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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Top 5 Things to Avoid During Your First Travel Therapy Contract

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!