Avoiding Bad Job Environments as a Travel Therapist

Combating the Stereotype

We often hear this idea from current therapists and students that travel therapists are expected to go into bad environments in their travel jobs. Have you heard this before? That all travel jobs are terrible clinics and work environments, and that “there’s a reason they need travelers”?

The thought process follows these lines: Since travelers make more money, then they should expect that the clinics they go into won’t be as good, or that the situation in the clinic will probably be less than ideal. A similar myth that is frequently told is that travel therapists are worked harder and given more difficult patients than the permanent staff at a facility. While there are certainly cases where these things are true, this has not at all been our experience as travel physical therapists over the past 4.5 years.

When we started traveling as new grad PTs in 2015, we heard all of these same stories and were warned to avoid traveling as new grads; but despite these warnings, we were confident in the path we had chosen. Now, years later, we couldn’t be happier that we made that decision. The vast majority of our contracts have been in clinics that we really enjoyed and have considered going back to in the future. Based on our experience interacting with well over a thousand other travel therapists over the years, we believe that travelers that get into those toxic situations have often not done their research or asked the right questions. We want to change this stereotype and give current and future travel therapists the tools to advocate for themselves and avoid those bad job environments!

Do Your Research

If you’ve read any of my prior articles here or any of my financial articles on FifthWheelPT, it’s probably pretty apparent that I thoroughly research things before making a decision. There are times when this is either good or bad, but in terms of our travel PT careers, this has certainly been a blessing. Before we had ever even graduated from PT school, I had already spent a lot of time researching about travel physical therapy to go into it as informed as I could possibly be. This included the basics, but also things like learning what a reasonable travel PT salary would be, what questions to ask during an interview with a facility, learning how to find a good recruiter and why it’s vital to work with more than one, learning how to solidify a tax home, and how best to approach getting licensed and finding jobs.

Researching these things may seem like common sense to some of you, but after conversations with many travelers in bad situations, I can assure you that it isn’t. In fact, it seems that a large proportion of travel therapists get all of their information from a single recruiter. This is a recipe for disaster, since often recruiters are trying to fill jobs as quickly as possible and not necessarily trying to find a job that is the best fit for the traveler. It may sound like they have your best interest in mind, and the good ones certainly do, but that’s not always the case. It’s extremely important to be informed and to get your information from sources that are as unbiased as possible.

Avoiding Bad Situations

We’ve talked to a number of travel PTs working in outpatient settings that have completely absurd schedules. One in particular we’ve talked to was having patients frequently triple booked throughout the day. That is not only very poor patient care, but also an extremely stressful environment for the therapist. This doesn’t just happen in outpatient though. In skilled nursing, I’ve heard of evaluating therapists that are expected to achieve 95%+ productivity. How?! Other settings can have equally ridiculous situations, but it doesn’t seem to be as common. The important thing to know is that these situations can be avoided, and we’ve had no issue finding good fitting assignments without unrealistic or unethical expectations.

The first step to finding a good clinic that fits you well as a traveler is having all the available options presented to you. This is where working with more than one company/recruiter comes into play. Many travel companies have contracts that are exclusive, meaning that no other travel company has access to those jobs. That’s important to know, because a certain travel company may have a perfect job for you in a great location, but if you aren’t actively job searching with them then you’d never even know it exists. While it’s unreasonable to try to work with a dozen or more companies, talking to 3-4 is reasonable and will ensure that you have an increased number of jobs available to you. On the other hand, many travelers that have a bad experience are working with only one recruiter and are likely only presented with a couple of different job options, and they’re told that if they don’t take one of those then they will probably have to go without work for a while. In some cases depending on your needs and preferences, that may be true, but often those are just the jobs that the recruiter needs to fill most quickly, or might be the only ones that company has, and that is why you’re being presented with only those few.

Once you are presented with a job (or several) that sounds like a good fit for you, then the next critical step is the phone interview with the manager/rehab director. Phone interviews can be intimidating, but they are usually pretty laid back with minimal or no difficult questions like you might receive during a perm job interview. The important thing during the interview is to go into it with a list of questions that YOU need answered prior to determining if the job will work for you. Sometimes the interviewing manager will be trying to get a traveler in the position as quickly as possible, in which case it may turn into you interviewing the manager more than them interviewing you for the position. If you don’t ask the right questions, then you can easily accept a job and really have no idea what you’ll be walking into. This is where you’ll ask about things like productivity, other staff on site, documentation systems, schedule, and job expectations. At this point in our careers, if double booking is expected in the outpatient travel PT job we’re interviewing for, then we’re out. Plus a few other red flags we look out for during the interview, such as PT/PTA ratio, being the only PT (in some cases), and being expected to “take your laptop home to document” (off the clock).

What if the Job Isn’t What You Expected?

Even when you go into an interview as prepared as possible, you’ve done your research, and you ask all the right questions, it’s possible that you get to the clinic and the job isn’t what you were told it would be. This is pretty rare in our experience, because clinics don’t want to waste time training someone for them to just turn around and leave/quit early, but it does happen. This is the situation that the cancellation policy in your travel contract is for. It’s always best to inform your recruiter of the issues you’re having and to do your best to work out a compromise with the clinic director/manager that works for everyone if things aren’t going as expected; but if that isn’t possible, then there’s no shame in ending your contract early and finding something that fits you better, especially if you’re being faced with illegal or unethical situations. Putting in your cancellation notice isn’t something that should be taken lightly because the facility and the travel company will both likely be upset, but if it’s between you leaving early or staying at a job that you’re miserable in (or potentially breaking laws/ethics), then put in your notice!

Don’t Fear Traveling

Bad situations certainly come up as a travel therapist, but if you’re an informed traveler and do your best to ensure that each contract fits you well, then it should be no more common than bad situations at permanent jobs.

The keys to avoiding bad job situations as a traveler are:

  • do your research on travel therapy and the process beforehand
  • allow yourself the largest number of job options possible by working with multiple companies
  • ask the right questions and listen for inconsistencies when interviewing for a travel position

If you do those things then you’ll be well on your way to having a successful and prosperous travel career while avoiding the bad job environments!

