselves in different locations, although this would mean you would have to live apart for a contract.
  • Extend your contract: If you’re currently on a travel contract, have not been cancelled, and have the opportunity to extend your contract, we would highly recommend it right now. The job market is very uncertain, and trying to line up a new contract could result in frustration and possibly cancellation. So if you are in a decent contract, we’d try to stay longer if possible until things improve.
  • Consider local/perm/PRN options: With times being uncertain, it may be better to consider more local job options. There is a big gamble right now with applying for a job on the other side of the country. There is a higher risk for cancellation, which would be made even worse if you’ve moved all the way across the country, paid for housing, etc. Consider travel jobs in your home state (or where ever you currently are) or nearby states so there would be less distance at least if you got cancelled, and you’d be closer to family/friends during tough times. If travel jobs just don’t seem viable for you right now, look into who’s hiring for perm or PRN positions in your area. There’s no shame in taking a more local job for a while and returning to travel when the job market improves.
  • Look into teletherapy options: Teletherapy is a great option for therapists and patients, allowing for social distancing while still being able to provide services. While teletherapy may not be the most readily available option or the most intuitive career move, if you have the ability to do teletherapy through an employer or look into options for learning to do it on your own, we highly encourage it.
  • Apply for unemployment: As a last resort, applying for unemployment is an option. We’ve been getting a lot of questions on this, and while we have not done it ourselves, lots of other travelers have. You should still qualify even if you’ve been working as a traveler. You can apply in the state where you’ve worked the most in the past year. It doesn’t hurt to apply and try to receive some money rather than no money while you’re unable to find work.
  • If you haven’t started traveling yet: This is not the best time to jump into travel therapy if you’re thinking about leaving a perm position. We would recommend staying put if possible until things improve. If you’re finishing school soon, it’s too soon to tell for those getting licensed in May-July. It’s possible things could improve by then. When the time comes, you can consider applying for travel positions and permanent positions and see what seems like the best move at the time. You don’t have to decide right now.

The Future of Travel Therapy

As you can see, it is definitely a very trying time for travel and permanent therapists right now. The travel therapy industry has taken a huge hit, and it’s not an easy time to find travel therapy jobs. On the bright side, we all anticipate that the job market will pick back up in the future when everything calms down from the pandemic and facilities are able to resume normal operations. There may even be an increased need for therapists for patients who have become debilitated from COVID-19 and other illnesses that have gone untreated by therapy during this time. Now we just have to wait and see how long it will take for the dust to settle, whether it’s weeks or months.

So, if you have to go on unemployment right now, or consider local job options, at least you know it doesn’t have to be permanent. Hopefully once everything picks back up, there will be a surge in the travel therapy market, and we can all go out and have all the travel therapy jobs!

Until then, hang in there everybody. It’s a tough time not only for therapists but for the whole world. We’re all in this together!

Stay safe and healthy, and reach out to us if you have questions.

 

Written by Whitney Eakin, PT, DPT

Whitney Eakin headshot

Whitney is a Doctor of Physical Therapy who has been a traveling therapist since 2015. She travels with her boyfriend and fellow DPT, Jared. Together, they mentor current and aspiring travel therapists via this website, Travel Therapy Mentor.

Navigating Travel Therapy as a Pair

Pros and Cons of Traveling Together

Whitney and I have been traveling as a physical therapist (PT) pair for almost 5 years now since we were new grad PTs in 2015. During this time, we have learned a lot about both the benefits and the disadvantages of traveling as a healthcare pair. Traveling with a healthcare partner can be a wonderful experience and can make pursuing a travel healthcare career much easier in some ways, but there are certainly some struggles to be had at times. If you’re considering pursuing travel therapy with a partner or friend, here are some of the biggest pros and cons you should consider, based on our experiences.

