Joys and Challenges
The profession of physical therapy opens a world of options about specialty and setting. One of these is in home health. In addition, it is an excellent path to achieve financial independence because the pay rate is higher than in other settings.
Because of the difference in pay, it takes a lot of hard work, mainly done after office hours. This consists of being constantly on the phone with doctors, nurses, clients, and office staff and unending documentation. (See how we used our note-taking process to plan our FI journey.)
Driving is also one of the significant challenges for any home health field clinician. This is another reason why our schedules can be long and unpredictable. Your whole day is at the mercy of the weather conditions, road works, and the driving aptitude of people around you.
Beyond the challenges, it is a very fulfilling career. Being Home Health Physical Therapists, my wife and I directly affect and change our clients’ lives daily. In addition, we are incredibly fortunate that with this line of work, we can hit our financial independence goals faster.
The average income of a home health physical therapist is $92,238. Financial independence can be achieved in just a few years by intentionally using your time and living your life.
How many years!?
Here is an example of Expenses and Savings Goals
At $71,827 after income taxes, you would have $5,985 a month to allocate
|Tolls / Parking||$20|
With the magic of compounding interest, if you save and invest the difference of $3,045 every month at an average growth rate of 8% in diversified index funds, you will have a total of $1,001,800 at your disposal in 15 years. You could retire, change careers, or continue seeing patients as you please.
Know that you are only as wealthy as your net worth, not your income. Do not waste the opportunity that your earning potential brings. Saving is critical, no matter how small of a percentage. It is your lifeline in the present and your freedom in the future. It gives you the flexibility that a paycheck-to-paycheck lifestyle can never have.
Visit our Top Saving Ideas to get ahead of your finances even more.
How do you ensure that while being the best therapist in the world, you can still reach your goal of having a wealthy life? Here are what we do to achieve a stress-free Home Health Physical Therapist life.
Define your work boundaries.
Home health clinicians get paid either by salary (guaranteed not dependent on the number of visits done) or by point (paid only on the number of visits done). Each company has a definition of a “point,” but it is usually the equivalent of an hour of routine visit (care, driving, and notes ). Holidays that take more time to finish, such as S.O.C.s, R.O.C.s, Recerts, and D.C.s, are given more points.
Let us look at a typical week of working from 9 am to 5 pm (approx. 8 points), 5 days a week, at $48 for each issue. You have tons of notes left undone, so after dinner, you do more documentation for 3 hours before bed.
This now makes a total of 11 hours of work. Because you were only paid for the 8 points, your rate is down to $34.90 (($48 x 8 points) / 11 hours). Thirty percent less than what you thought it was. The blurred boundary between work and life has a cost. Make sure to revisit and define it every time.
Hey, we’re not telling you not to be the best doctor-calling and on-time-documenting clinician that you are! But you want to live a life too, right?!
My wife was shadowing a senior therapist at a new job. The clinician was teaching her tricks to navigate the arduous documentation process, but towards the end, she said it was just too much. In addition, she told my wife that every night her husband complained about them not seeing each other even after work because she was making her notes until he was asleep.
She told her a simple strategy that we had always used, templates. Templates are pre-populated answers to Electronic Medical Record (E.M.R) questions. The goal is to edit these paragraphs and provide relevant information for your patient and the current visit. Then, whenever you see a patient, you don’t have to reinvent the wheel constantly.
Browse the common questions in your company E.M.R. and compose answers, but place blanks or asterisks so you can put in unique and pertinent client information later. Save them in your device’s word processor, notes app, or email. Then, copy, paste, and edit every time the question pops up.
But be cautious of repetitive documentation. You must edit and read your responses carefully. Yes, we need to manage our time well, but the quality and accuracy of our documentation take priority.
Learn how to use the S.O.A.P. documentation format to plan our personal and financial goals by clicking the link.
Shrink your area of coverage.
I used to think driving for hours for work was every day if I was getting paid more. Now I believe more is gained by eliminating long commute times than sticking to higher-paying jobs. It saves money on gas, maintenance, and time. With less drive time, you can see more bubbly patients, rather than being stuck daydreaming on a freeway somewhere.
Actual Rate comparing distances of 5 miles vs. 10 miles per patient
|Miles per visit||5 mi||10 mi|
|Daily Miles||40 mi||80 mi|
|Number of Visits||8||8|
|Drive time per visit||12 mins||25 mins|
|Total Drive time||1.6 hours||3.3 hours|
|Total Visit time (45 mins/visit)||6 hours||6 hours|
|Total Hours Worked||7.6 hours||9.3 hours|
You are not paid your Rate whenever you drive around rather than seeing more patients. But wait, our company pays for mileage; that cancels it, right?
|Reimbursement per mile||$0.45||$0.45|
|Daily miles||40 mi||80 mi|
|Daily miles paid||$18||$36|
|Miles paid per patient||$2.25||$4.50|
|True Rate with mileage||$52.77||$45.79|
At almost a $7 difference, you could have earned $13,440 more if, instead, you saw patients than sat in the car.