If you need help getting started with travel therapy then check out the articles I linked to in this post as well as our Facebook Live videos covering many common questions we get. If you need help finding recruiters you can trust with good companies, fill out this short questionnaire and we’ll do our best to match you with a few great recruiters and companies that should work well for you!

 

Written by Jared Casazza, PT, DPT

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Reaching Semi-Retirement in Three Years as a Travel Therapist: Jared’s Story

Written by: Jared Casazza, PT, DPT

The Past

Education

I spent a total of 8 years in college (3 of which were in community college trying to decide my direction in life) which culminated in a Doctor of Physical Therapy degree, earned in May of 2015. Even though I was very proud of this accomplishment and the incredible amount of work it took to achieve it, I knew that physical therapy was not something that I would spend the next 20-30 years of my life doing full time. I’ve had various interests throughout my life and knew myself well enough to know that eventually I would likely become bored with physical therapy like so many of my passions in the past.

My Personality

You see, I get consumed with an area of interest for a period of time, before eventually becoming mostly disinterested once I feel that I’ve achieved a certain level of proficiency in the area. I seem to find something I like and throw myself into being the best that I can be in that area, which ultimately leads to me burning out with the pursuit. In my 30 years, this has happened with basketball, chess, video games, diet/nutrition, powerlifting/bodybuilding, and now to some degree physical therapy and finance. I still enjoy all of these things, but I no longer feel an intense urge to learn everything or be “the best” at them anymore like I did with all of them at one point or another in my life. At some juncture, the return on invested time and energy in any area of interest leads to a point of diminishing returns, and this is always where I seem to gradually disengage. At 30 years of age, I still don’t know if this is a good or bad thing, but I have accepted it as a part of my personality.

Knowing about this personality trait (flaw?), I was skeptical whether the time and money investment that is synonymous with 3 years of graduate school (after already completing 5 years of undergraduate work) would be worth it when I had no idea how long I would be passionate about the field. I ultimately decided that it was, and I am very happy with where I am now because of the choice. Although, I would be lying if I said I never questioned whether a DPT degree is worth it.

Student Loan Debt

Upon graduation in 2015, I had about $95,000 in student debt from grad school alone, and that included trying my best to be frugal by living at home and commuting to classes. Even though this is a massive sum, it is generally on the low end of the debt range of what many physical therapists graduate with. Terrified by this student debt, I became engrossed by the idea of increasing my income and decreasing my expenses to pay down the loans as quickly as possible.

After hundreds of hours of research and performing my own calculations and projections for the future, I ultimately decided that it would be in my best interest to pay the minimum on my loans while investing heavily in retirement and brokerage accounts. This has turned out to be a very good choice so far, with my student debt growing at an effective rate of about 3.2% per year while on the REPAYE plan, and my investment portfolio growing at a rate of around 9% since I started heavily investing (this was closer to 11% before the big drop in December 2018)… and this isn’t even accounting for the tax savings from utilizing the retirement accounts. This plan isn’t for everyone, of course, but I do think it should be a consideration for those trying to reach financial Independence as soon as possible with a lot of student debt.

Financial Independence

As for financial independence, while researching what to do with my student loans in late 2014, I stumbled upon a couple of blogs talking about saving heavily and retiring early, and I was immediately sold. Once I knew the math behind achieving financial independence and calculated “my FI number,” I knew that was the goal I needed to reach as soon as possible. My main motivation for pursuing financial independence so aggressively was to have as many options as possible for the future in case my interests shifted again and I became passionate about something different and wanted to pursue that.

Traveling Physical Therapy

In my first year of physical therapy school, I researched the options and found that the easiest way to make the most money as a physical therapist, in order to reach my financial independence goal, is by taking travel contracts. In some cases a travel physical therapist can make twice as much or more when compared to a therapist taking a permanent full time job in one location, especially as a new grad.

Whitney, my significant other of over 5 years and also a physical therapist who graduated at the same time as me, also liked the idea of making extra money while going on adventures, moving to and working in new places around the country together. Without a doubt, this was one of the best decisions that either of us have ever made.

Living in a Camper

Finding affordable short term housing at each assignment location can be the biggest difficulty of being a travel therapist, and to combat that we saved our money and paid cash for a fifth wheel camper and truck to haul it after our first 6 months of working and saving aggressively. For the majority of our travel careers, we have lived and traveled in the camper. Whether or not we have come out ahead financially with this decision is still up for debate, but we did enjoy the simplicity of finding somewhere to live while traveling in the fifth wheel and also the consistency of our living arrangement. There have been many pros and cons to traveling in a fifth wheel, but overall we wouldn’t change our decision.

Maximizing My Income and Savings Rate

After having a goal of financial independence in my cross-hairs, I wasn’t content with just making more money as a traveling therapist, so I did everything feasible to minimize my expenses while simultaneously finding ways to make more money along the way. This led to working as many hours as my travel assignments would allow with hundreds of hours of overtime in total over three years, taking part time jobs when available, creating this blog (just as a hobby initially with hopes to eventually generate some income), and going a little overboard with credit card rewards.

In reality, I hustled so much and minimized my expenses to a point that I have been able to save 100% of my income earned from my regular 9-5 travel physical therapy jobs, and even extra on top of that some months. The first two years, I was able to live on just the money earned from credit card/bank account sign up bonus combined with overtime hours and part time work. The last year, to my surprise, the FifthWheelPT blog actually started consistently bringing in enough money to cover all of my living expenses most months.

The Present

After 3 years of living frugally and saving my entire full time paycheck as a travel therapist (each year with a savings rate of between 85-90% of my total income), combined with the investment returns I mentioned above, I officially “semi-retired” in July 2018 at 29 years old. I tracked my progress to financial independence with my monthly “Path to 4%” posts each month for the past 2.5 years along the way, and will continue to do so until I fully reach my “FI number.” Even though I haven’t fully reached that number yet, there were various reasons that I went ahead and transitioned into semi-retirement when I did, with a primary one being our desire to travel internationally.

