Consulting--Part 1. Why consultations fail

The first article in this series describes a research project--a survey of more than 300 physician executives. Asked to share their personal experiences of unsuccessful consultations, our correspondents painted a picture of what can go wrong when organizational consultants enter health care systems, and described the lasting destructive sequelae to failed consultations. The two issues responsible for most failed consultations were the intrusion of internal politics into the consultation process and the failure to clearly establish and maintain consensual goals. Part 2 of this series will explore the consultation process from a different perspective, examining the issues that often trigger requests for consultation services and the dynamics that can foreshadow success or failure before consultants are even engaged.