Last night I was talking to another health care consulting friend of mine who just ended a long assignment. She was asking how things were on the health care front, and I told her things were a bit slow, but probably ready to start warming up again.

We started talking about some of our shared experiences, because many of us who work in this business will encounter some of the same things, even if we’re at different hospitals. There seems to be some running themes in what we try to do.

The first syndrome is coming in after someone else who didn’t do a good job. That may be a permanent employee who just wasn’t working out, or another consultant who couldn’t get the job done. Right off the bat, you’re under pretty tough scrutiny, which consultant’s usually are anyway, but people are wary and mistrustful; they feel they’ve been burned before, and don’t want to get burned again. Eventually, if you’re pretty good, you’ll get people to come around, and some will even embrace what you’re trying to do, but it might take a little bit of time to get them to warm up to you.

The second syndrome is walking into a situation where the politics are intrusive. When you’ve been brought in by one person to do something, but someone else who’s either just above or below either you or the person who brought you in wants something else done, even if that something else is to do whatever they can to make you fail. That happens, believe it or not.

Unfortunately, not every person in management is really out for the best of the organization; sometimes it’s all about “me”, and who cares about anyone else. That can be difficult to deal with, and the way I work through it is to talk to the person who brought me in and tell them that they need to somehow take care of these things because I’m going to ignore them and do what I came to do, and that’s that.

No, it’s not very consultant like in a way, because many consultant’s feel they’re supposed to defer to every whim that someone else has. But I like to think I’m building my reputation on getting things done right, not always giving everyone exactly what they want. At a certain point, if they’re insistent, I will give them what they want, as long as it’s not illegal, but I also make note of it and make them confirm they said it so that no one can come back on me later on and say that wasn’t accurate. That’s usually where I’ll win, because no one wants to commit themselves like that, I’ve found.

The third syndrome is the one where people are afraid you’re going to come in and make them look bad. That’s actually one I haven’t had to deal with all that often because many times I’m going in to a situation where the people who should have been doing the job aren’t there, so none’s the wiser. However, that type of thing has prevented me from getting other gigs, because I might produce results that the top dogs would then ask someone else “why didn’t we know about this before?” That’s a question some folks hate answering, and it’s not a difficult question because not everyone knows everything. I’ve said this many times, in health care, people are often over things that they have no practical experience with, and are too busy to learn it, so why should they be expected to know it all?

But the jealousy factor is a tough one to overcome. I know many consultants who have had good plans overridden because the person they’re reporting to decides they don’t want it done. They might not have a good reason, which unfortunately happens often, and if there’s not a good reason, then there’s not even any discussion that can take place.

If someone needs me for an interim position, one of the first questions I usually ask is how much latitude will I be given to do what I need to do to get the job done. They almost always say I’ll have as much freedom as I want; that’s not quite always true. For one gig, I wasn’t told until I was there about the division between management and the union; that was ugly, but what can you do? For another, I was told there was this big issue with one thing, only to find there wasn’t that issue at all, but I couldn’t get anyone to listen to me on it. Happens sometimes; consultant’s aren’t omnipotent either.

Think about your own work situation, if you work with others. Are you able to allow others to find something wrong with whatever you might be doing? Are you able to accept an idea from someone else and possibly act on it in some fashion without worrying that it might make you look bad? Are you forthcoming with enough information so that proper decisions can be made? If you had to think about yourself as a consultant, would you be a good one or a bad one?