Choosing a Medical Practice Consultant

Last week's blog extolled the benefits to a medical practice of outsourcing problem solving and enumerated the four essential elements of a successful outsourcing:

• The practice's commitment to solving a specific problem;

• A clear definition of success;

• The mutual responsibilities of the practice and the outside resource; and

• An outside resource that can and wants to do the work.

Choosing an outside resource is, arguably, the most critical step. That is because any truly competent outside resource, or consultant, will insist that the first three components are in place before agreeing to the engagement. So, how does a practice make a good choice of consultant?

1. Identify candidates

Colleagues who have faced similar situations are an excellent resource, as is your local medical society. I would also suggest casting a wider net, depending upon the issue at hand.

All businesses, including a medical practice, face essentially the same challenges in terms of leadership, personnel, facilities, IT, work flows, etc.

The practice knows medicine. What it usually needs is access to in-depth knowledge and experience in the general business disciplines. An ancillary benefit to straying at least a bit out of the medical mainstream is that the practice can be exposed to what works well in similar but non-medical environments.

2. Narrow the field

Credentials and certifications are often irrelevant. I am particularly wary of experts with long strings of letters after their names. Right or wrong, my initial impression is that they are trying too hard to impress and be seen as credible before they open their mouths and demonstrate any wisdom or expertise.

A biographic summary is de rigueur. Its purpose is to introduce the candidate or firm, state qualifications and experience, and often includes mini-case studies. The bonus of these one-page documents is that they reveal a lot about the candidate's personality and outlook.

Interview five to six of the most promising candidates, the people who will actually do the work, and let them guide the conversation. What you are looking for is an interest in the practice and its problem, very good listening skills, and an open mind. If they only talk about themselves and already know exactly how to solve your problem, they are not tuned in to you and the practice as they should be. It is important that this person be both communicative and likable. You will know what you need to know within 15 minutes to 30 minutes.

3. Request proposals from the two or three candidates you like the best

With your request, provide a format for the proposal:

• Status quo at the practice

• Problem to be addressed

• Desired outcome, in terms of what it will mean to the practice

• Constraints on any potential solutions

• Tactics to be employed

• Timelines

• Specific deliverables

• Fees and terms

• References

The information provided will be the basis for any subsequent contract. It will help ensure that both the practice and consultant have the same understanding of the engagement. A standard format will also make your comparison of competing proposals much more efficient.

When you receive a proposal that does not conform to the format you supplied, you know that the candidate is not right for your job. (By the way, please don't even consider a consultant or group that wants to send a proposal before they have even had a conversation with you.)

The proposal may describe a two-stage process: observation and analysis that will be used to inform a definition of the actual process. This is entirely appropriate, and often the only way the consultant can resolve enough unknowns to make a comprehensive proposal.

Note that references are a part of the proposal. Current and former clients do not feel the same constraints on their comments as current and former employers.

4. Negotiate deliverables, timelines, fees, and terms

You may want to add another element to the project or ask for a lower price. Be wary of consultants who are willing to lower the cost without also adjusting the scope of work. You either did not get their best price in the first place, or they will have to make some sort of adjustment to the work to make the new fee work.

Make sure the final agreement is recorded in a permanent, enforceable format, and both parties retain copies. It's much better to have it and not need it than the other way around.

This may sound like a lot of work, and it can be. At the same time, choosing the right outside resource can be a high stakes gambit and it behooves the practice to mitigate as much risk as possible.