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Choosing a Consultant

by Patrick C. Alguire, MD, FACP
Director, Education and Career Development, ACP

As you enter into private practice or change your practice to adapt to the changing medical environment, the help of a business advisor can smooth the transition. This article provides a few tips on how to make that selection.

Define the Problem: Spend some time outlining the issues you want help with. Do you need a five-year strategic plan or simply some advice on how to organize your practice to better cope with managed care? Identifying the scope of work needed will help narrow the list of possible candidates.

Identify the Right Person: Consultants generally fall into three broad categories: operational, transactional, and strategic. Operational consultants focus on the business side of a medical practice and typically are used to analyze accounts receivable and evaluate information systems, or for staff training in specific areas. Transactional consultants are experts in the valuation, buying, and selling of medical entities, including medical practices. Strategic consultants are adept at defining the market and anticipating changes that will impact medical practices.

Choosing the Right Person: Picking a business consultant is like choosing a doctor or any professional. Assess the reputation of the consultant or consulting firm in the community. Has the consultant had assignments in your community? Is he/she able to recognize and take into account the local factors that may influence business or strategic decisions?

Look most carefully at consultants that have been engaged by other local physicians you respect. Chances are, these consultants understand the physician perspective. A consultant that has worked primarily for institutions may not understand the physician perspective.

Ask your colleagues for a recommendation. Ask what they liked about the consultant, and their negative experiences as well. This type of conversation can save you time and money. Consider calling your local County or State Medical Society. It's likely they can identify consultants who have worked in your market area and are familiar with the problems you face.

The Screening Process: Contact the consultants that look promising based upon the recommendations of your colleagues and professional society. Based upon your identified needs, ask for written proposals from the consultants. Be explicit about what should be included in the proposal. Consider the following:

  • Scope of Work: The consultant should be able to clearly identify the goals and objectives of the assignment as well as the resources required to obtain those objectives. An inability to directly address the issues in the proposal may indicate a lack of attention to detail and attention to the project in general.
  • Timetable: The proposal should indicate major milestones in the life of the project such as when activities will begin, how long different aspects of the project will last, and when certain deliverables will be available. Be sure to identify the start and completion dates; open-ended assignments are generally not a good idea.
  • Personnel and Qualifications: Experienced consultants provide resumes or a curriculum vitae for staff assigned to the project. Look them over. Does the experience seem right? How long has the firm been in business? Is the firm familiar with the local environment, including managed care influences?
  • Cost: Make sure you understand what you are paying for. Many consultants and most attorneys bill based upon an hourly rate. Get an estimate cost for the project based on the time required for completion. Ask the consultant to detail all other costs, including travel, secretarial help, phone and copying fees. If you can, get an agreement on a maximum cost for the project. That way, you will know the maximum commitment you will have to make to complete the project.
  • Deliverables: Many consultants will break down the project into discrete units or deliverables. Make payments upon the completion of the deliverables to ensure the timely completion of the project.
  • References: After asking the obvious question of your references (Were you satisfied?), be specific. Ask the references if they would hire the consultant again, And, if not, why not? Ask about the consultant's ability to work with physicians.
  • Client list: Review the client list with two objectives in mind: identify clients the consultant has worked with in the past, and identify possible conflicts of interest. Think twice about a consultant that represents an institution that you are negotiating a contract with.

Making a Decision: At this stage, you should be able to narrow down your choices to two or three firms that look like they can get the job done. You may want to meet with the consultants individually and review the proposals. You will want to accomplish three things:

  • Clarify outstanding issues or concerns
  • Agree on the overall scope of the work and objectives
  • Have sense whether or not you and the consultant can establish a productive relationship.

Engaging the Consultant: Put it in writing. Formalize the consulting agreement by putting it all in a letter of agreement or contract. You may want to consult an attorney at this stage to make sure the agreement is complete and accurately represents the work you want done.

The content of this article was abstracted from Choosing a Consultant published by the ACP Managed Care Resource Center.

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