I refer to what I’m currently doing as “semi-retirement” because I still plan to write on this website, write on the FifthWheelPT blog, andhelp those interested in travel therapy get started, which takes up about 5-10 hours per week, and I will also likely continue to work one travel assignment (3 months) per year to keep my physical therapy skills from getting rusty. I still enjoy the job and helping patients, but I no longer wish to do it full time for the entire year.

We celebrated this semi-retirement with a 5 month trip around the world at the end of 2018, which was a wonderful and eye opening experience. By utilizing credit card points to keep expenses lower while traveling, I was able to spend less than an average of $37/day on the trip, all of which was able to be covered by money brought in from this blog. This meant that I didn’t even have to start withdrawing money from my investment accounts, which was a blessing with the market taking such a hit at the end of 2018! This trip really made us realize that life is short and there is so much that we want to see and do before settling down and having kids. We plan to take several more 3-6 month long trips all over the world for the next few years before deciding what’s next for us. We’re currently planning a 15 week trip to Europe in May, which we are extremely excited about.

The Future

Right now, we still own our fifth wheel and truck, but we are considering selling them between now and May when we leave on our next trip, so that we don’t have to pay personal property taxes, insurance, storage fees, and deal with further depreciation while taking these long trips and not using the truck and camper. I have to admit that this has led to a bit of an identity crisis for me, since many people know me as the “Fifth Wheel PT” now… if we sell it do I have to rename the blog?!

We haven’t worked as physical therapists in 7 months since leaving for our Around the World Trip, but after searching for jobs since we returned to the US in December, Whitney finally found a Travel PT contract about 3 hours from home. She started work this week, however I still don’t have a job lined up as of now. I’m working on trying to set up a short term contract or PRN work in the same area as Whitney. But, if I don’t end up working before leaving on our next trip to Europe in May, then I will most likely find a travel contract in September when we get back from the trip. Although that will mean I will have a 15 month gap in my work history, which I’m a little concerned about.

We plan to go to a few physical therapy conferences each year to network with other therapists and students and talk about travel therapy as well as finances and how these things have so positively impacted our lives. I may not be as ravenous with learning new things about personal finance and investing as I once was, but I still enjoy writing and talking about it. I’m also not nearly as involved with travel therapy as I once was, but I have learned a ton and want to spread the knowledge and let others know that an exciting and lucrative adventure is possible.

I’m considering writing a book in the future about personal finance and investing from the perspective of a physical therapist, and possibly even more specifically from the perspective of a travel therapist, but I don’t know that I have the motivation required to do that right now. Nonetheless, I plan to continue to write about whatever interests me on the FifthWheelPT website and to write articles about travel therapy on this website.

Ultimately I’m grappling with the realization that financial independence and retiring early is really just the beginning, not the end of the journey. With time and brain power freed up to a large extent, I’m not sure where I’ll go from here, but I’m okay with that uncertainty.

Conclusion

It has been a wild ride for both Whitney and me since graduation in 2015. I would have never anticipated doing what I am now back then, but I’m very grateful that things have turned out the way that they have.

I undoubtedly sacrificed on some things to reach semi-retirement so quickly, but by no means was I a “miser,” living an unfulfilling life in those 3 years of saving aggressively. We took dozens of weekend trips all over the east coast (Whitney has written all about those trips here); spent a few days in Canada; stayed at an all-inclusive resort in Jamaica for a week; I took my brother to Aruba for his high school graduation; Whitney and I went on a cruise to the Bahamas; and we bought plenty of stuff that we really didn’t need (you know, the American way).

I really didn’t do anything special to get in the position I’m in besides looking for ways to maximize my income and minimize my spending while still having a good time. This combined with a cultivated urge to learn as much as possible in my areas of interest have paid dividends. No two paths are the same, but I feel that just about everyone has room to make headway on these fronts.

Thank you for reading this. If you’re a regular reader, then I hope that you have a little better insight into who I am, and if you’re a new reader, then this should be a good introduction to me and my life. Feel free to reach out to me with questions or comments!

 

This article was originally published on our personal blog. You can learn more about Jared’s story by visiting our blog at FifthWheelPT.com.

Factors to Consider when Comparing Pay Rates to Other Travel Therapists

Written by: Jared Casazza, PT, DPT

Background

One of the biggest fears for travel therapists, especially those new to traveling, is getting taken advantage of by recruiters. There is good reason for this fear since there are plenty of recruiters out there that are willing to low-ball those that don’t know what is reasonable in terms of pay and benefits. This is actually one of the main reasons that we created this website and began mentoring those new to travel therapy. Whitney and I  have had such an awesome experience while traveling, and we want to do our best to ensure that other travelers have a positive experience as well.

Since travelers are often so worried about their pay being inadequate, there is often open discussion regarding weekly take home pay between travel therapists. In general, I think this is a great thing and that everyone (not just travel therapists but therapists in general) should be more open to discussing their pay in order to have more transparency in this area.

Alas, as a travel therapist, there are some pitfalls to these discussions and comparisons that should be considered. If another travel therapist is working in the same state and at a similar facility but making significantly more than you, are you being taken advantage of? Sometimes, but not always. Let’s look at some of the factors that can affect discrepancies in pay. (If you’re completely new to travel pay then check out this comprehensive article on how it works for some background information)

Differences Between Travel Companies

Each travel company does things differently in terms of pay. Sometimes these differences are minor and sometimes they are major. The biggest difference affecting pay is your hourly taxable pay rate. For example, getting a pay offer from two different companies offering different taxable hourly pay rates is going to make the total take home pay each week much different even if the bill rate is the exact same. Some companies have a policy of not allowing taxable pay to go below a certain level (this can be as high as the $25-$30/hour range) whereas other companies will allow a much lower hourly rate (we’ve seen as low as $15/hour for PT, OT, and SLP). If your taxable rate is higher, that means your total weekly take home pay will be lower. The reason for that is not only do you have to pay extra money in taxes on that higher hourly rate, but the travel company has to pay a higher amount toward FICA taxes on your behalf as well. The difference between a $15/hour taxable rate and a $25/hour taxable rate can be $100-$200/week or more on your take home pay! If comparing your weekly take home pay to a fellow traveler, make sure to always consider your taxable pay rate compared to theirs.

