Getting to the heart of travel healthcare.

A podcast hosted by Sunny & Matt

Podcast Transcript


Experts T.J. Cantwell and Kelly Grant are the guests on Cardium podcast to talk about the PT Compact and the impact on travel therapists.

The PT Compact: What Travel Therapists Should Know

October 2, 2019


Voice Over: Welcome to Cardium the podcast that gets to the heart of travel healthcare and asks what's your why. With each episode we explore the topics and issues that impact healthcare professionals in the fields of nursing and allied health. Now here are your hosts, Sunny and Matt from Aureus Medical.

Sunny: Welcome to another episode of Cardium. If you're a subscriber, welcome back and thank you for being part of our family. And if you're a new listener, thank you for stopping by. We hope you enjoyed the podcast and we would love for you to subscribe so you can enjoy future podcasts. Hello Matt, how are you?

Matt: I'm good, Sunny, how are you doing today?

Sunny: I'm doing okay. A little dreary outside, but that's all right.

Matt: I don't mind. I don't mind.

Sunny: You know, I'm really excited today about our conversations, so I kind of felt like we need to just jump right in there.

Matt: I agree. It's a great topic.

Sunny: It is. And it's something that I'm really, really passionate about. So been working a little bit in therapy in my past life, a little bit. And we have an exciting guest. His name is T.J. Cantwell and he is currently a part of the Physical Therapy Compact Commission Administrator, and that's what he's serving as at the Federation of State Boards of Physical Therapy. He is a successful nonprofit executive with 20 years of experience in the national nonprofit and trade association industries with expertise in membership, marketing, program building, organizational operations and a plethora of other things. He's just got a lot of talent and we're so glad to have him here, so welcome T.J. Cantwell.

T.J.: Thank you. Thanks for having me, good to be here.

Sunny: Yeah, thank you. And we have another exciting guest, someone that I have worked with over the past few years and I'm excited to have as well.

His name is Kelly Grant and he's a branch manager with the therapy division of Aureus Medical group. He's been with the company for over 10 years and is responsible for leadership, employee development and building relationships with therapists and healthcare facilities across the country. And prior to his role within the therapy specialty, he served as a team leader with Aureus Nursing. Welcome Kelly Grant.

Kelly: Thanks sunny. Happy to be here.

Sunny: Thank you. Thank you very much. So just wanted to talk a little bit about today's episode. We'll be discussing the PT Compact and why you should know about it. And so just wanted to just kind of jump right in.

Matt: I'm glad we're talking about it because I know enough to not even be dangerous about the PT Compact. So T.J., thank you very much for joining us again. And can you tell us a little bit about the movement that led to the organization, the creation of the Compact. I think that that would be really interesting way to start.

T.J.: Yeah, happy to. So the Compact is one of those ideas that's taken a long time to really come to fruition. Starting back all the way to 2010 the first conversations were around what things could be done to help really increase consumer access, patient access to more PTs and PTAs especially in those rural areas with, are underserved. But really throughout the country and you know, a variety of things have been said in terms of potentially creating a national licensure doing something where there was regional contracts, regional agreements between certain states. Just essentially having some standards for regulation. And then the Compact was another option and all those things were considered between the Federation of State Boards of Physical Therapy and the APTA and other stakeholders really that were saying, "What's the best options out there?"

They had several years of discussions in order to determine what was going to be the best option. And not until 2014 did they really determine that the Compact was going to be the best solution. A way to both increase mobility for PTs and PTAs, but also to increase the consumer access and even improve the public protections that are out there. And so they went with the Compact commission model, which then took several more years to develop what that looked like in terms of language for legislation and then get states on board to start introducing legislation in 2016, with finally in 2017, 10 states, which the requirement in order to officially have a commission.

You know, were April of 2017 the Commission came to actual being. And then even since then we've been working to write rules and policies and have our first meetings in 2017. And so it's been quite a journey to get to where we are today. But you know, as I'm sure we'll talk about now we've got 25 States on with the Physical Therapy Compact Commission, which is fantastic. And so really it's been a been a long journey of nine years from the original conversations, but now we're actually reality in helping consumers get access and for PTs and PTAs to be able to have that greater mobility, which is fantastic.

Matt: What a project. This has been a child for you. Nine years-

T.J.: I'll be honest, I'm maybe a stepfather or an adopted father. I haven't been here the whole time but there's many others that came before me that helped to create it. But I've been here since 2017 when the Commission really came into fruition with those first 10 States. And so yeah, it's been even work since that time to make sure that it's been growing ever every year as we can do it. Hopefully we'll keep continuing to grow it.