Pros:

  1. Having a guaranteed adventure buddy!It’s not uncommon for Whitney and I to have some sort of adventure planned nearly every single weekend when we’re away on travel assignments. This is especially true if we’re in an area where we’ve never been before and there are lots of things we want to do and see within a few hours drive. For example, while working in Massachusetts, we took weekend trips to Boston, New York City, Rhode Island x 2, Maine x 2, New Hampshire x 2, Vermont, Connecticut, Quebec City, and Montreal! That was a busy and exciting few months! In our opinion, going on hikes, visiting waterfalls, and exploring cities is a lot more fun with a partner. It’s certainly possible to find someone to explore with in a new area as a single traveler, but it can be much harder than taking your adventure buddy with you!
  2. Saving money on housing expenses!Our thoughts on this have actually shifted a little over time. Initially we looked at it as basically half the costs when traveling as a pair due to being able to split housing and utility costs when at each location. While this is true theoretically, in reality housing options are more limited and more expensive for a pair than for a single traveler in many cases. This is especially the case when comparing a single traveler that’s willing to rent a room in a house to a travel therapy pair. We’ve found that most people who are renting a room in their house don’t want two people there and if they will allow it, they always want higher rent each month. That almost always leaves the travel pair looking for an apartment of some sort, which can often be 2-3x as much as a room in a house. But, when comparing traveling as a pair and renting an apartment to traveling as a single traveler who wants their own space and isn’t willing to rent a room in a house, the pair will come out ahead by splitting housing and utility costs!
  3. Less potential loneliness!We’ve met tons of single travelers that seem to really thrive on getting a brand new start in each location. But we’ve also met many other single travelers that feel lonely when starting a new assignment, or never start traveling at all because they fear being away from everyone they know. This seems to be the case even more so for travel assignments in rural locations where there is less to do and it’s harder to meet people outside of the clinic. We find that many single travelers avoid rural locations because they’re afraid they won’t be able to meet new friends or find people to hang out with when population density is lower and options are more limited. Meanwhile, Whitney and I love traveling to rural places as a pair due to the more laid back environment, lower cost of living, and usually more friendly people. We know that even if we don’t meet new friends in the area that we will always have each other to hang out and do things with! And it decreases our loneliness from being far away from our home community, family and friends.

Cons:

  1. Less available jobs.This is definitely the biggest downside to traveling as a pair in our opinion. While there might be hundreds of open travel PT jobs throughout the country, there are usually less than a dozen jobs that are outpatient (the setting we prefer) and close enough to each other for us to consider at a given time. We’ve been lucky to mostly avoid lengthy commutes and find consistent outpatient jobs near each other, but we’ve had to be much more flexible on the location we’re willing to go to in order to make that happen. When we’re looking for new states to get licensed in, we aren’t necessarily looking for where we really want to go, but instead where we have the best chances of finding two outpatient jobs close to each other since that’s our main priority. For a travel therapy pair, it is vital to be lenient on either setting, location, or both, whereas a single traveler will undoubtedly be able to be more picky when job searching.
  2. Less negotiating power on new contracts.Anyone familiar with negotiation knows that the more good options you have, the more negotiating power you have. For a single traveler with many jobs that fit their criteria, it’s not a big deal if they miss out on a job by playing hardball to make a little extra money on a contract or passing on a job until the perfect one comes along. They’ll almost always be able to find something else that is decent with a start date in their desired time frame (provided they aren’t being too picky). For a travel pair, trying to negotiate for higher pay on good fitting contracts can lead to missing out on one or both of the jobs, which means going back to the drawing board and potentially one or more weeks of missed work. Because of this, Whitney and I only work with recruiters that we trust to give us their best offer right off the bat so we don’t risk missing out on two good jobs near each other, which can sometimes be tough to find.
  3. More difficulty finding housing.As mentioned above, a travel therapy pair will have less housing options in any given location than a single traveler will. This is simply due to the fact that landlords offering some rooms or small efficiency apartments will only accept an individual, not a pair. This difficulty with finding viable and affordable housing was the primary driver of us deciding to buy our fifth wheel camper. For our very first assignments in a rural area of Virginia, we spent dozens of hours trying to find housing, only to settle on a less than ideal place. Had we been single travelers, there were rooms in houses in the surrounding area where we could have stayed, but none of them would accept a pair!

Is Traveling as a Healthcare Pair for You?

When comparing travel therapy as a pair versus traveling as an individual, I really think the pros and cons even out. This depends highly on your personality though. If you’re an extroverted person who’s great at making new friends, is willing to rent a cheap room in a house, and isn’t worried about being lonely, then traveling by yourself will be an awesome adventure and you’ll almost certainly come out ahead when compared to a travel therapy pair. If you’re more introverted (like me O_O), wouldn’t want to rent a room and live with a stranger, and want someone to experience new things with, then traveling as a pair would probably be better.