Cost of Living

A huge factor to consider is the cost of living and desirability of the location in the area that you’re working in. In general, areas with higher costs of living (big cities) are able to offer higher stipend amounts for housing, meals, and incidentals. These stipends usually aren’t able to be fully maxed out in those areas though because the bill rate won’t support the full amount. Keep in mind that in general, rural areas are willing to pay more due to a lower demand in the area. As you can probably imagine, most travelers (and permanent therapists) want to go to the desirable areas in the country, which means that the demand for therapists there is lower and the facilities can offer lower bill rates and still know that someone will still take the position. If you’ve looked into a  contract in Hawaii then you’ll know what I mean. Hawaii is an extremely desirable location for travelers, and despite the high cost of living there, pay rates are very low due to the high demand. If you’re taking a job in Hawaii, it’s for the experience of the island life, not the pay.

Be careful comparing your weekly take home pay in lower cost of living states to others taking assignments in higher cost of living states (such as the west coast). Even though someone on the west coast might be making significantly more per week, you have to remember that their living expenses might be significantly higher there as well!

Up-Front Reimbursements

Some companies may offer up-front reimbursements as part of their pay packages, while others don’t and instead add that money into the weekly pay. This isn’t necessarily a good or a bad thing either way, but it can affect weekly take home pay significantly and cause a discrepancy in pay between you and a fellow travel therapist, which is something to be cognizant of.

For example, let’s imagine both you and a fellow traveler recently accepted 13 week travel contracts in California after getting licensed there last month. You’ll both be traveling there from your home state of Tennessee. Your company offers you $500 in reimbursement for your CA license, as well as $400 to travel from Tennessee to California, and another $400 to travel back to Tennessee when your contract is completed. The other therapist’s company does not offer any reimbursements. Their take home pay is quoted to be $1,900/week after taxes, whereas your take home pay will only be $1,800/week. If you met this traveler while in California and discussed your pay, you may very well think that your company is taking advantage of you by paying you $100/week less, but in reality when you factor in the reimbursements, your pay is the exact same!

Be careful comparing weekly pay without considering reimbursements. Some companies and recruiters will purposely not offer reimbursements in order to be able to offer a high weekly pay rate since that’s what most travelers are concerned with. This is just moving the same money around, don’t be fooled!

Travel Company Size

As I talked about in the post I wrote on bill rates, travel companies take a different percentage of the bill rate depending on their overhead. Bigger companies are going to have higher overhead due to more people on payroll, bigger marketing budgets, more buildings, etc. Small companies usually have lower overhead and can get by with taking a lower percentage of the bill rate, although this isn’t always the case as we’ve found over the years. If bigger companies have higher overhead, isn’t it always better to work with a smaller company? Not necessarily. Bigger companies often have more jobs as well as exclusive contracts. They also tend to have better benefits and lower costs for the benefits due to having more employees working for them.

Combining Multiple Factors

When these factors are added together, differences in weekly pay can huge. If you compare weekly pay amounts between a big company that pays a high taxable rate and offers a lot of up-front reimbursements with a job on the east coast to a small company that pays a very low taxable rate with no reimbursements with a job on the west coast, you can see differences of $500/week or more in some cases!

Conclusion

Be careful when comparing weekly pay rates to other travel therapists without also considering all the factors influencing weekly pay rate. Don’t automatically feel bad about your pay the next time you see another travel therapist bragging about their high weekly pay rates when working with small companies on the west coast, when you’re working with a big company with more jobs and better benefits on the east coast.

If you’re in need of a company/recruiter that you can trust, send us a message with some info about yourself and your reason for traveling and we can set you up with a few that match well with you and that we trust!

Do Travel Therapists Work Overtime and Is It Worth It?

Written by: Jared Casazza, PT, DPT

“Travel Therapists Don’t Work Overtime”

When Whitney and I started traveling, we were told by most recruiters and other travel therapists that overtime in the travel therapy world is rare. We heard that facilities don’t want to pay extra to have a traveler working overtime, and they won’t allow them to get overtime. In general, that does seem to be the case for the majority of travelers, but it has definitely not been the case for me. In fact, in almost all of my contracts I’ve worked some overtime and in a couple of them I worked A LOT of overtime. I’m not exactly sure why this has been the case for me, but it is probably the combination of two factors:

  1. I was very eager to work all that I possibly could in order to save as much as possible for my first few years as a traveler. I went out of my way to offer to see extra patients or stay late at each of my contracts if needed. I also always asked about the potential for overtime in my phone interview with the facility, and in some cases their answer would sway my decision of which facility to choose if there was more than one that I liked.
  2. We worked primarily in small rural areas where they didn’t have PRN help. If it got busy, they were fine with me working extra hours in order to make sure all of the patients were seen. Whereas most clinics in more populated areas have PRN therapists they can call for help when things get busy, many rural facilities do not, so that means overtime for the regular staff, even if that happens to be a traveler.

It’s true that most facilities do everything possible to avoid having travelers work overtime. The big reason for that, of course, is money. Bill rates for travelers can be huge, and often the facility is obligated to pay 1.5x the bill rate for any hours worked over 40. That could mean that a facility is paying $100/hour or more for each hour of overtime that we work in some cases! Meanwhile, 1.5x the hourly rate for a permanent employee is likely in the $50-$60/hour range, which is much more palatable for them. Even though this is the case, I’ve found that often the permanent staff isn’t willing to work overtime, so with no PRN help and me being eager to work all the hours I can, they just approve it. Or, in some cases, I’ve been the only PT on staff, with no permanent PTs or PRN PTs. So in that case, if patients need to be seen outside of 40 hours of work, then I’m the only option and thus get asked to work overtime.