Matt: Yeah. Really buoys the industry to see that type of movement and not an easy task. But even since you've joined, you said joining at 10 and now being at 25 is that...

T.J.: Yeah, that's right.

Matt: That's exciting and more to come from what we understand. So that's really exciting. That's great.

Sunny: You know, so it's truly been on labor of love and you talk about patient accessibility as being one of the main reasons as to why getting this movement and for those of us that are laymen, we hear about the nurse Compact, we hear about that. What truly makes it a main reason for it to be accessible for patients? Why, why does that help patients?

T.J.: Good question. So you know, there is a shortage of access in, in several states of available PTs and PTAs, especially in those rural areas and in many cases it's because they've become a growing need in those rural areas or other areas throughout the state. And then the time it takes for somebody to be able to be licensed to get a regular license in those states can be lengthy in in certain cases and more difficult in other cases then and where they currently live.

So what the Compact really accomplished was creating a more streamlined, faster, a quicker, easier way, more efficient way for those PTs and PTAs that are qualified to be able to then get a Compact privilege, which is the technical term, what we call…instead of getting a license in another state, you get a Compact privilege in that state.

But that really just means that it's the requirements and the criteria to get those, that privileges is far less and means that we can issue it much quicker. So essentially as long as someone lives in a state that's a member of the Compact that's active, that's got a permanent residence there, they hold a regular license in that same state. And they don’t have any encumbrances, or any adverse actions within the last two years, they're eligible.

So all of these other pieces of paper and things that typically have to be done to get a license verification of licenses and other states. You know, verification of their disciplinary actions and things like that. We've automated 99% of that, which means that within 10 minutes after they complete that jurisprudence, they can be able to get that Compact privilege, which then means they can get that job. So for travelers, it's a boon. They know they can go and get a job in those other States and you know, be told there's a job available and really within the same day be able to get the privilege of practice there.

Matt: And you mentioned travelers and I think Kelly, that's your arena. So maybe you can add as well to T.J. specific to the traveling community for PTs.

Kelly: Absolutely. You know, just obviously we staff a lot of those rural areas and over the next eight to 10 years, the therapy industry is growing 28% and so there's really going to be a shortage of therapists. And without the Compact, it really limits that pool of people that can get in there and help those patients whether it be rural areas, relief areas or whatnot. The Compact simply just makes that pool greater and then obviously gives a lot of opportunity for this therapists that do reside in those Compact states.

Matt: And what a benefit for the patients. I mean when you really talk about advocacy and being able to have access to the healthcare professionals. It sure does make it easier for the patients to receive the care they need and ultimately that's why the professionals are there. But to have that patient care delivered in a timely manner and not be worried about putting on a list where they or they can't receive the care in a timely manner.

Kelly: Yeah, I think a lot of times it's really easy to think about a therapist that they want to go to Oregon or to the coast or to a nice area, but ultimately the reason that they got into the therapy field was to help patients. And so this really allows them to check both those boxes for helping patients that really need it, but also seeing those areas that they, they may not have been able to in the past.

Sunny: Yeah, exactly. You know, we talk about some of the benefits of the Compact and you gave a little bit about the history T.J., but what were some of the bumps in the roads that you faced getting that Compact going?

T.J.: Right. Well I'd love to say that we've gotten rid of all those …but I don't think that's the case. You know, obviously our goal is to have the Compact be adopted in all jurisdictions but we haven't gotten there yet. We are working towards getting there and you know, part of the challenge has been, is really getting those states to adopt that legislation. So it's not simply another state would love to become part of the Compact and they call me up and they're part of it's a long process to get, that legislation has to be actually enacted in each one of the states. It becomes official law for that state to join our Compact. And then they abide by all the requirements that I talked about before. And so part of that is working with those state chapters, working with APTA, working with the state boards to try and make sure that they understand what a Compact is in the first place. So then there'll be interested in actually joining.

And once they do, then they have got to educate all the legislators in those states, make sure we've answered their questions, they understand what it means and what it doesn't mean and then hopefully ultimately get that passed. And once that's passed, then we've got other hurdles to get through. Each state has to implement several new rules, some new procedures, in many cases in order to be ready to get the Compact, start issuing and accepting Compact privileges. And so that's my job. You know, to make sure that they're ready and they can know their requirements. But you know, all of those things have been bumps in the road. Things that are hurdles that we have to overcome every time we have a new state join.

