What Happened to Thanksgiving being the busiest Travel Week?

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Having the opportunity to travel to a client the week of Thanksgiving, I worked myself all up to be in for endless lines of families with luggage the size of my car, delays, and miserable people everywhere.  I mean traditionally, I’ve always found Thanksgiving week impacts everything from traffic, to restaurants, to security…and well, pretty much anything to do with traveling.  Then there’s Black Friday which alone rises images of mothers fighting over Cabbage Patch kids (…I may be dating myself there).  My question here is what happened?  Perhaps my fears were based on the the stories you read about or see on the news. I know they always show those famous airport shots of millions of people.  Not the case this year.

Let me share my travel experience with you.  When I arrived at the airport the Sunday before Thanksgiving at 12 noon, it was empty.  I parked my car on the first floor right in front of the door. There was not a single person in the TSA pre line.  I had a quick lunch at Legal Seafood where I counted maybe 10 people in the entire place.  I was upgraded to first class 5 days before and noticed a lot of empty seats on the plane.  This all made me wonder, are my fears unwarranted?

My return flight was Tuesday evening from St. Louis to Detroit to Boston.  I was sure that I would run into giant crowds and delays on this trip home.  Surprisingly relatively normal mid-week volume, minus the business suits.  I landed at 1am in Boston and noticed a lot of cars waiting to pick up passengers, but it didn’t create any slowdown for me.  In fact I was out of there in record time.

I have to say, my travel experience was so pleasantly surprising.  I wish every week of travel was like this. As for Thanksgiving, it was a total success…and I personally avoided going anywhere on Black Friday, so I may have dodged a flying doll or two by staying away.  🙂

What about everyone else?  How was your Thanksgiving travel this year? Leave your comments below.

Should you expect a lower hourly rate for remote engagements?

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Most of us would love an engagement, from time to time, that takes us off the road.  The benefits of work life balance and increased time at home with family is significant. Not to mention being able to work in your pajamas, if you so choose, is enticing to some.  The question I hear often is why the hourly rate is so much lower for a remote engagement.  Below are my thoughts on what you may be facing when looking at remote project support roles.

Let’s start with the basics associated with the sales side and bidding on business and negotiating bill rates.  When positioning cost to the client, firms take many different aspects into consideration.  These include; skill set needed, level of expertise, years of experience, specific deliverable expectations, duration of contract, location of contract, required margins, and yes…is there remote opportunity.  From a sales perspective firms take these requirements and look at market value while trying to find opportunities to be competitive in their pricing.  The idea of working remote saves the client on costs related to travel for sure.  Knowing that working remotely is also appealing to consultants gives the firm another option to reduce cost to the client by cutting professional service fees as well.

Positioning the up side of working a remote project often falls on the recruiter.  They also have the challenge of getting you to agree to a lower hourly pay rate.  Just like a full time job at your local hospital, your annual compensation would be reduced as you are not traveling long distances every week and away from home during off time.  The answer to the question is simple, your hourly rate takes travel and time away from home into consideration.  You can expect an average of 10% reduction in hourly pay for remote work…which really isn’t bad at all.  So if you are used to making $95, you’ll likely be offered $85 for remote work.

Not everyone has this happen to them.  However, I believe it’s become more the norm to meet the demands of the client.  Take a look at the example below to see the big picture.


Candidate Requirements – The client is seeking a certified Epic OpTime analyst to assist with their Refuel project for the next 3 months.  They require a candidate with a minimum of 3 years of build experience and prefer they also have anesthesia certification, but it’s not required.  They are located in San Francisco with several facilities throughout Northern California.  They are open to remote work, but need to understand the cost benefit.

Average Cost – Let’s assume the average market rate for an OpTime analyst with 3 years’ experience is $140 an hour.  Then let’s take the cost associated with weekly travel and lodging in San Francisco for 3 months.  Professional fees would come in at $67,200 and expenses would fall at about $16,000.  That’s $83,200.