My Experience

In my first two years as a new grad travel therapist, I worked a total of over 400 hours of overtime! That’s an average of about 4 hours per week, but that wasn’t distributed evenly. Most weeks I worked only 40 hours (even less in some cases), but then other weeks I worked as many as 65 hours when a facility was really desperate to have patients seen. That meant some really long weeks sometimes, but I was very happy with the extra money!

Facilities/managers will often approve a couple of hours of overtime per week for a traveler, but there are rare cases where they will approve as much overtime as is needed. When those times came around, I took advantage!

Is Working Overtime Worth it as a Travel Therapist?

Whether or not it’s worth it to work overtime as a travel therapist depends on a couple of factors:

  1. How much you’re earning for each hour of overtime that you work based on your contract.
  2. How eager you are to make extra money.

A mistake that I made early on as a travel therapist was not negotiating a higher overtime rate, or even realizing that it was negotiable. As I mentioned above, the travel company can often make $100/hour or more when a traveler works overtime, because the facility pays out 1.5x the full bill rate, but that doesn’t mean that the extra money goes to the traveler automatically. In fact, in most cases the traveler will make only 1.5x their taxable pay rate, which often means overtime pay in the $30-$35/hour range. This means the amount they’re making for overtime hours is actually less than the amount they make during normal hours. How does that work exactly? Because during normal hours, we get paid our hourly taxable pay + our stipend pay. Whereas, if we’re only making 1.5x the hourly taxable rate with no additional stipends for the overtime hours, the overtime pay is actually less than the normal pay. In this case, the extra money is made mostly by the travel company, not the traveler, because the facility is still paying the travel company 1.5x the full bill rate.

This happened to me in the beginning, but I quickly wised up and you should too if you’re planning to work overtime. I recommend that you negotiate at least 2x (ideally 3x or more) your normal taxable pay for working overtime hours. Keep in mind that stipends can’t be increased when working overtime, because there is a max amount of stipends you’re legally allowed to earn each week regardless of working over 40 hours, but a multiple of the hourly rate should be possible. Another option that some companies do instead of writing in a certain hourly rate for the overtime hours is they’ll arrange for you to receive an additional bonus at the end of the contract for any overtime hours worked, which equals out to the extra money you should be receiving on an hourly basis for each hour worked. This has been the case with one company we’ve worked with. However, if a company tells me overtime rates are not negotiable period, then that’s a deal breaker for me in terms of working with that travel company.

Many travel therapists have no desire to work overtime. Since we already make a lot more money than at permanent positions in most cases, these travelers don’t see the need to work extra hours. This is especially the case in desirable areas where working longer hours takes away from time that could be spent exploring! This is completely understandable, and if you value your free time more than you value the extra money that you’d make while working overtime, then feel free to decline the hours. A facility can’t require that you work hours that aren’t in your contract, so you’re in the drivers seat in this situation.

Conclusion

If you look for opportunities to work overtime as a travel therapist, you can usually get some extra hours depending on the facility and location. Whether or not the extra hours are worth it depends on you and your priorities.

If there is at all any potential for you to work overtime based on what you hear during the phone interview, make sure to negotiate a higher rate for those hours than the standard 1.5x hourly taxable rate. Don’t get taken advantage of by the travel company earning a lot of extra money for your overtime hours like I did when starting out! If the travel company/recruiter that you’re working with isn’t willing to work with you to find a fair amount for your overtime work, then there are plenty of other fish in the sea!

If you’d like some recommendations for recruiters/companies that we’ve had success working with, then reach out to us here and tell us about your main priorities as a travel therapist, and we’ll match you with a good fit. If you have any other questions about travel therapy or overtime pay, contact us!

 

Intangible Benefits to Consider When Choosing a Travel Company

Written by: Jared Casazza, PT, DPT

The biggest concerns for most therapists when considering starting out as travelers include pay and benefits. Whitney and I were no exception here. I wanted to make as much as I possibly could while also getting decent health, dental, and vision insurance.

However, over the past several years as travel therapists, we’ve learned that there are other important factors to consider when deciding between travel companies which we call the “intangible benefits” of the companies. The reason these things are intangible is because they don’t show up directly on your weekly paycheck or in your health insurance package, but they can make a big difference in some cases.

Day One Insurance

Depending on your situation, not having to wait 14-30 days before your health insurance benefits take effect can be really important. For Whitney and I, this isn’t necessarily a deal breaker when working with a particular company since we rarely use our health insurance anyway, but it is important to consider. We prefer to work with companies that offer health insurance benefits starting on the very first day of the contract and encourage you to ask this question when interviewing potential recruiters as well.

401k Contributions and 401k Matching

I’m a big proponent of contributing to tax deferred retirement accounts. Not only does contributing to these accounts lower your income taxes, but also your income based student loan payment as well, so working with a company that doesn’t offer a 401k is not something that I’d do very often except in some sort of extenuating circumstance. A 401k match is also a perk that isn’t always offered and may have limited usefulness to travelers in some cases, but should be considered when deciding which travel company to work with.

CEU Reimbursements

Not all companies will offer CEU reimbursement, instead putting that extra money directly into your weekly pay. Depending on your weekly pay and your other reimbursements for a contract, this may or may not be a big deal to you. For us, if we are offered jobs by two different companies with similar pay but one offers a certain amount of CEU reimbursement per contract, that can sway us toward that company. Others may offer access to MedBridge or other online CEUs while on contract with them, at no additional cost to you, which can be a nice perk.

Free Gifts and Trips

Some travel companies will reward their therapists with free gifts such as: shirts, cups, mugs, bags, food, or even all-inclusive trips! These things are always exciting and can be a huge benefit in some cases. Usually we’d prefer to just make more money each week instead of that money going toward gifts and trips, but if two companies offer similar pay, but one offers a free trip each year in addition to the pay, then that company would be hard to pass up! Depending on the traveler’s personality, even small surprise gifts can turn a bad week into a good one, which can make a big impact over the long run.