And so it's one of those things, the conversation I have a lot with folks is, "Well it looks like the state has just inactive legislation. Can I now participate in the Compact tomorrow?" And unfortunately I always had to give the news that you know, it's going to be a good eight to 12 months before they're probably ready simply because of bureaucracy in many cases that it's just difficult to move things forward quickly.

And so we've continued to run into those challenges. But I think the good news is because the Compact is what it is and we've talked about, all the benefits already that not only are the states chapters interested and the state board's interested, but largely you know that the state legislatures are very interested in joining the Compact as well. It just takes a bit of education that moved them from, from point A to point B if you will.

Sunny: You know, Kelly, you hear about the Compact at a different level working with candidates or also working with clients. What are maybe some of the challenges now that you have T.J. here that you hear? Any kind of questions that you can ask him?

Kelly: You know, and I think the common one that we get is does the therapy Compact work like the nursing and that's obviously, nursing's changed. There's a little bit over the years, but maybe you can allude a little bit to the comparison because that's something that people in the healthcare profession, they immediately hear Compact and they think it's the exact same thing as the nursing.

T.J.: Ah, that's very true. So while we based a lot of what we're doing on the Nursing Compact, because what they do is great. But we did make some tweaks and especially in terms of the operation of our Compact. So while the nursing combat is a multi-state license that you have to go and get and then you can be able to practice in all the states. Once you have a multi-state license, you can practice in all the different states for nursing. For the PT Compact, we specifically made it so that you have to get a Compact privilege in each state that you want to work in. So just like today, you have to get a license in every state you want to practice and you're going to have to get a Compact privilege in every state that you want to work in.

And so there was several reasons we did that, but some of the main benefits of it is essentially you can actually go and do an a la carte if you will, to choose the states you want to actually be able to work in. It's not going to be one of those where, where you have to purchase a multi-state license where you may never even want to go to half of those states. In this case, you can then pick and choose which ones you want on a yearly basis if you will. And then you'll be able to practice in those states. And so we, we kind of change that mode. It's also helpful for us to know what people are interested in, which states they're actually working in or they plan to work in. And so for the most part that's really the biggest difference is that multi-state license is not the way we operate. We operate in a state by state manner.

Kelly: And I'd say just a couple of other things that that tend to come up with therapists is they're wanting to know about the PT Compact is every state's Compact requirement the same. And that is not the case. Although there are a lot of similarities. That is something that comes up and we often refer to you know, T.J. said that they have updated information and it's fast moving and they really go through, and do a great job of keeping us informed, keeping the travelers informed, keeping patients and clients informed of what are the processes and what are the timelines for those types of things.

Matt: You guys both mentioned timelines and as you and as you know T.J. and Kelly that in the traveling world, time is sometimes of the essence and sometimes people that didn't know they wanted to go to a Compact state, there's an opportunity to do that. So what kind of timelines are we talking for that to obtain that? From a novice point of view, which was where I'm coming from and for maybe for the audience that doesn't quite know about the timelines to obtain the ability to work in those states.

Kelly: So in a Compact it's going to the turnaround time is going to be very quickly as, as T.J. alluded to earlier. We even had prior to some states joining the Compact, we consider them quick licensed states. I'll let T.J. alluded a little bit more to that.

T.J.: Process is pretty simple. In terms of length, really it does, probably more of a important point is regarding the jurisprudence requirements. So some States have requirements to complete that jurisprudence exam before you get a Compact privilege. And we allow people then to go take that through the state, which the information is available in our website of how to access that. Some stats it's online and you can take it within a matter of a few minutes and an hour. Some states it's a more of an in person process and that may take several days for registration, et cetera.

So once they actually complete that jurisprudence though, it really only takes about 10 minutes or less. And the reason is they can log in on our website at That org with their FSBPT ID and password, which many have, if they don't, they can get it pretty quickly. And then they essentially go through a walkthrough process where they have their information that they can update. The system automatically verifies their eligibility. They select the states that they'd like to get a Compact privilege for, attest that they've completed the jurisprudence requirements, pay like any eCommerce site, and then instantly are issued unique Compact privilege numbers for each one of the states that they've selected.

And so essentially they're good to go right there. The state's notified automatically that that person has gotten Compact privileges and what their privileged number is that's tied directly to our database where they can verify that information online again within a matter of minutes. And so they've got the ability to practice basically instantly, if you will.