Opportunity for Savings – The firm knows that client will be enticed just by removing the cost associated with expenses.  But they want to also lower the professional fee since the work is all remote.  The firm has been successful by typically offer about a 10% discount on remote efforts.  By doing so the new cost to the client will be $60,480 in total.  That’s a whopping 25% savings with a guarantee on same quality and delivery from the firm.

There are a lot of opinions on what is impacting project costs when using an outsourcing firm.  Without a doubt, as quality of delivery becomes a major focus for firms, clients will continue to look into remote options.  The trust of quality is there.  Moving forward you’ll see more opportunities presented to you that will be remote, but like come with a lower rate.


Have you take a lower rate for remote opportunities?  Leave your comments below.


Contract to Hire…Do I have to Accept the Full Time Position?

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I’ve seen a consistent increase in the request for contract to hire positions this year.  Firms are adding language to their service agreements to allow clients to extend an offer for permanent full time positions to consultants after 90 days of contracting.  Clients are using firms to find resources who are open to relocating and becoming a full time employee of the hospital.  It’s really a win win scenario for both the client and consultant.  The question is, if you accept a contract to hire role…do you have to accept the full time position?

I suggest candidates take these types of offers seriously and not waste anyone’s time if they are not truly interested in relocating or taking a reduced salary.  Too many times I see candidates begin the interview process but when it comes time to accept the offer, they turn it down.  Realize that these opportunities are meant to fill a permanent position and will come with a salary associated with being a FTE, not a contractor.  My suggestion is ask right away the terms of employment including relocation reimbursement (if any), firm to client transition time frame agreement, and expected salary.

That first 90 days is the time for you to begin planning your transition, including relocating.  Terms of your employment are typically agreed upon prior to you starting.  Timing on the transition may vary based on the firm’s agreement with the client.  Typically it’s 90 days, but may be less.  Regardless, once you’ve accepted and started, it is expected that you will accept the terms of employment and become a FTE at the end of agreement.  So my advice is simple…do not accept a contract to hire role unless you are 100% committed to accepting the full time position.

A couple more thoughts on variations of contract to hire.  Not all hospitals will make a full time offer before you start your contract.  In fact, many won’t offer information on salary prior to starting either. That first 90 days may be considered a trial period to determine if your skill set aligns with the position.  Your firm should know this is the expectation ahead of time, so you are fully aware a full time offer may not result from the contract.  You should also know that it is becoming more common to hear from clients that they want direct to hire candidates.  That situation obviously is much different…but worth mentioning.

Have you taken a contract to hire position?  Share your thoughts in the comments field below.

What Consultants Should Know About CHIME, HIMSS, MGMA and Others

HIMSS Conv Center

Our industry has several organizations that are focused on professional development, networking, and innovation.  Understanding these different groups and how your firm participates can greatly improve your awareness of industry trends, various client initiatives, upcoming projects, and other opportunities.  I’ve selected three that you should be aware of and understand how your firm’s involvement may help you with future placements and project support work.  Let’s take a look at CHIME, HIMSS, and MGMA first.


CHIME (College of Healthcare Information Management Executives) The College of Healthcare Information Management Executives (CHIME) is an organization created to serve the professional development needs of CIOs working in the healthcare industry and to promote effective information management within that industry. CHIME meets these objectives through networking and education opportunities as well as partnerships with health information technology vendors and service firms. The organization was formed in 1992.

More than 1,400 health care CIOs are currently members of CHIME. According to the organization, its members come from hospitals, clinics, physician groups, government agencies and health information exchanges, and their responsibilities include telecommunications, medical records and information services. CHIME members also often serve as chairpersons for IT steering committees.

CHIME’s current advocacy initiatives include helping CIOs implement the hardware, software and security measures necessary for digitizing patient records, which is one requirement for achieving the meaningful use of electronic health records (EHR).  CHIME’s Fall CIO Forum is being held in San Diego from October 30th – November 2nd 2018.