It will take some negotiation and convincing. For example, we often tell our managers and schedulers that we could increase productivity if we stayed within a 20-mile area. Usually, they are receptive because they are in the business of visiting patients, not paying licensed clinicians to drive around in circles.
Pamper your car
In-home health, your car is your call center, cafeteria, office, and best friend. If it breaks down in the middle of a shift, you’re kind of screwed. To pinch pennies (being lazy), I deferred routine maintenance and repair that my car needs. Hoping that all the blinking lights will eventually calm down. Bad idea!
Neglecting car maintenance like oil changes will cause more expensive damages to your car, like needing a new engine. But, on the other hand, being cheap about care, like running on worn-out tires, could also put you and others in danger. So instead, stay on top of routine maintenance by taking your car to your trusted mechanic. This way, your best friend remains ready to work for as long as you need to.
Take advantage of pre-tax savings.
Pre-tax accounts such as 401(K), 403(b), traditional I.R.A.s, and H.S.A.s let you save a portion of your paycheck before taxes. This effectively lowers your taxable income. In addition, it benefits home health clinicians who typically owe more taxes because of the higher wages and for working so freaking much!
On the $92,238 average home health salary, the following table summarizes the taxes you would owe for each percentage of contribution to your company 401(K)
|Amount Contributed||Taxes Owed|
The amount you owe could differ between getting a refund or a tax bill during tax season. Pre-tax accounts such as a 401k or H.S.A. has incredible tax benefits to incentivize folks to save money for retirement. Contributing to these accounts puts your money to work thru investing while lowering your tax bill. This way, you don’t feel penalized for seeing a couple more patients on the weekend.
Ask for a performance review.
Before anything else, the first step to this advice is to do your job well and be genuinely nice to the people you work with. Do I really have to? Yes! Because you don’t want to hurt your chance of getting a raise by slacking off and being mean to everyone, do you?
A month before the anniversary of your hiring (or if you have not asked for one in years), email whoever is in charge that you want a performance review to be done. It would look like this.
Good morning (Director),
Hoping you are doing well. I would like to let you know that this past year of working as a Physical Therapist in (Company name) has been very enjoyable and fulfilling to me. I have learned a lot and improved in doing patient care thanks to your guidance. I appreciate being part of this team every day.
I am requesting a performance evaluation to know where I am standing with regards to the work I am doing as a home health PT. This would be great feedback for me to see if there are areas where I excel or fall short. We can discuss ways for me to perform better as a clinician to know how to meet or exceed expectations in performing my duties.
If the result of the evaluation justifies it, I would like it to reflect on my (rate/salary) moving forward.
Looking forward to working with you in providing the best care our patients truly deserve.
Your office will then start the process by collecting data from people that you interact with in doing your job (case managers, schedulers, marketing, etc.). If you have built a good relationship with them, there should not be any problem.
Your supervisor will sit you down to tell you the review results. There will be praise and areas of excellence, but there could be criticisms or areas that need work. Be genuinely open, and remember that part of the reason you want this done is to improve.
If it is not brought up, ask for an increase in your pay rate. You could come in with figures on how much you want to be paid so you can negotiate. Once accepted, celebrate the raise you truly deserve!
If the answer is No, then take it as a chance to improve your performance in your company for the following review or start looking for better opportunities in other companies. It is what it is, but you would have never known if you had never asked.
Ready for the challenge?
With a higher earning potential, the home health setting is an excellent path to Financial Independence for physical therapists. But it takes a lot for a clinician to venture outside the comforts of a clinic or facility. There will be sacrifices of time and effort that may be uncompensated. However, the love of patient care should drive us to cater to our patient’s needs more than our salary.
But who can say we cannot have both!? Of course, you can provide the best care even while working less, not driving around in circles, and getting paid what you deserve. It just takes being intentional with what you want work to look like and taking small steps to ensure your journey to financial independence is as stress-free as possible.
We are a Pinoy Physical Therapist duo living somewhat unconventional but intentional lives. Trying to be smarter and better than before, we surround ourselves with content, experiences, and people that help us discover practical yet powerful ways to achieve our goals.
We aim to be financially independent by making small changes to our lives. We invite you to join our journey! We hope that you learn something valuable from our experiences.
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We are NOT certified financial advisors, analysts, or CPAs. Investing strategies shared in this article and the website are not financial advice but our opinions for educational purposes only. We want you to treat our content as a preview to do your research so you can make intelligent financial decisions.
5 thoughts on “Home Health Physical Therapist Journey to Financial Independence”
Nice write up. On the retirement savings, I know 401K would save you some money now due to tax deferral but start incorporating Roth 401K into the mixture. You could put certain percentage into 401k and some into Roth 401k. If the company does not offer Roth 401K then set aside a percentage for personal Roth IRA. That is tax free money in the future not deferred.