Matt: You guys have really made it easy for your physical therapist to have that ability to be mobile. And I think that's probably one of the more exciting things of what the industry. With the way the world is going, people want that ability to make it quick and pretty painless. So it sounds like you guys have done your due diligence with trying to make that process happen. So kudos to you.

T.J.: We tried.

Matt: I think it's exciting.

Sunny: Yeah, it's pretty impressive.

Matt: Of course, of course. I have a question again from a novice point of view, what are your thoughts, and this is for either of you gentlemen of having the OT organization having a Compact licensure or a portable licensure similar the PT Compact.

Kelly: From my perspective, you know we really love the impact that the PT Compact has had. It's obviously early in its, I guess infancy if you will, really from a grand perspective to try to get to 50 states, or 25 now and started with 10. But to bring OTs along with that, I think you would see a lot of great impact for therapists on that side. Again, patient cares is only going to improve and as you mentioned that quick turnaround time, yeah it's great to know what you're going to do in three or four months down the road to get that license. It may take that long. But that's just simply not a way of life for all people. And so having that Compact available to the therapist is just a huge advantage. So we'd love to see the OT mimic or mirror or something similar.

T.J.: And from our perspective, we're happy to see other professions go down the road of a Compact. We work closely as I was talking about nursing before, we've talked with nursing a lot. They've given us a lot of experience and background of you know, what they've had years of experience working in with a Compact. And so we learned from them. We are working with other Compacts like the psychology Compact right now actually, trying to help them develop their Compacts. And - and so we are always working with other groups to try to see what we can do to help, not recreate the wheel. And you know, I think any profession that can do it and I would encourage them to look into it for sure. Just because I think it's a great advantage for all patients. And for the industry as a whole.

Sunny: Well, where do you see that feature of the PT Compact heading?

T.J.: Well as I said hopefully the future is bright and that we are going to get a eventually all of the jurisdictions on board. Part of the Compact we had a few more add this year. We anticipate hopefully a couple more before the end of the year and then you know, in 2020 and 2021 and beyond. You know, I can see more and more states joining, but in terms of the Compact as a whole and the commission, I think we're always looking to improve. We hope that we're continue to even make it easier for people to get Compact privileges through our system. And I think it has a lot of impact on the future of providing the physical therapy services.
You know, I was talking the other day with somebody that said they are looking to set up a, a tele-health practice and you know, all the things that that means and obviously there's a lot of regulations and law that's still need to be done related to telehealth. But in terms of the Compact I think what it does is as it allows people to really expand that idea of what telehealth could be. And the example was given of somebody that you know today does not have the advantage of a Compact. And so they get a call from somebody, a patient that's potentially in another state and that patient would need assistance. You know, right now, and unfortunately right now they usually have to tell them, we'll give me two weeks to a month that then I'll be able to get licensed in your state and be able to talk to you and help you.

In the case of a Compact, if those two people were in Compact member states then that's PT or PTA could be able to say, well let me look and see where you live. You're in a Compact member state. Give me 10 minutes or so, so I can complete that jurisprudence requirement. Be able to get a combat privileged to work in your state, I'll call you back. And then I can help you that same day.

I think that kind of quick turnaround is something that is possible, are going to be made possible by something like a PT Compact. And again, that's that patient consumer access that will really be benefited by something like the PT Compact. So I think that's the future. You know, it's setting up, if you will the foundation of the future of medicine, telemedicine, things like that. So yeah. So it's pretty exciting if you look at it kind of big picture like that.

Sunny: I think that's amazing. You know, a question that just popped in my head. You know, as we look at the Compact and tele-health, do you think the health care community will ever streamline tests and fingerprinting where maybe all of the states will have a hub where all of the information can be held so that not each state will be expecting different requirements?

T.J.: That's a great question. I think that's something that the industry is probably not ready for today. But you know, in the future if we can get to, I guess a good example is if we can get to the fact that we have a PT Compact where years ago that was just have been an outlandish idea. You know, the hope is out there that there are things that can be done to be able to make things more streamlined in the future as well. So it's difficult to kind of predict those things but again, who knows, that might be possible and obviously that would be a great thing to even streamline the process further.

Sunny: So you're saying there's a chance.

T.J.: That's right.

Sunny: Okay.

Matt: Speaking of a chance, T.J., you mentioned 25 states today, you signed some states this year and some other states that are and potentially coming on board this year as well. Does success to you look like all 50 states? Do you think that that's a possibility? Do you think that from your perspective, especially with the nine years of development, what does success look like to the Compact?

