Joys and Challenges
The profession of physical therapy opens a world of options with regards to specialty and setting. One of this is in home health. It is a good path to achieve financial independence because the pay rate is relatively higher than other settings.
Because of the difference in pay, it takes a lot of hard work that are mostly done after office hours. This consists of being constantly on the phone with doctors, nurses, clients and office staff, and the unending documentation.
Driving is also one of the big challenges for any home health field clinicians. 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. My wife and I, both being Home Health Physical Therapists, feel like we directly affect and change our clients’ lives every day. We count ourselves extremely fortunate that with this line of work we also have the means to hit our financial independence goals faster.
The average income of home health physical therapist is $92,238. By being intentional with the way you use your time and live your life, financial independence can be achieved in just a few years.
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, $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 key, no matter how small of a percentage. It is both 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 make sure that while being the best therapist in the world you can still reach your goals of having a wealthy life? Here are the things 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 (get 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 ). Visits that take more time to finish such as SOCs, ROCs, Recerts and DCs 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 point. You have tons of notes left undone, so after eating dinner you do more documentation for 3 hours before going to bed.
This now makes a total of 11 hours work. Because you were only paid for the 8 points, this takes your rate down $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?!
At one time, my wife was shadowing a senior therapist on a new job. The clinician was teaching her tricks on how to navigate the arduous documentation process, but towards the end she said that it is just too much. She told my wife, that every night her husband complained about them not really seeing each other even after work, because she is doing her notes until he’s asleep.
She told her a simple strategy that we had always used, templates. Templates are pre-populated answers to EMR questions. The goal is to edit these paragraphs and put in information that is relevant to your patient and the current visit. Whenever you see a patient, you don’t have to reinvent the wheel all the time.
Browse the common questions in your company EMR and compose answers but place blanks or asterisk so you can put in unique and pertinent client information later. Save them in your device’s word processor, notes app or email. Every time the question pops up, copy, paste and edit.
But be cautious of repetitive documentation. It is very important that you edit and read your responses carefully. Yes, we need to manage our time well, but the quality and accuracy of our documentation takes priority.
Learn how we use the S.O.A.P documentation format to plan our personal and financial goals here.
Shrink your area of coverage
I used to think that driving for hours for work is normal if I am getting paid more. Now I think that 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 in a freeway somewhere.
True 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|
It turns out you are not really paid your rate whenever you spend time driving around than seeing more patients. But wait, our company pays for mileage, that cancels it out 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 $7 difference, you could have earned $13,440 more if instead you saw patients than sit in the car.
It will take some negotiation and convincing. We often tell our managers and schedulers that we could increase our 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 your best friend. If it breaks down in the middle of a shift you’re kind of screwed. For the sake of pinching pennies (being lazy), I found myself deferring 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. Being cheap about maintenance, like running on worn out tires, could also put you and others in danger. Stay on top of the routine maintenance by taking your car to your trusted mechanic. This way your best friend remains in shape to work for as long as you need to.
Take advantage of pretax savings
Pretax accounts such as 401(K), 403(b), traditional IRAs and HSAs lets you save a portion of your paycheck before being taxed. This effectively lowers your taxable income. It is beneficial for 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 be the difference between getting a refund or tax bill during tax season. Pre-tax accounts such as a 401k or HSA has awesome tax benefits to incentivize folks to save money for the retirement. Contributing to these accounts puts your money to work thru investing while also lowering your tax bill. This way you don’t feel penalized 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 prior to the anniversary of your hiring (or if you had not asked for one in years), send an email to 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 had built a good relationship with them there should not be any problem.
Your supervisor will sit you down to tell you the results of the review. There will be praises and areas of excellence but there could be criticisms or areas that needs work as well. Be genuinely open, remember that part of the reason you want this done is to improve.
If it is not brought up, ask for the increase in your payrate. 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 next review or start looking for better opportunities in other companies. It is what it is, but if you never asked, you would have never known.
Ready for the challenge?
With a higher earning potential, the home health setting is a great 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. The love of patient care is what should really drive us to cater to our patients’ 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 in making sure your journey to financial independence is stress free as it can possibly be.