40 Hour Guarantee

40 hour guarantees (sometimes also called guaranteed work weeks “GWW”) have been huge for me and Whitney! In fact, in almost 4 years of traveling, we’ve never accepted a contract that didn’t have a 40 hour guarantee included. If we take contracts, we want to be sure that we will always be getting full pay even if the facility suddenly starts having fewer patients for some reason and tries to decrease our hours. The security of knowing we’ll be getting paid our full amount no matter what is vital for us.

Most companies offer 40 hour guarantees on some or most contracts, but this varies from company to company. Also, as we’ve found out over the years, all 40 hour guarantees are not created equal. Some companies will only pay you for the full 40 hours if the census is low at the facility, but not if there’s a holiday or inclement weather that causes the facility to be closed. In most situations, we go with companies that pay the full 40 hours no matter what, with all other things being equal. Getting paid even on days when the facility is closed has meant I’ve made thousands of extra dollars over the course of my traveling career. This is one of the biggest intangible benefits for me.

Number of Available Jobs

I’ve talked in the past about smaller companies being able to pay higher weekly amounts with a given bill rate due to lower overhead, but this doesn’t always mean that smaller companies are the optimal choice. Bigger companies often have more available jobs, including exclusive contracts, which means more options for the traveler and potentially less down time between contracts. An extra $100/week can easily be offset by a few weeks of unintended time off due to not finding a contract that fits the traveler well, which could sometimes happen with smaller companies with less job options.

Job availability is even more important when traveling as a pair like Whitney and I, or Travis and his wife, Julia. Having one person in the pair accept a job while hoping to find something for the other person before the job starts can lead to a lot of unpaid time off. Whitney and I have had very good luck with finding two jobs that started exactly when we needed them to over the years (except a couple cases), and we attribute most of that to working with several different companies (most of them bigger) that have the most job options.

Conclusion

Having a high weekly pay rate is certainly important as a travel therapist and the most important thing to me, but it’s important not to forget about the intangible benefits that can directly or indirectly lead to more or less money in your pocket over the course of your traveling career. Make sure that you’re informed and consider all of the variables when deciding which travel companies to work with and which travel assignments to take to ensure that your travel career is a success!

If you would like some suggestions for companies/recruiters that we’ve found to have the best offerings in terms of pay and intangible benefits over the years, then reach out to us here! If you have any questions about travel therapy or these intangible benefits then feel free to contact us!

Understanding a Travel Therapy Contract Bill Rate

Written by: Jared Casazza, PT, DPT

All travel therapists want to get the most money possible out of their contracts. In fact, the increased pay associated with travel therapy is the #1 reason that most people that we talk to choose to travel in the first place, so not getting as much money as possible would be no good. While there can often be room to negotiate when presented with an initial offer from a recruiter, there is, of course, a limit to how much they can actually pay a traveler for each contract. The big limiting factor in the equation of pay for any travel contract is the “bill rate.”

What is a Bill Rate?

A “bill rate” is the amount of money that the facility (hospital, clinic, nursing home, etc.) pays the travel company for each hour that a traveling therapist works. As travelers, this is a number that we rarely ever find out about, since it is negotiated between the travel company and the facility usually before they ever even list the job or present it to travelers. Most recruiters do not wish to share this number with travelers either, but you really can’t blame them for that. The bill rate is much higher than the hourly rate that the traveler receives, but that is because it has to account for all overhead costs and company profits as well, so sharing the bill rate could make the traveler feel like they’re being taken advantage of, even when that’s not the case. BluePipes wrote a great article on other reasons why travel companies don’t divulge bill rates as well, which you can find here.

How Much is an Average Bill Rate?

Bill rates vary drastically depending on setting and area of the country (just like traveler pay), but I’ve heard of ones as low as $60/hour and as high as $80/hour, which shows why there can be such variation in traveler pay across the board, since it’s all based on the bill rate. In some situations, the bill rate can even be higher if the facility is in urgent need of a traveler and is willing to pay more to get someone there quickly. In general, the facility is going to pay the travel company as little as possible, while ensuring that their opening will be filled, so how desperate they are can have a big impact on the bill rate.

So if a company is receiving around $70/hour ($70 x 40 = $2,800/week) from the facility, while the traveler is only getting a take home pay of about $1,600/week, where is that extra money going?!

Costs that have to be Subtracted from the Bill Rate

Overhead costs of running a travel company can be pretty high. The company has to pay staff (recruiters, managers, payroll department, benefits department, etc.), for rent and utilities on their offices, for marketing, for taxes, and they also have to make a profit in order to stay in business. This all usually adds up to about 20-25% of the total bill rate, depending on how big the company is and how much their overhead costs in total. That means that after overhead costs are subtracted out, that $2,800/week turns into about $2,100/week.

From there, we have to consider that the company pays for part of the traveler’s health insurance (assuming the traveler chooses one of the company sponsored plans); maintenance fees on 401k plan; CEUs (if offered by the company); FICA taxes on the traveler’s hourly pay (7.65%); and credentialing costs for the traveler for each assignment such as: license reimbursement, travel reimbursement, drug tests, TB tests, and backgrounds checks.

They also usually have to keep a small percentage to account for contract cancellations, since when a traveler’s contract is cancelled early, not only does the traveler lose out on money, but so does the travel company. I think of this as like an “emergency fund” for the travel company for when unexpected events occur.

It’s also important to keep in mind that the “take home pay” amounts that we usually use to discuss travel contracts is after the traveler’s taxes are subtracted out, which means that the travel company actually pays you more than that amount, but that’s the amount you see on your paycheck after federal, state and FICA taxes are subtracted. So “take home pay” refers to after-tax, or net pay, not gross pay.

For example, a $1,600/week “take home pay” usually means that the travel company actually pays out $1,800/week in gross pay to the traveler. It’s easy to see how the $2,100/week devoted to the traveler’s pay can quickly be reduced to much closer to that $1,800/week figure paid out to the traveler each week, once all of the above costs are factored in.

