Travel Therapy During the COVID-19 Pandemic

April 1, 2020March 31, 2020 ~ Travel Therapy Mentor ~ 1 Comment

Information as of April 1, 2020 – Unfortunately 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 2^nd, 3^rd, or 4^th 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 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.

Top 5 Things to Avoid During Your First Travel Therapy Contract

September 5, 2019September 5, 2019 ~ Travel Therapy Mentor ~ 1 Comment

Written by Whitney Eakin, PT, DPT, ATC

Starting your first travel therapy contract is an exciting time, but there are definitely a lot of factors to consider when choosing your first contract, and mistakes to avoid once you get there! Since we covered choosing your first job recently, now we want to cover things to consider when you’re working at your first travel placement! These things apply both for new grads and experienced clinicians starting travel therapy for the first time. Some of these do have to be negotiated in advance as well, and they will come into play once you start working!

Productivity

Productivity is a dreaded word in healthcare. But, unfortunately, it is a part of our jobs as healthcare professionals. It’s important that you ask about the productivity expectations during your phone interview for the travel therapy job and consider whether the expected productivity is reasonable and realistic.

This will look different based on your discipline and setting. For example, for a SNF placement, the expectation could be anywhere from 75-95% (or potentially even higher with the new Medicare Patient Driven Payment Model changes on the horizon)! We urge you to consider whether the suggested productivity expectation is doable if you remain within ethical and legal guidelines. In general, we feel anything close to 90% or above is not realistic, especially for an evaluating therapist (PT, OT, SLP). In most cases, 85% is probably the max we would accept. For an outpatient physical therapy clinic, you might be looking for how many patients per day or per hour you are expected to see. In our experience, for an 8 hour day, between 10-14 patients is what we feel comfortable with. But, the therapist’s ability to meet these productivity standards in any setting is going to depend heavily on how the clinic is set up and how it operates.

When presented with a productivity standard that sounds high, we would encourage you to have a discussion with the manager or interviewer. Find out how the facility operates on a daily basis to help you decide if the productivity will be achievable. Are there techs or aids to assist with ancillary tasks such as setup/cleanup or patient transport? If it’s an inpatient or home health setting, is the productivity weighted based on what type of patient session is performed (evaluation, treatment, discharge, etc.)? When are the full time therapists able to complete their required documentation throughout the day? These are all important things to consider and ask during your interview.

In general, we don’t recommend you sign a contract that has the productivity standard written into the contract. This happens sometimes with SNFs, and sometimes they try to use this to say that if you drop below the written productivity, they can deduct your pay. If possible, avoid taking contracts like this, and if you see it written in a contract, talk to your recruiter to get it removed.

Once you’re on the job, be aware whether the productivity, and the various factors that affect productivity, are in line with what was discussed (and promised) during your interview. Is the clinic what you were told it would be, or is it totally different? Are you being asked to suddenly meet unrealistic productivity standards? Are things like the documentation system, support staff, and scheduling conducive to you being able to meet the productivity?

As a travel therapist, you are generally expected to be able to “hit the ground running” without much ramp up time. Sometimes facilities are able to provide more or less ramp up time or training than others, it just depends on the contract. But regardless of these expectations, you have to be honest with yourself and your supervisor. If the productivity expectations are not reasonable enough for you to meet them within your regularly scheduled hours, you need to stand up for yourself as a healthcare professional. Don’t let anyone guilt you in to stretching the limits of your ethics and legality, or your personal sanity, to meet unrealistic productivity expectations. Always remember, it’s your professional license and your quality of patient care at stake.

Working Off The Clock

Discussing productivity leads directly into our next topic, working off the clock. All too often, if the productivity standards at a facility are unrealistic and cannot truly be achieved during a standard workday, it leads to employees working off the clock to get their documentation done. For permanent employees who are on salary, there isn’t really such a thing as “working off the clock.” So, often, they will be in the habit of coming in early, staying late, working through lunch, or taking paperwork home with them. If you’re a practicing clinician, you are undoubtedly familiar with this, and as a student having gone through clinicals, you may be as well.

However, as a travel therapist, it’s important to remember that you are an hourly employee. You are paid by the hour that you work. Therefore, you should be able to complete all required work (including documentation) during your scheduled work hours. This can be difficult for employers/supervisors to cope with, because they’re used to their salaried employees. So if necessary, if this becomes an issue, it may require a conversation with your recruiter and/or your supervisor.

We encourage you to get paid for all of your time. So if the schedule and productivity expectations are not conducive to you completing your required work within your regular hours, something needs to change. This could mean a conversation about your schedule to reduce the caseload or allow built in time for paperwork. Otherwise, if you are working beyond your scheduled workday, you should be getting paid overtime.

Overtime

This leads in to the next topic. As stated above, if you’re working overtime hours, you should be getting overtime pay.

Typically as a traveler, facilities do not want to pay overtime. So, we have approached this situation in a couple different ways. Either we would let them know upfront that based on our schedule and our documentation, we would be going into overtime, and see what they say. Or, we would just do the required work, and if this required 30mins to an hour of overtime, we would then write that on our timesheet for the week. If nothing was said, we would just continue to write our hours down as we worked them, even if that meant overtime. But, often if you put down overtime hours, this will spark a conversation from your recruiter or supervisor. This is then the time when you would want to discuss the various factors of your day that make you unable to complete the required patient care and documentation within your normal hours. Then, perhaps the supervisor will work with you to make changes to your schedule, or they will agree to allow you overtime.

