Practice management consultants would have you believe that physicians lack the DNA to run a practice and cannot function well without professional consulting services. While things are not that black and white, physicians who hire consultants do often find they get exactly the advice, ideas and guidance they were looking for. And they generally say the consulting engagement was worth the cost.

Here are tips from colleagues for making the most of your experience with practice management consulting.

1. Take the plunge sooner rather than later.
"After several unsuccessful attempts to go to an open-access scheduling system, we engaged a large consulting firm to help develop the process," says Leroy Ounanian, MD, medical director at Beaver Medical Group in Redlands. "We are succeeding in the process at this stage and fully expect to reach our goals."

Given his positive assessment, Dr. Ounanian says he'd do one thing different. "In retrospect, it would have been better to involve consultation earlier," he says. "We would have profited by learning from others' mistakes rather than our own."

2. Know your limits.
"I used a medical practice consultant for four months last year to help me with the transition of my medical practice from a traditional internal medicine private practice to an exclusive medical practice," says Irvine-based James Strebig, MD. "It was a very big project that I could not do by myself. I am in practice by myself--with a receptionist and medical assistant, but no office manager. I needed an expert to guide me during the transition process."

The outcome? "The transition went very well, and I was glad that I hired a consultant," Dr. Strebig says. "His recommendations were very detailed. I have subsequently recommended to colleagues in the same situation that they also hire a consultant to facilitate their practice transition."

3. Know your consultant's limits.
W. Lee Wan, MD, head of Coastal Eye Specialists in Oxnard, notes that his practice hired a consultant do a comprehensive review of operations, including studying the possible expansion of the office; evaluating staffing, salaries and overhead; and assessing financial processes and procedures.

Still, Dr. Wan didn't expect stunning insights or revelatory assessments of the situation. "We usually find that consultants don't tell us much that we don't already know," he says. "However, they have time to focus on problems much more than we do internally when we're caught up in the day-to-day operation of the practice. Importantly, they can give us reassurance that the problems we face or the solutions we are pursuing are in the norm rather than the exception."

4. Expect extra work.
Consultants make recommendations, and recommendations mean more responsibilities. Dennis Flynn, MD, MBA, vice president of medical affairs at Epic Management LP in Redlands, got a taste of this when his company engaged a consultant to help set up a clinic with same-day access. The group had tried to set up such a clinic in the past "with only partial success," he says. So the consultant put the group through its paces. "[The consultants] worked more as facilitators and taskmasters in terms of making sure deliverables came in on schedule. At times it was, given our other responsibilities, a little bit challenging. But at the same time, it was probably necessary."

5. Understand that cost does not equate to value.
"The consultants who are most helpful and effective are generally the ones who are cost-effective," Dr. Wan says. "They're not pushing to do more and more, and they're conservative in their hours billed and the amount of work they recommend. Consultants who still see doctors as potential clients who have lots of money are out of touch with modern medicine."

6. Know what you want.
"Don't go to a consultant until you've done your own needs assessment," Dr. Flynn advises. "The consultant doesn't know what will work in your organization. You do."

7. Secure management's backing from the start.
"You have to have absolute commitment from the top down," Dr. Ounanian says. "Be sure your governance leadership is prepared to commit to the program," Dr. Flynn agrees. "Don't get involved until you're sure of that piece."

8. Get the consultant up to speed ASAP.
"It's essential for a consultant to understand the practice's culture, internal and external relationships, history and position in the market, as well as its mission, goals and values," Dr. Wan says. "It requires a fair amount of work to prepare that information, but if you don't, I don't think you'll get information that's specific enough to your practice to be worthwhile. I want the consultant to know as much about me and my practice as possible coming in, so he or she can get to work right away in identifying problems and recommending solutions that are very specific."

9. Beware the possible recommendations.
Ophthalmologist David H. Aizuss, MD, FACS, relays a story about an early experience with using a consultant. "The first practice I joined brought in a consultant to appease the new young doctor," says Dr. Aizuss, secretary of the Los Angeles County Medical Association. "Everything the consultant recommended was stuff I had been urging. As a result, the two older guys wanted me to just buy their practice, which was in Chicago. Because I didn't know whether I wanted to spend the rest of my life there, I quit!"