Getting the Highest Pay Possible

In most cases, honest recruiters are doing their best to offer the highest pay possible to the traveler, within the bounds of the bill rate that they have to work with. Many travelers hear about how high some bill rates can be and quickly assume that recruiters are trying to take advantage of them, without first considering all of the costs incurred by the company, taxes they have to pay, and also also the benefits offered to the traveler that aren’t seen in the weekly take home pay number. Don’t forget to consider these factors before jumping to conclusions! But, it doesn’t hurt to push for more money when you feel it’s warranted, have considered all the “extras” already included in your pay package, and have considered the type of job, location, and cost of living!

The bill rate is also the reason that it is important for travelers to push for higher pay for overtime hours worked. Overhead costs don’t need to be factored into overtime hours worked, due to them already being accounts for in the initial 40 hours. With overtime, the company will get the same bill rate (sometimes 1.5x the bill rate even), while the traveler only receives 1.5x their taxable pay rate in most cases. This is a great situation for the travel company, but a terrible situation for the traveler. So understanding how the bill rate works and how your pay is broken down is a key factor here in advocating for yourself with a higher overtime rate!

Conclusion

It’s very important to have an understanding of the bill rate and all the costs that must come out of that hourly pay amount the travel company receives from the facility, in order to understand how your weekly take home pay is determined as a travel therapist. The more you understand, the better you can advocate for yourself and get the highest pay possible.

I hope you have a little better insight into how the weekly take home pay amount is calculated now with a basic understanding of bill rates!

Thanks for reading and feel free to ask any questions you may have on bill rates or anything else travel therapy related in the comments below or contact us directly. If you need some recruiter/travel company recommendations that we trust to not take advantage of you as a traveler, then send us a message here and we’ll help you out!

Navigating the ACA Health Insurance Marketplace as a Travel Therapist

Written by: Jared Casazza, PT, DPT

Update 7/24/2019:

After applying for coverage through the marketplace this year, I found out some new information that contradicts part of the original post, so I wanted to make an update.

I learned that you are not eligible for marketplace subsidies if you are currently offered health insurance through an employer. This means that even with a low income, health insurance through the marketplace will be full price as long as you have been offered an affordable coverage option through the travel company that you’re working with.

When not on contract, going with a marketplace plan would still be a very affordable option for most travelers (those taking extended periods of time off like Whitney and me), but it may not be the most affordable option while on contract without being able to take advantage of the subsidies.

Be sure get a quote to see what the cost would be in your state and situation through the marketplace in order to make the most informed decision! 

 

Original Post 11/21/2018:

As I mentioned in my last post regarding the various health insurance options for travel therapists, Whitney and I have consistently chosen to take the company sponsored health insurance over our past few years as travel physical therapists. However, this is no longer going to be a viable option for us moving forward since we took six months off in 2018 and will likely be taking nine months off in 2019. Taking the company sponsored insurance and then using COBRA once we finish our assignment would be much too costly for that long period of time between contracts, so starting in 2019 we are planning to sign up for an ACA marketplace plan.

I’ve done a lot of reading and researching about the marketplace plans as well as the subsidies offered, and I hope to shine some light on them for you based on what I’ve learned. Keep in mind that health insurance costs can vary greatly depending on location and that some states have more or less options than others. The information in this article is going to be based on my own information for my home state of Virginia. It’s possible that your own state will be different, but I imagine that much of the information will apply to some degree for every state.

Disclaimer: this is not meant to be personal advice for your individual situation, as I am not an insurance expert or financial advisor. This is information that I’ve learned from reading and researching, and that I plan to implement in my own situation. Everyone’s situation is different, and this information could change at any time. If you’re interested in doing anything similar, then do your own research or reach out to a licensed professional for help, as this post is meant for illustration purposes only!

 

Background on the Different ACA Marketplace Plans

The plans offered through the marketplace have various premiums, deductibles, and out of pocket maximums, as well as other distinguishing features. These plans are tiered into levels called Bronze, Silver, or Gold based on cost and how good the plan is in general. You can usually expect a Bronze level plan to have a lower premium cost, but a higher deductible and out of pocket maximum, while a Gold level plan will likely have a higher premium but better coverage. It’s always important to look at the plans closely to find the one that fits your needs the best since even plans in the same tier can differ significantly at times.

Another factor to consider is that as travelers, we move from state to state often, and since health insurance is purchased through your home state, coverage and providers could be limited in some places that you may travel to. It is a good idea to consider this when choosing a plan. You can check out the website of the insurer that the plan will be through to see if they cover providers in a variety of places nationwide, or just in and around your own home state. For marketplace plans, there is a section (shown below) where you can go to the website of the insurer to see where providers are located.

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Depending on your situation (mostly your Modified Adjusted Gross Income), it’s possible that you will be eligible for subsidies (the ACA marketplace refers to these as premium tax credits) that can make a health insurance plan bought through the marketplace even cheaper than the company sponsored plans available to you. These subsidies are available to anyone that makes between 100% and 400% of the federal poverty level. The 400% level actually ends up being a pretty generous amount of income to still qualify and will include the majority of travel therapists. The reason that many travel therapists will qualify is because of a generally lower AGI, due to part of our income being untaxed. Oddly enough, with an income less than 100% of the federal poverty level, you wouldn’t be eligible for any of the premium tax credits since it is assumed that you would qualify for Medicaid in that scenario. Below are the income levels that would qualify you for premium tax credits (subsidies) for 2018 courtesy of ehealthinsurance.com.

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An Example Scenario

For a traveler working 48 weeks per year, making a taxable income of $21/hour, he would have a Modified Adjusted Gross Income (MAGI) of approximately $21 x 40hrs x 48 weeks = $40,320. The traveler would still qualify for a partial credit at that point, which would help to make the health insurance more affordable.

Let’s assume this traveler is a single, 30 year old, at an income level of $40,320 with his tax home in VA (which would be a scenario for me if I was working 48 weeks per year). In this scenario, he would be eligible for a subsidy of $222/month as shown below in a quote from the healthcare.gov website.

