Category Archives: Traveling PA

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.

Student debt was ruining my life.

 

I graduated from PA school in December of 2014.  For those of you who don’t know me well or my story, a brief background: I have three degrees and a lot of debt.  I made a lot of stupid choices with my education when I was young. I went to two private colleges before PA school.  I have a bachelor’s in psychology and master’s in counseling psychology.  I already had a lot of debt and I wasn’t happy with these choices (I know solid self high-five for me to screwing that one up).  For a multitude of reasons, I made these choices.  I had little to no guidance at what the hell I was doing <with my life>  and like I mentioned before I didn’t really have an academic or life direction.  I spent the majority of my childhood with my mom being very ill with cancer and my dad and I had a rocky relationship at best.  Regardless, I made those choices and I own them.  Fast forward to deciding to go to PA school and take on more debt.  I said screw it.  I can either live with a career that I’m not satisfied with because of extra financial burden or pursue what I want.  Obviously, I pursued becoming a PA and I don’t regret it.

However, I had/have a shit ton of debt. My federal debt is under control. But, I had private loans my father took out to pay for my undergraduate education (yea I signed the papers but lets be honest I had no idea what I was doing).  A process that I’m still not sure how I didn’t qualify for more federal loans–but, that is a story for another day.  I graduated to discover these loans had been thrown in to collection. I wasn’t paying them while I was in PA school and my dad didn’t pay them towards the end. So, there I was new white coat and 50k in private debt that I had no way to pay.  I had already accepted a position that wasn’t great paying–but, I took it because I knew the physician and I knew it would be a good learning experience (and it was a great group and experience).  Well–I definitely couldn’t afford both my federal and private loans.

There is a long story in between, but months later while talking with one of my supervising physicians she told me that I couldn’t stay at this job for loyalty.  That I had to take care of myself.  So, I did.  I looked in to work as a traveling PA.  Working as a travel PA would allow me to significantly increase my income and decrease my living expenses.  Hence, allowing me to pay off these private education loans that had become a real pain in my ass.

Back to my supervising MD.  She told me to set an alarm on my phone for one year from today.  She told me that one year from now your life will be substantially better, more stable.  Things will work out.  I did it. I set an alarm my phone and on August 1st I contacted her to tell her that she was right. This too shall pass and that I was strong enough and smart enough to take on everything that needed handled in my life. The result right now is that I’ve paid off nearly 25k in debt in 8 months. I’m over half way to my goal of paying off these damn private loans.

What’s my message and purpose? Why am I being so transparent about shit no one talks about?

This too shall pass. Loans suck.  Life is hard sometimes. Grab life by the balls, horns or whatever object you would like to insert here.  For anyone else out there who has suffered for whatever reason in student debt that has seemed insurmountable it will be ok.  You can find ways to make money and cut costs.  Especially as a PA–there are so many opportunities.  If you are in my shoes and want to pursue locum work, please e-mail me.  I can help you get in touch with the right person!

I tell my story to innumerable amounts of people in hopes that they will learn from my mistakes.  Go to community college first.  Know what your end goal is.  Have purpose in your action and education. Work during school and put that money–whatever you can towards your tuition. Go to state school.  No one gives a shit about your private college education besides you or your parents (hey if it’s paid for and you want to do it go for it–I’m speaking purely from a financial perspective).

I had no business going to college when I did. But it was expected and the norm–so I did.  I had no idea what I was doing and again to reference Amy Poehler: “We need to stop asking young people what they want to do and start asking them what they don’t want to do.”  I couldn’t agree more. Once you see what you want zero part of–you start narrowing down your options and what you want becomes more clear. Not only that, but you become more motivated to pursue things that will keep you from doing what you do not want to do.  We are a species that will avoid what we don’t like at all costs. Hence, you develop drive to pursue something you want.

I can blame my situation and point fingers–but I didn’t.  I might mention it, but I took responsibility and control.   People may read this and go “wow, that’s embarrassing” and laugh.  Whatever. Laugh, judge do whatever you want. You know why I say “whatever”? Because somewhere there is someone who is having the same emotional breakdown I did, and I’d rather help that one person than stay quiet for my pride.

If anyone out there has questions for me or needs direction or reassurance please feel free to contact me.  Always remember: “This too shall pass”.

First Assignment

Despite the fact that I just started my first assignment as a traveling PA, I feel like it has been a lifetime because I spent so much time preparing and researching in the process to make this switch.  The first position I took out of school was a great experience and I loved my co-workers. My supervising physician’s were very in to teaching me and supportive and I will always be thankful to them. If you need a PCP in Pittsburgh hit me up and I can refer you–I would let them treat my loved ones which I think says a lot. However, I had personal factors driving my decision to take the route as a traveling PA and I do think it’s going to be great decision for advancing my career and from a financial standpoint.  The representative I work with from Barton Associates (Steve, God love him for dealing with me) told me I asked more questions than anyone he has ever worked with before.  If you are considering doing the travel thing I can hook you up with him, he is great at his job. Anyways, there was a lot to consider–but I’m really glad I’m here.

So, where is here?  Currently, I’m in central PA within the Geisinger health system (there are various locations and I will refrain from saying exactly which location in case I share experiences under my “knowledge bomb” tab–cause you know HIPPA is a thing).

I was really reluctant to move from the city life of Pittsburgh to well an area where the closest Starbucks is 20 miles away (At least I think that is how far it is–I haven’t been to one since I got here which is probably good for my pocketbook).  A great number of locum’s positions are in what we call “rural areas”. I previously lived in Pittsburgh for 8-9 years and was kind of terrified at not having certain amenities at my finger tips.  I told Steve as long as there was a CrossFit gym, I was ok with it.  I can say this–I DO NOT miss sitting in 45 minutes of traffic to go 7 miles. I was working 8 hour days, but putting in 10 with travel time. So far I am loving my position.  There is a lot more independence and I’m dealing with a higher level of acuity patients, while this is some what scary–its exciting and a good kind of scary because I am learning so much.  I’m also working 12 hour night shifts which is a completely different job. I thrive on new situations and love exploring new places, even if it is the middle of no where 🙂 As you can see in the picture below the main attraction is farm land, barns, silo’s and cows.

My fur baby, Piper and me exploring trails while at my first assignment in Lewisburg, PA
My fur baby, Piper and me exploring trails while at my first assignment in Lewisburg, PA

I bring my dog everywhere.  She is seriously my fur baby and I’m so glad I have her right now.  I left a lot of people I love back in Pittsburgh, who I am lucky to have supporting me wherever I go.

My boyfriend, Jeff and myself. He's starting Physician Assistant school at The University of Pittsburgh this year! I'm fortunate that he is supporting the path I have chosen. So proud :)
My boyfriend, Jeff and myself. He’s starting Physician Assistant school at The University of Pittsburgh this year! I’m fortunate that he is supporting the path I have chosen. So proud 🙂

 

Welcome!

 

Welcome!  We are currently getting underway!  Be patient… LOTS of info coming your way 🙂

 

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My Name is Danielle Kepics, I am a 2014 graduate of The University of Pittsburgh. I currently work as a traveling Physician Assistant in my second position of my career. I don’t claim to be a super expert on the Physician Assistant profession, I am just someone who has been through the trenches. Through my process I spent a lot of time gathering information and learning what I needed to do for various phases of pursuing my career. What I found was that all of that information is kind of scattered everywhere. My hope is that this site can be a centralized hub for information pertaining to all stages of becoming and practicing medicine as a Physician Assistant.