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NEJM BOOK REVIEW ON CONSULTANTS:FYI (fwd)

  • 1.  NEJM BOOK REVIEW ON CONSULTANTS:FYI (fwd)

    Posted 11-04-1997 13:16
    Fowarded from the AoM listserv, ODCNET.


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    ---------- Forwarded message ----------
    Date: Tue, 4 Nov 1997 08:25:50 -0500
    From: Robert Munzenrider <rfm@PSU.EDU>
    Reply-To: Academy of Management - ODC Section <ODCNET-L@lists.psu.edu>
    To: ODCNET-L@lists.psu.edu
    Subject: fwd: NEJM BOOK REVIEW ON CONSULTANTS:FYI

    Hey Gang: Is this a book that folks like us should read?
    >
    >From: "Vernon E. Weckwerth" <weckw001@maroon.tc.umn.edu>
    >Subject: CONSULTANTS:FYI
    >Date: Mon, 3 Nov 97 18:41:07 -0600
    >
    >Dangerous Company: The Consulting Powerhouses and the Businesses They
    >Save and Ruin By James O'Shea and Charles Madigan. 384 pp. New York, Times
    >
    >Books, 1997. $27.50. ISBN 0-81292-634-X
    >
    >The New England Journal of Medicine -- October 23, 1997 -- Volume 337,
    >Number 17 Jerome P. Kassirer, M.D.
    >
    > Sex is a lot like consultants. It can be treacherous to live
    >with but untenable to live without. Achieving the right balance of both
    >is something, I suspect, that a great many health care executives
    >struggle with. Consulting, not sex, is the focus of Dangerous Company, a
    >revealing book by two Chicago Tribune reporters. It is one of the first
    >exposes of an industry that tries hard to keep its activities out of the
    >public domain. Consultants are hired by the government, the largest
    >medical centers and managed-care organizations, and the smallest group
    >practices. The consulting industry eats up precious health care dollars
    >and has grown remarkably in the years since market-driven forces began
    >to dominate the field.
    >
    > Dangerous Company relies on many well-documented anecdotes to
    >paint an incomplete but compelling picture of the way consultants, and
    >especially the large consulting firms, operate and the kinds of
    >influence they can have on huge corporations. Though several of the
    >anecdotes illustrate how effective consultants can be in helping
    >companies cope with change, the bulk of the book details the mess they
    >can make. Failing to make good on promises, raising inappropriate
    >expectations, overcharging, assigning inexperienced junior employees to
    >complex tasks, obtaining the wrong answers, and nearly
    >bankrupting a firm are but a few of the outcomes that O'Shea and Madigan
    >describe.
    >
    > Most of us in health care have had similar experiences. Cynics
    >might describe the experience as follows: pin-striped consultants a few
    >years out of business school take our time to learn about our
    >"business," then issue a report that regurgitates what they have
    >learned. They then make a recommendation that makes no sense, and it
    >ends up on a shelf with others of the same ilk. Many of their decisions
    >seem to be designed just to please the people who pay their bills. Even
    >people who are less cynical will recognize this pattern, and it is no
    >surprise that heads nod in health care organizations at the
    >hackneyed definition of a consultant as one who "borrows your watch and
    >then tells you the time."
    >
    > Dangerous Company is a must-read for leaders in health care.
    >Apart from gaining a greater appreciation of the scope of the disasters
    >that can befall organizations that rely too heavily on consultants, they
    >might benefit from the recommendations that O'Shea and Madigan make
    >after their two-year study. These proposals could help executives obtain
    >help when they need it without exposing themselves to the confusion,
    >obfuscation, and drain on resources that consultants sometimes bring to
    >an organization.
    >
    > Some of the helpful hints are these: Define the goal clearly and
    >narrowly. Don't ask a consultant to solve a vague problem. Decide
    >whether outsiders are really needed to help reach the goal. Don't hire a
    >consultant to take the blame for decisions that you already know you
    >must make. Find out the cost and how long it will take. If you're not
    >happy about the process, say so immediately. Don't lose control; make
    >sure that your own managers stay in charge. Value your own employees;
    >remember that long after the consultants are gone, your employees will
    >still be there. Remember that it is in the consultant's best interest to
    >find trouble where there isn't any. If you know that something isn't
    >broken, don't let them persuade you to try to fix it.
    >
    > I've often wondered how much health care we could buy if we
    >eliminated the superfluous costs of consultants. Even before reading
    >Dangerous Company, I was convinced it is quite a lot. The judicious and
    >appropriate use of consultants should be a major criterion for
    >evaluating the performance of all health care executives.
    >
    >Jerome P. Kassirer, M.D.
    >
    >
    >Vernon E. Weckwerth, Professor, Director ISP, U of Minnesota
    >Healthcare Management, Carlson School of Management
    >C-304 Mayo, Box 97, 420 Delaware St. S.E.
    >Minneapolis, MN 55455-0381, Fax: 612-626-1186
    >PHONE: 612-624-0603, EMAIL:weckw001@tc.umn.edu WEB: ispweb.csom.umn.edu
    >
    >
    >