T.J.: Oh, that's a great question. I think success for sure in part is the fact that we would have all 50 states, the other jurisdictions like the district of Columbia, Puerto Rico that are on board. That's not the only measure of success for us though. I mean our goal is really to make sure that this is an efficient, easy and practical system. And so as I said, we've automated a lot of it, but really it's in the name of being able to provide great customer service, things that makes this process open and transparent, but also easy for people to use.

And so we want to be as efficient as possible. So I think that's one of the other things. Our goal is to make sure that the Compact is not only just successful in terms of expanding, but that it truly is a benefit for people. That this is something that PTs and PTAs seen as a value and that's something they want to take advantage of and use in the future. So it's not only about just delivering on the basics of it, but really exceeding expectations on what we can actually provide and working with partners out there, to get that information out there and to make sure that we are continually evolving and making sure we're delivering on what we promised.

Matt: I love your focus on customer service, it's so important these days that you will be judged by the customer service that you deliver. So kudos to you guys for focusing on not just numeric numbers and the States that you bring, but the quality of what you guys provide. And it's not just about the numbers, but it is about how you deliver that. So kudos to you. It sounds like you guys are a bright future ahead of you. That's awesome.

T.J.: Thanks.

Sunny: Well, this is the point of the show where we like to ask our guests about their why. Why do you do what you do? And so T.J., I want to ask you, what's your why?

T.J.: What's my why? So I like to consider myself a builder. I have had other positions and jobs where mostly it's about building something, something that's going to outlast me, something that's going to make an impact on society and a positive impact on other people. And so my why specifically for the Compact is do just that, to create something that is going to be an effective organization that's going to outlast me, be here when, years and years from now when I'm, when I'm long gone and my grandchildren are hopefully around and be able to point to something that was, that's still there, still functioning and doing good things for people and hopefully, again, making sure that there's even more consumer access, patient access out there. And that's - that's my why. I want to make sure that there's really something out there that's going to be important and valuable to society. And I think this is doing that.

Sunny: That's beautiful.

Matt: That's a great way, Kelly. That's a lot of pressure.

Kelly: A great one to follow. Holy cow. You know, I would say in my role, my why is really about helping other people accomplish their why. I get the fortunate opportunity every day to help people get to the places they want to go. Whether that be a candidate, I'm helping an account manager, a recruiter, helping with a candidate, find their first job. Help a client with a difficult need in one of those rural areas.

That's ultimately what charges me up. That's what gets me going in the morning, and that's what makes the job so enjoyable and that's ultimately why I show up every day.

Matt: Well thank you both for joining us today. It's been really informational. I think at least from again, from my point of view a novice point of view, I learned a lot. So thank you again both for joining us. We also like to hear the why's from our healthcare professionals themselves. This is Liam. He's a traveling physical therapist. Let's hear his why.

Liam: Everybody always has like this great story for why they became a PT. Like all they broke their leg and they tore their ACL or like they had this great experience. Like, honestly I didn't have like any of this big injury or anything like that. For me it was more I was attracted to just like the human interaction part of physical therapy. Like I really like the fact that it challenges me to get to know people from different backgrounds on a regular basis, like all the freaking time.

Especially like going across the country and everything, like, I learned what people are like in Boston, I learned what people are like in New York and now I learn what they're like in Omaha, Nebraska. And soon to be like New Mexico. So you really get a lot more of like a... you build a social skillset way faster than you would in any other setting whatsoever because you're a physical therapist first and the second of all like travel works with me because travel second makes it so you get even more of that exposure. Just helps it become a little bit more like worldly and exciting while you're young and you can still like have a lot of space to grow and do these things, before you settle down.

Sunny: And that's going to wrap up today's podcast, we'd love to hear from you. So please drop us a review and let us know what your thoughts are on today's topic and we'll also put up a link directing you to the website so that way you can find out more about the PT Compact. And also what states are currently enacting, I guess the license of the Compact privileges.
And you can also give us a comment on anything you'd like to discuss. So until next time, thank you for listening.

Matt: Thanks everybody.

Voice Over: You've been listening to Cardium from Aureus Medical with your host, Sunny and Matt. We're the podcast that gets to the heart of travel healthcare. To subscribe, access show notes, or to learn more, visit C A R D I U M or wherever you're listening be sure to rate us, review and subscribe. Thanks for tuning in. Until next time.

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