As far as overtime pay goes, this works a little bit differently for travel therapists. Typically, overtime pay is a standard “time and a half” on your hourly pay. However, this amount does not make sense for a traveler, because time and a half on our hourly is actually lower than our standard 40 hour pay when you account for the stipends received during our normal working hours. To learn more about overtime pay, check out this article.

The bottom line is that if you are going to be working overtime hours, you need to get compensated appropriately for the overtime hours. Hopefully you were able to negotiate an appropriate overtime rate when you signed your contract (in general for PT/OT/SLP this should be at minimum $45/hour but could be up to $85-100/hour). But, if for some reason you find yourself in a travel contract where you are actually working a lot of overtime hours, and your overtime pay is still only time and a half of your hourly, you need to discuss this with your recruiter and get it increased. Sometimes they can create an addendum to your contract to add a higher overtime rate, or they may be able to pay you a bonus at the end of the contract to compensate you for the difference in what you should have been receiving for overtime. Either way, make sure the overtime pay you are receiving is worth your time. Otherwise, don’t agree to work overtime, and instead make sure your schedule is adjusted accordingly.

Work Drama

Switching gears a bit, our next recommendation for your first contract (and all subsequent contracts!) is to avoid the work drama! As most of us healthcare professionals know, there is usually some type of work drama at any facility, whether it be interpersonal relationships, a bad manager, a bad coworker, staffing issues, or new rules and changes happening at the facility. This should be one of the best parts about working as a travel therapist. You’re only there temporarily, so you shouldn’t have to worry about this drama at work!

Not only is it good for your mental health to avoid work drama, but this recommendation will also help you to be more productive and get out of work on time. I can’t tell you how many times I made the mistake of getting caught up in the work drama and happenings of the clinic, and I ended up sitting there talking to a coworker for an extra 20 minutes, hour, hour and a half, when I should’ve been getting my notes done and getting out of there! Take our advice, and avoid the work drama as a travel therapist, and you’ll come out ahead in all respects!

Planning for Your Next Contract

The last thing we encourage you to consider during your first contract is planning for your next contract! This can be a tricky part of being a travel therapist, and this will be your first time navigating the transition. If you wait until the end of your current contract to start looking for your next contract then you’ll be way behind! We recommend that around mid-contract, you start to consider where your next move will be.

Are things going well at your current contract, and maybe you’re considering extending? Usually you can get a feel for this after the first few weeks. You might also already have an idea whether the facility might need you to extend or not. Have they found someone to cover their staffing needs already, or are they still searching? Is the caseload still high, or has it dropped and they won’t need anyone any longer? By about halfway through your contract, if you want to extend, you should start talking to your supervisor about it. Sometimes they will approach you themselves, but often you have to ask. In the past, we have usually approached the supervisor and said something along the lines of, “It’s about halfway through my contract and this is when I need to decide what my next move will be. I was wondering about your current staffing needs, and if you think you might need me longer than my 13 week contract?” This is usually a good opener to the conversation. If you do want to extend, and they need you to extend, you then go back to your recruiter and proceed with the contract extension negotiations.

If extending your contract is not an option or not something you want to do, then you need to start thinking about where you want to work next, and when you want to start. If you’re interested in going to a different state, you need to already be working on the next license. We always recommend having the license in hand before applying to a job in a certain state. Sometimes while you are already on contract with a company, they will be able to help you start the process of getting your next state license.

If you plan to start work immediately after your current contract, it’s best to start looking for your next job about 6 weeks out from your end date. We usually try to have our next contract locked down within 2 to 4 weeks of our end date. If we get down to 2 weeks from our end date, that’s when we start getting a little nervous, and also when we might consider expanding our search criteria and getting a little less picky.

This is an important factor to consider as a travel therapist on your first contract and on all subsequent contracts. 13 weeks goes by a lot faster than you think! In order to avoid a lot of unwanted (and unpaid) time off, you need to be on top of your job searches. Hopefully you have a team of recruiters that is proactive and will also be reminding you of this and helping you with the process. But we encourage you to be proactive in your job search, because ultimately you’re the only one who is going to go without work and without pay if you don’t lock in a contract.

Conclusion

While there are lots of things to think about during your first contract, these are the main ones we wanted to highlight that we think pertain to all travel therapists. There will undoubtedly be a lot of other factors, especially various clinical nuances, to consider. But, in terms of being successful as a travel therapist, the biggies are: making sure you’re not being taken advantage of in terms of productivity, not working off the clock, and overtime; as well as avoiding work drama; and planning ahead for your next contract!

We hope this information helps to set you up for success during your first travel contract! If you have questions for us, don’t hesitate to send us a message!

If you’re still in the process of getting started with travel therapy and would like recommendations for recruiters we have worked with that will have your back during your journey as a traveler, fill out this form and we will get back to you with recommendations!