Monthly Archives: May 2017

Life as a Traveling PA

Recently I have had A LOT of questions about becoming a traveling or “locums” PA.  I decided to address everyone’s questions and tell everyone a little about my experiences to help out! Please leave additional question in the comments section and I will do my best to address them 🙂

FAQ:

1. Can I do this as a new grad?

You can.  However I imagine there would be pros and cons to this.  As a traveler/locum you are pretty much expected to go in somewhere, adjust to the EHR (electronic health record) if you have never used it before and roll like you’ve been there before.  So– there isn’t a lot of room for you to learn how to treat patients.
I tell most people that if you feel like you had great patient care experience, clinical experience and/or clinical rotations and if you can treat patients without feeling like you need to ask a lot of questions go for it.  I was a mental health therapist before being a PA and didn’t feel like I had strong rotations so it wouldn’t have been a great choice for me.
Second, expect to work in the “less desirable” areas or specialties.  I’m not trying to be rude or anything, but there aren’t a lot of people who wanna work in the middle of no where in North Dakota in psychiatry. BUT– if you take that job and get something on your resume it makes finding your next position a lot easier.  You have bargaining room.  Also, don’t expect the high-end of the pay spectrum (you would likely– most likely still be making more than anyone you graduated with).

2. What is the pay like?

It’s good.
I am unable to talk specifics, but it is definitely more than I was making as a new grad anywhere else.
You are paid hourly and always– ALWAYS high ball people.  The money is there.

3. What specialties can I work in?

It depends on what you are looking for.  As a new grad– see above. It also depends on what you have experience in.  You will always get more money in fields you have experience.  However, if you want to try something new and are ok with taking a little less money you might be able to try something new.

4. My friend/significant other and I want to travel together can we get an assignment in the same location?

Sometimes, yes.  Or it could be relatively close– or in between so you could share housing. But I would think with some positions this would be possible.

5. How do I find a company to work with?

NALTO is the National Association of Locum Tenens Organizations. This is basically the BBB for travelers/locum providers.  It is to protect you and the organization who is placing you from anyone getting treated like crap (for lack of better words)

6. Who finds your housing?

Your company has an entire department that is responsible for finding and paying for your housing.  And YES you can bring your dog =)  My nugget comes everywhere with me! I know some travel nurses who get a stipend and then find their housing– I haven’t heard or encountered this as a provider.

7. What about malpractice/licensing/credentialing?

Again, your company should have an entire department for this– if they don’t you’re with the wrong people.  I don’t lift a finger for any of this.  Make sure they cover “tail” insurance.

8. Can you pick your sites?

Yep.  I don’t go anywhere or do anything I don’t want to.  I’m an “independent contractor” which means I DO WHAT I WANT.  =) It also means I file taxes as an independent contractor— get a good CPA.

9. How long is each assignment?

It’s totally up to you.  I like to take assignments about 3-6 months long.  Then it is worth it for me to move all my stuff and be kind of settled, explore the area and peace if I want to!  If you’re good you’ll be offered extensions or permanent positions.  PRO TIP: a lot of companies have clauses about taking permanent positions out of a locum position.  As in how long you have to be gone from the position or there are also “locum to permanent” positions out there too.

10. What about benefits (medical, dental, vision, 401k)?

The only company I have come across that offers this is COMP HEALTH.  I didn’t take an assignment with them yet, but all of the recruiters I talked to were really nice and I would consider taking a job with them.  Their hourly pay is a little less compared to other companies, but you do get benefits.  PRO TIP: they have a 6% 401k match which is pretty good.
To give you an idea of benefits cost per year here is what I have been in for:
Health insurance: 260/month with a 4,500 deductible
Vision: eye exam was like 180$ and my contacts $120 for about a year
Dental: x rays and cleaning cost me $240.
I recommend a health savings account. I’m also increasing my disability insurance to better reflect my current earnings which will cost me about $150 per month.

11. Are you re-reimbursed for transportation and travel?

YES.  You should not drop a DIME.

12. What are the PROS and CONS?

PROS: 
The pay, no rent or utilities.
You get to travel and see the country on someone else’s dime. You aren’t subject to all the “office politics” because you are an independent contractor.
If you don’t like something about the job— it has an expiration date.
CONS: 
You move a lot.
You don’t have control over “the little things”– see below —

13. Are there positions outside the USA?

No idea.  Not that I have found yet.

14. How does retirement work?

I have my own retirement funds as of right now.  Comp Health (which is a locum company) does offer benefits to their employees.  6% 401k match.
I recommend a good financial adviser.  I love mine if anyone needs a rec.

15. Can you get hired on permanently?

This depends on the company you are currently contracting through and their rules.  Some have clauses in your contract that state “cannot work for x,y,z for one year after end of contract” others don’t care and some positions are also noted as “locum with opportunity to transition to permanent”

16. Are there any PA schools that incorporate study abroad?

Yes, my friend is applying to one but I cannot remember which.