Unfortunately not everyone has the ability to choose between the two, as we usually encounter single therapists that are going to travel by themselves or not at all, and couples or friends that are going to travel together or not at all. In that case, it’s important to understand the pros and cons and be willing to accept them whatever your situation happens to be, and employ certain strategies to make traveling successful!

Strategies for Traveling as a Pair

Taking into account these pros and cons for traveling as a pair, there are lots of strategies we’ve learned over time that go into being a successful travel pair. Here are our top suggestions for traveling as a pair:

  1. Be Flexible!As I alluded to above, it’s important for travel pairs to be flexible on setting, location, and/or pay in order to successfully line up two jobs together. These variables are always at play regardless of whether you’re traveling as a pair or traveling solo, but when traveling as a pair, your top priority has to be finding two good jobs close together, so the other factors have to go lower on your priority list. In an ideal situation, you’d always find two jobs together, in your favorite setting, in the perfect location, and with the highest pay. Sometimes all the stars align and this is the case, but realistically you need to be as flexible as possible on these factors to maintain consistent employment as a healthcare pair.
  2. Work with multiple recruiters!We always recommend that travelers, whether traveling solo or as a pair, work with more than one recruiter to give themselves the most job options and be able to compare how different recruiters/companies operate, and compare pay and benefits on different offers. However this is most crucial for travel pairs. It is much more challenging to find two jobs together, so pairs need to have as many job options available as possible. We generally recommend working with 3-4 different recruiters as a pair. While each recruiter will have access to some of the same jobs, they will each have some exclusive/direct jobs that the others may not have.
    • *For more information on the process of working with multiple recruiters and companies, check out this article.
    • *If you’d like specific recommendations from us for recruiters and companies that would work well for you as a pair, you can fill out this form.
  3. Strategically choose states licenses!In order to be more flexible on finding jobs, it’s important to have at least 2-3 different state licenses. You need to be strategic in choosing these state licenses, based on which states tend to have the most jobs for your disciplines. Over time, we’ve tracked different job lists and talked to several recruiters to learn the trends for which states tend to have more PT jobs for us. We also pay attention to which states tend to have two jobs closer together that will work well for us as a PT pair. In our experience, some states that have been good for PT pairs are: California, Oregon, Washington, Arizona, Massachusetts, Virginia, North Carolina, South Carolina, Georgia. We have made sure to get licensed in a couple of these states, and we always have the license in advance before applying to jobs in each state.
  4. Scope out housing in advance!A final piece of advice we have for lining up travel jobs as a pair is being aware of the housing situation before accepting your contracts. Quite often, recruiters will try to pitch two jobs close together to you, stating that if you “live in the middle,” then you will each only have a commute of “X” time or distance. However, sometimes when you start looking more closely, you’ll see that there’s no way to actually live in the middle to make this a realistic commute for the both of you. Often, the only real housing options are closer to one job or the other, making the commute unrealistic for one of you, or the area has really bad traffic, so even though on the map it looks close, the commute time would be insane. We always try to at least scope out the housing options to see if there are viable options that will make the two jobs worth our while before we accept a position. Ideally, you’d try to secure the housing before accepting, but this is not always possible with how quickly contracts move in the travel healthcare world. So at least do a little housing research before you agree to any contracts!

The Bottom Line for This Travel Pair

For both Whitney and I, I don’t think we would have been adventurous enough to travel by ourselves, and we almost certainly wouldn’t have continued to travel for almost 5 years now if we weren’t traveling as a pair. Travel therapy as a pair has not only provided us with countless adventures and lifestyle flexibility but has also brought us closer together as a couple when we encounter the inevitable hardships. Despite the challenges that sometimes come with traveling as a pair, we wouldn’t change anything we’ve done to this point for the world!

If you’re a current traveler (individual or pair) let us know about your experience in the comments below!

 

Written by Jared Casazza, PT, DPT

Jared and his girlfriend Whitney have been traveling as a physical therapist pair since 2015. Together they form Travel Therapy Mentor and offer free advice and mentorship to current and future travel therapists!

img_8842