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With this premium tax credit accounted for, his cheapest option through the marketplace would be a Bronze level plan, for a monthly premium cost of $168.40. He could also get a Gold level plan for $283 that has a much lower deductible and out of pocket maximum. But if it were me, I’d opt for the lower cost plan since I likely wouldn’t meet the deductible either way.

bronze level $40,000.jpg

$168.40 isn’t terrible, but it’s definitely more than I’d like to spend. Luckily with some smart planning, the traveler in this scenario can bring this cost down significantly! An easy way to reduce his MAGI is through 401k contributions. Not only will these contributions save him money on taxes, reduce his student loan payment (only on an income driven repayment plan), and set him up for a better financial situation in the future, they will also save him money on his health insurance premium cost by giving him a higher premium tax credit amount!

Another Scenario – With 401k Contributions

Let’s consider the same situation as above with the traveler that is working 48 weeks per year, but now let’s assume that he maxes out his 401k, which is $19,000 for the 2019 tax year. That would bring his MAGI down from $40,320 to $21,320. Now we can see what he would be eligible for with a MAGI of that level.

With the same variables as above (30 y/o male in VA) the lower MAGI now makes him eligible for a premium tax credit of $458/month!

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With a premium tax credit of that amount, a Bronze level plan would be $0/month (even HSA eligible!), and a very good Silver level plan would only be $48! Both of these options are shown below.

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Basically, by contributing $19,000 to a 401k, the traveler in this example would save $168.40/month ($2,020/year) in health insurance premiums, while also saving about $4,000 in taxes (between VA state and federal taxes). That’s a pretty awesome return on that investment.

It should also be noted that the reason the deductible and out of pocket maximum on the Silver tier plan in the above scenario are significantly lower, in addition to it being in a higher tier than the Bronze plan, is due to Cost-Sharing subsidies. These are an additional layer of subsidies on top of the premium tax credit that are put in place to specifically reduce the deductible, co-pays and out of pocket maximum for low income individuals/families. These cost-sharing subsidies only apply to the Silver level plans and aren’t available for the Bronze and Gold plans at all. The closer an individual is to the 100% of poverty level (without going below that level as noted above due to Medicaid territory), the lower not only the monthly premium gets for the Silver level plans, but also the lower the deductible, co-pays, and out of pocket maximum gets as well.

Drawing Some Conclusions From These Scenarios

At an income level of $12,500, one would be able to qualify for a Silver level plan with a $3/month premium, a $250 deductible, and a $700 out of pocket maximum! Healthcare plans don’t get any better than that these days.

Even with this being the case, I don’t think it’s worth it to go below the $19,000 MAGI level, at least in my case, since I don’t use my health insurance often anyway and would rather have a plan that is eligible for an HSA. None of the Silver tier plans that I have seen qualify for an HSA.

Another downside of a MAGI near the poverty level would be limited benefit from the Saver’s Credit since it’s nonrefundable (more on that in this article). On the other hand, for someone with higher medical costs each year, having a much lower deductible and out of pocket maximum could be worth much more than the value of having an HSA and the Saver’s credit so this is definitely something to consider depending on each individual situation.

If contributing $19,000 to a 401k is too much for you, don’t worry there’s still hope. Even at an MAGI of $27,000, which would be a 401k contribution of about $13,000, the monthly premium for a Bronze level plan would still only be $2.60/month. The premium steadily increases from that point as MAGI continues to increase.

Even though I don’t need any extra incentive to max out my 401k each year, I’m happy to accept a reduction in health insurance premiums for doing so! In this case, the more you contribute to your future retirement the more you save on health insurance now. So, even if you can’t contribute a large amount, it’s definitely to your benefit to contribute as much as possible. It’s also important to point out here that even though traditional IRA contributions reduce your AGI, they don’t reduce your MAGI since they are added back in to calculate your MAGI. For this reason, the only real meaningful ways to reduce your MAGI would be with a 401k or health savings account.

Our Plan for 2019

For Whitney and I, we plan to contribute enough to our 401k and HSA to get our MAGI down to around $18,809. At that level, not only will we have the option of a free Bronze level health insurance plan through the marketplace, but we will also pay $0 in federal taxes and have a $0 income driven student loan payment! How can you beat that?

Running Your Own Scenarios

If you’re interested in getting quick quotes for your own situation and don’t want to enter your information on the healthcare.gov website, I’ve found that this subsidy calculator works well and is really quick and easy to use. The downside is that, at least for my state, it doesn’t show the actual cost of the plans available, just the amount of subsidy that I would receive. The healthcare.gov website is definitely the most comprehensive way to compare different scenarios, and I encourage you to familiarize yourself with the site and see what you’d be eligible for based on your situation.

Take-Home Points

  • For a travel therapist that wishes to take significant amounts of time off between contracts or switch between different travel companies often (especially those that often meet their health insurance deductible), travel company sponsored health insurance probably doesn’t make sense. Luckily as travel therapists, most of us will qualify for premium tax credits for health insurance plans through the ACA marketplace.
  • With some planning ahead and saving for the future, it’s possible to actually get a Bronze level plan for free, provided that you reduce your MAGI enough through 401k and health savings account contributions. The amount required to achieve this for you will vary, but for me as a 30 year old male living in VA, anything below a MAGI of $26,500 will mean a free Bronze level plan due to the subsidies offered at that income level.
  • Contributing to your 401k is already a great idea, but the premium tax credits make it that much sweeter! If you’re a big saver like me and planning to transition to less travel assignments each year or part time work in the future, the combination of tax savings and health insurance premium savings from investing in your future with 401k contributions can be massive! If you aren’t currently a big saver, then maybe the savings on your health insurance premiums will encourage you to start!

What do you do for your health insurance as a travel therapist? Let us know in the comments below. If you have any questions about this or anything else travel therapy related, feel free to reach out to us. But do keep in mind that I’m not an expert in this area, and all of this information is based on reading and researching for my own situation.

If you are new to travel therapy and would like help getting started or  recruiter/travel company recommendations, then we can help with that as well! Thanks for reading!