17. How does state licensing work?

Literally your company should do EVERYTHING for you.  You should not lift a finger. Or pay a dime.  And don’t let anyone ever tell you that you cannot work for another company because “they paid for your license” that is complete bullshit and a rep just trying to bully you into staying with them.  I highly recommend not working for someone who tells you this as they definitely don’t have your best interest at heart.

18. Do you get a living stipend?

No.  My costs are literally all covered.  I don’t pay rent or utilities.

19. What is the best way to prepare for this type of position before/during/after PA school?

Before: Get experience as a CNA, in a hospital, work as a nurse– some type of position that prepares you to be immersed in health care and you don’t feel like a fish out of water as you graduate.
During: Really really really focus on the plan of care.  Know what you would do for the patient.  Also know what you would do if something went wrong.
After: Apply? And be willing to take a job somewhere not ideally located or not in the perfect specialty

20. How competitive is being a locum?

There is a HUGE need.  This also is variable based on specialty.  I have done all hospital, family or urgent care med.

21. Can you change specialties?

Sure. It helps if you have prior experience in these specialties.

22. TAX DEDUCTIONS

So– you can turn A LOT of things in to tax deductions.
Flights
Food
Coffee
Health Insurance
Dental work
Vision
Hotels
Cell phone
Electronic purchases
Amazon Prime
Kindle
iPad
Anything that “is a cost of operating business”

23. Are certain areas in higher demand.

Yes Rural areas.

24. How does salary/payment work?

You are an hourly employee
If you don’t work you don’t get paid– but you are paid well and honestly it doesn’t matter.
You are paid through your company.

25. Is salary competitive?

Yes.  More than competitive. And again– always, always HIGH BALL on your offer for what you want compensation wise.

26. If you live in a state that NCCPA exempts you from taking PANRE and you travel to a state that requires it, do you have to take the PANRE before you go?

So, as a traveler I would no recommend going without NCCPA cert. Most locations want or require it.

27. Are you given additional training?

I have not been.  You need to be ready to step in to someones shoes for the most part.  But– I do think there are jobs out there that are longer contracts that may be willing to train if you took less pay or something.

Tid-Bits:

  • Keep copies of everything.  Especially the malpractice insurance you have with each company/position.  You will need this with each new position you apply for
  • Make a folder for each company/position you work in your e-mail.  Keep everything.
  • As for copies of proof of wherever you are living.  I recently lost my housing (which wasn’t my company’s fault but a total pain in the ass) Ask for every damn thing in writing.
  • If people are interested in how I cook/eat/count macros while living in a hotel let me know.  I’ll write a post all about that
  • Yes, your dog can come.
  • Get a file folder for all of your “business related” receipts

Things you don’t have control over that you probably haven’t thought about:

  • Your shower pressure
  • closet space
  • washer/dryer
  • neighbors
  • dishwasher
  • how long does the hot water last?
  • sometimes contracts fall out.  I swear all of the “this never ever happens” have happened to me.
  • Fridge space
  • THE MATTRESS.  I swear if any performance mattress companies out there want to sponsor me I AM IN.  My last 2 places had shitty soft mattresses and I have honestly thought about having one sent to me.
  • Concealed carry license.  I’m not trying to be political at all but if you have a concealed carry license for a weapon it will be a pain in the ass to transfer it so you can actually use it.
  • If you like your position and they want to hire you depending on your contract they might not be able to
  • Auto insurance.  As long as you are only in a location for 6 months you can use whatever permanent location you want.

Stuff you wouldn’t think of but need to know:

License plates.

Yea totally didn’t think about this.  There are a couple routes you can go.  You can sell your car or park your car somewhere and have your company rent you one.  Or you can say “eff it” and figure it out as you go– which is what I did because I LOVE LOVE LOVE my Nissan Rogue!!!!  My plates actually expire this month.  I am using a co-workers address in a county in California that doesn’t require smog inspection. What is tricky is that in order to change your drivers license address you normally need a lease, mortgage or utility bills to “PROVE” you live there.
Well I have none of those. So, what do you do?
The DMV also accepts bank statements.  So, I changed my investments and my bank statements to that address and I explain my situation and bring those documents.  That has worked with me in the past and hopefully when I go for my license plates and address update they change it for me!

Driving Insurance

I left my insurance under the town I lived in for my first travel assignment in Danville, PA because the rate is dirt cheap. You are “LEGAL” as long as you are only staying somewhere for 6 months. You don’t necessarily have to change your location.

Health Insurance

So, I haven’t had to deal with cross states yet.  I’m also for national health insurance (bring on competition and drive down rates hahahaha).  However, my guess is that moving to a different state would be a “qualifying event”

Voting

See my debacle regarding license plates!

Banking

I recently switched all of my regular banking with USAA (my dad was in Vietnam so I automatically qualify to have accounts with them).  I HIGHLY HIGHLY recommend them.  They are so kind and always willing to help and EVERYTHING– EVERYTHING can be done on the internet or phone.