By David Maister
The categorization scheme used here does not define whole disciplines, but rather different market segments. For example, some clients for a service like market research may (historically) seek out a Pharmacist (the work, in their view, being mostly programmatic and performed with little need for ongoing client contact). However, other market research clients may want pioneering work and require (and request) extensive diagnosis, and also want a great deal of ongoing client interaction. They may seek a provider with demonstrated Nursing or Psychotherapy skills and methodologies. Which box a firm is in is determined less by the profession it practices than by the market segments it is trying to serve.
And therein lies the problem! Suppose that you are a highly skilled tax practitioner who handles complex, frontier tax problems through creative, innovative thinking (i.e., you are a Brain Surgeon). A client comes along who wants to get their basic tax forms completed to ensure compliance with all tax laws. Since this is your client, it’s a tax problem and you’re a tax provider, it is tempting to conclude that you’re the perfect person to help the client.
Wrong! As a Brain Surgeon, you are probably high-priced, and your key talent is creativity and complex problem solving. Completing tax forms and ensuring compliance is a Pharmacy job; it is not work for a Brain Surgeon. A Brain Surgeon may have the tendency to treat all problems as if they required Brain Surgery: The client says, “I’d like to buy some aspirin,” and the Brain Surgeon replies, “Sure! But first, get on the operating table so we can investigate and find out whether it’s aspirin you really need!”
(Of course, the opposite problem is equally unacceptable. If a client says “I have a unique bet-your-company problem,” it is not very sensible to respond by saying, “Let us show you our established methodology based on years of solving identical problems!”)
Even if you as a Brain Surgeon recognize the need to treat a problem as an “aspirin” job, it would still be a misallocation of resources for you to do it, since low-cost, methodology-driven activities are not the Brain Surgeon’s key talents. In fact, everyone will lose if you, a Brain Surgeon, do it yourself: The client will not get low cost, you will be underutilizing your talents (and will probably find the work dull) and your junior staff will be denied the opportunity to perform work that, while old hat for you, might be interesting and skill building for them.
What this analysis points out is that while it may be acceptable for a firm to be a “full-service hospital” with capabilities to meet a broad range of client needs, it is not acceptable for individual professionals to try to do so. It is highly unlikely that any one individual will excel simultaneously at all the virtues of efficiency, creativity, counseling and diagnosis.
While Brain Surgery is the traditional self-image of many professions, the harsh reality is that Brain Surgeon needs probably represent a very small percentage of the total fees paid in any profession. It is also true in “real” health care, where surgeons may be the most glamorous providers but represent only a tiny fraction of the health care needs of society.
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