HIMSS (Healthcare Information and Management Systems Society) The Healthcare Information and Management Systems Society (HIMSS) is a nonprofit organization whose goal is to promote the best use of information technology and management systems in the health care industry.

Founded in 1961, HIMSS provides a forum for collaboration among the various stakeholders in health care IT, using advocacy, education and collaboration to further its mission. Its membership base of more than 44,000 individual and 570 corporate members includes health care providers, students, IT vendors, consultants and other stakeholders in the health IT industry. HIMSS currently focuses its attention on health IT topics such as electronic health record systems, HIPAA security and privacy provisions, software interoperability and technical standards.

HIMSS produces an annual conference that brings together health IT stakeholders for several days of education and networking. The organization also offers a research arm known as HIMSS Analytics and a philanthropic group known as the HIMSS Foundation.  HIMSS 2019 Annual Convention is being held in Orlando from February 11th-13th.  Regional conferences and events happen monthly.


Medical Group Management Association (MGMA) is a key element in perpetuating success throughout the healthcare industry. The organization provides resources to initiate change and drive results. With exceptional peer-to-peer and mentor-to-peer support systems as well as abundant hard-copy and digital resources, MGMA is spearheading the path to healthcare advancement. They are well known for providing members with consistent expert resources and solutions that include, but are not limited to:

  • Educational collateral and certifications
  • Success strategies for students, healthcare practices, and employment needs
  • Innovative ideas and networking events
  • Expertly compiled benchmarking data and statistics
  • Access to industry experts and thought leaders
  • Information and materials for making your practice more successful and profitable


There are several others that you may hear about.  Health Connect Partners (HCP) focuses on areas including IT, Pharmacy, Radiology, and the OR (Read More).  The Institute for Healthcare Improvement (IHI), provides insight and partnerships focused on health care improvement worldwide (Read More).  And Academy Health hosts its annual Health Datapalooza which is a large conference which exists to promote access to open data in the United States for the purpose of improving public health. 

As a consultant, we all should be aware of our firms participation and/or sponsorship of these organizations.  Let’s be honest, the primary reason for a firm’s involvement is expected return on investment by identifying new clients, building relations, and showcasing capabilities.  That directly impacts you and your future opportunities for placement.  You could be a self promoter by sharing with your client how your firm supports these organizations.  Additionally you could be asked to represent your company…so always be aware of your firms involvement.  

What organizations are you or your firm a member?  Share your thoughts and comments below.

State vs Federal Holidays – How they Impact Consultants

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Monday is Columbus Day.  A recognized federal government holiday where all federal offices and banks are closed.  However, it is not recognized in 27 states.  Interestingly enough not one west coast state celebrates the holiday while all of the east coast states minus Florida, New Hampshire, and Vermont do.  Then we have states that use the same day for other holidays.  South Dakota has Native Americans Day and Hawaii has Discoverers’ Day for example.  Both are official state holidays. Every year I am asked the same question, “Do I get the 2nd Monday of October off as a recognized holiday.”  Sadly, the answer is no for most consultants.

There are 11 federal holidays which include; New Year’s Day, MLK Day, President’s Day, Memorial Day, Independence Day, Labor Day, Columbus Day, Veterans Day, Thanksgiving, and Christmas.  Hospitals often provide these but allow for a “float holiday” to be used on any day.  If you are in one of those 27 states that does not recognize Columbus Day you are out of luck.  However the list may also contain various religious holidays like Easter or Yom Kippur, which is a public holiday in Texas by the way.  There are several state holidays to consider as well.  Massachusetts and Maine celebrate Patriots Day for example.  I strongly encourage you to ask your firm and your client for a complete list of recognized holidays.

Regardless of all these variations of holidays, you should plan your travel around the client’s expectations for their full time employees.  While being a consultant who lives in another state may warrant you wanting the day off, I suggest you follow the client’s normal process. Ask well in advance…and plan accordingly.  Even for those big holidays like Christmas…is the day after or day before recognized?  Are you required to travel if the holiday is mid-week?  These are all things you should get clarified well in advance.  IT offices don’t shut down in hospitals, ever.  You may be asked to work on those holidays you would otherwise expected off.

Have you ever thought you had a holiday off but didn’t at a client?  Share your experience in the comments field below.

Crying Babies and Crazy Passenger Antics – Airlines Approach to Passenger Comfort

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There are several stories this month that made headlines regarding airlines approach to the crying infants and unruly passengers.  Evidently a United airlines attendant said it was “absolutely unacceptable” that a baby was crying to a mother.  This was on a 13 hour flight from Sydney, Australia to San Francisco in first class.  On a Southwest flight a family was booted off the plane from Chicago to Atlanta as their 8 month old was throwing a tantrum prior to departure.  A United flight from Heathrow to Washington Dulles turned back one hour into the flight as a passenger was just randomly screaming and cursing.  My favorite one is the Chicago flight on ANA Airline where a drunk passenger urinated on a man two rows behind him and was restrained for the duration of the flight.  We all have stories and have seen some wild crazy behavior.  The question is how should you and the airline respond?

After some research I found that airlines have several clear policies regarding passenger comfort and issue management.  The easy ones to find include approach to obese passengers, emotional support animals, intoxicated passengers, infant seating requirements, pets, luggage handling, and dozens of common sense items.  I couldn’t find anything on airlines policy on crying babies.  According to the attendant from United on that Sydney flight, there is a policy that states babies should not be allowed to cry for more than 5 minutes.  How the heck do you enforce that?  I think she made that up.

For those unruly passengers who are confrontational to fellow passengers and/or staff…there are some guidelines and policies, but they are primarily discretionary.  Airline staff are empowered to confront passengers based on their interpretation of actions that may; put other passengers at risk, are violating other passenger’s privacy, are disrespectful to the staff, or may impact the overall safety of everyone.  Consequences include restraining or evicting passengers.  Either of which may also include a fine and/or arrest.

For your own piece of mind, don’t get involved with these type of passengers…you don’t want your travel interrupted.  Invest in a good set of noise-cancelling headsets.  Watch a movie or read a book.  While you should always try to be courteous, don’t engage with a fellow passenger complaining about the service.  It’s a slippery slope and may inadvertently have repercussions for you as well.  I am not suggesting you have to tolerate rude behavior, just don’t verbally participate.  Call your attendant over and make them aware of the issue.

What about those screaming infants?  I used to get so upset.  I remember sitting in first class next to a mother who had one child and her husband was two rows back with another child.  Throughout the flight they just kept swapping screaming kids.  Everyone in first class was given 5000 sky miles.  These days I just turn my music on full blast and get caught up on work.  Let’s face it, kids are kids.  You’ll fade away into your own happy place with good music and good headsets and hopefully arrive at your destination on time.

Have a funny passenger story to share?  Write your comments below.

J.D. Power 2018 North America Airport Study – How did your airport rank?


I always look forward to this annual study. This one is specifically ranking the airport based on traveler’s satisfaction of services and amenities.  No surprise my airport (BOS) continues to be all the way at the bottom.  Note that the study focuses on 6 areas that include; terminal facilities, airport accessibility, security check, baggage claim, check-in/baggage check, and food, beverage and retail. To read the full report (click here).  Below is a quick snap shot.

The chart above is for the mega airports, other results included:

John Wayne Airport, Orange County ranks highest among large airports, with a score of 815. Dallas Love Field (810) ranks second and Portland (Ore.) International Airport (804) ranks third.

Buffalo Niagara International Airport ranks highest among medium airports, with a score of 814. Indianapolis International Airport (811) ranks second and Fort Myers/Southwest Florida International (810) ranks third.

Surprised by the results?  Share your comments and thoughts below.