Episode: 142 |
Mary Kate Scott:
Healthcare Consulting:


Mary Kate Scott

Healthcare Consulting

Show Notes

Our guest today is Mary Kate Scott, a McKinsey alum who has been running her own boutique healthcare consulting firm, Scott & Company, since 2002. She has been a close friend and mentor of mine for years, and in this episode we cover a wide range of topics including:

– Three things MK does before every proposal, including her five-factor rule for evaluating potential projects

– The three phases her consulting practice has gone through over the past 17 years

– Maintaining relationships with clients over time

To learn more about MK’s practice, visit:


One weekly email with bonus materials and summaries of each new episode:

Will: Mary Kate, it is great to have you on the show.
MK: Will, it’s really good to be here, and feel free to call me MK. We’ve known each other a long time, okay?
Will: Okay. All right, MK, you gave some training to an Umbrex event, where you talked about three things that you do with every proposal. Talk to me about that. What are the three things?
MK: Okay, so the first thing is how much time are you going to spend on a proposal? Sometimes you can spend a lot or a little, but my quick check is for roughly every 10,000 in fees, you should spend about two hours on the proposal. Now, you can vary that a little bit, but it just helps you really think about what’s it going to take to win this business?
MK: Another thing I really do is … This is the gut check. The first one might be, what’s the math? The second one is gut check. Do you really want this work?
MK: Then the third thing I do is much more deliberate, which says, why do you want this work? I assess it against five different things. One: Is the work itself interesting and challenging? Two: Are you going to work with great people? Three: What’s the working environment going to be like? Are you going to be working 70-hour weeks? Are you going to be traveling every week? Are you working remotely? Four: Are the rewards worth it? Five: Is it going to really build your business? Ideally, you get all five, but I’m a little dark Irish, and I think I can live with about four out of five these days. That’s how I think about proposals.
Will: How did you come up with that five-factor rule, MK? Were there some … It’s probably … I can imagine there’s been some scars. Have you bid some projects that you did not hit those, and once you got into it, you realized that you probably should have said no?
MK: You know, a long time ago, I did do a couple of projects. It was much earlier in the consulting business, and at the end of it, I’d say, “Why am I doing this work?” That’s when I realized I needed to assess each project for two things: one, to figure out if I should propose on it, but two, I mentioned I get four out of five things. Let’s say, one of those things that I’m not going to get that I don’t like so much is the working environment. It means I’m going to travel every week, for example.
MK: I always actually jot these down, because when I am traveling every week, I go back and say, “Hey, you knew you were signing up for this, so don’t whine to yourself. You knew what you were getting into.” I just find, as you assess each proposal, you get smarter and better at doing it.
Will: You know, I think it’s so easy, when you don’t have a project on the horizon, and there’s not much in your pipeline, to say yes to anything and forget about the opportunity costs of the other things that might come up, that you’re now going to miss, and to think about, on each project, not just in the near term, am I going to get paid for it, but what am I going to learn from it? Am I going to be gaining skills from this? Am I going to be gaining relationships from it? I like your five-factor criteria and get at least four out of five, and if it’s only two or three out of five, really give it some second thoughts.
MK: Yeah, really think twice. There’s so much great work out there, and so many interesting projects and great people that are well rewarded, that will build your business. They’re out there. Just believe in that.
Will: MK, you have been doing independent consulting for far longer than I have, and you’re one of the people that I have learned a lot from, and mentored me, and given me a ton of advice. You’ve been doing this long enough that … You explained to me once that you felt that your business had gone through, really, three phases. Could you talk about that and about the phases that your practice has gone through?
MK: Sure, so I started, Will, in 2002, which now feels like forever ago. In that really early phase … It was so long ago, just as context, there was no LinkedIn, okay? Sure, there was Google, but it wasn’t nearly the Google we now have. My business was really traditional. I had an office. I hired employees. As you know, I worked at McKinsey for seven years. Some of my first clients came from McKinsey. They referred people to me. Yeah, it’s like you never leave the firm.
MK: It was very traditional. I also had a much broader focus on not just health care, which I do now, but I actually worked for Google a long time ago. I had energy clients, health care clients, so it was broad focused, and it was West Coast focused. That was really traditional.
MK: Then, somewhere around 2006, as the marketplace changed, and there were many more folks like us, and people willing to be subcontractors … That was really my phase two. I created a team of subcontractors. I do remember the day when I looked around my office, and I thought, “All I’m doing is bringing in work, and I don’t get to actually do it.” For me, it’s what I really love to do. I really do love to solve the problem, spend time with a client, dig into the facts. That was really the reason for the shift to phase two. I have a great team of subcontractors, and it was focused more, in one way, because it was health care, although it was pretty broad health care. It was payers, device, pharma, health systems, but it was also more national. I did much more traditional marketing, because it was a national business. I wrote books and whitepapers and was a speaker on many topics.
MK: Then I shifted again in about 2010, still with a subcontractor model, but geographically broader. My business is now very much global. My clients are global, and they look to me to bridge the Europe and U.S., and now Asia, aspects of their business. In another way, it’s more focused. It’s really two practices. One is pharma clients. The other is large, not-for-profit foundations that are focused on health care, like Gates Foundation and California Health Care Foundation.
MK: The thing is, Will, I’ve really grown with my clients. I’ve had some clients since, I guess, 2004 and 2005, really from the very beginning, and my clients are grown, so now they no longer run one brand or a portfolio. They run a 5-6 billion dollar business. I’ve been lucky enough to actually grow with those clients, so in some ways broader, because it’s global, in some ways narrower, because it’s more focused on aspects of health care.
Will: Having done this a long time, how have you maintained those relationships with those individual executives over time, particularly outside of the context of client engagement? When you’re on one client engagement, it can suck up all your time. How do you stay in touch with the other folks that you’ve served, so that they keep calling you back for help over a period of 14 years?
MK: Yeah, so some of it’s deliberate, and some of it’s serendipity. As I said, I have really three or four pharma clients. That’s not that many, but I have very deep relationships, so I work across their peer groups, their marketing, their medical groups, and different parts of their business. I do have a Google alert on their business, so I do know what is in the news. I am old-fashioned enough that I still have a paper subscription to the Wall Street Journal. I do have electronic for everything else, but I love the serendipity of reading that newspaper and thinking, “This is going to be interesting,” and sending someone an article.
MK: I might not do that very often, maybe once every few months, but sometimes that’s all that’s needed, just to say, “I’m here,” and, “How are things going?” I also think about what city I’m in, and who I want to catch up with in that city. I have a terrific assistant, and it’s one of her jobs to always say, “Okay, in the database, this person …,” and that’s just a great reminder, as well.
Will: That’s fantastic. Tell me a little bit about how you work with your assistant. I talk to a lot of independent consultants, who are looking to find an executive assistant. Tell me about some of the things that you have your assistant do for you.
MK: Okay, well, I’ll tell you a little bit about her first. Here’s my first recommendation. Hire a military spouse. First of all, they can pack up a house in a heartbeat. They’re incredibly resilient and resourceful, and they have a hard time finding work. You can get someone, who’s absolutely brilliant, highly educated, and really just wants to be able to work, and if she has to move, it’s okay. My assistant used to live in Colorado. She then lived in Germany. She lived in the UK. She now lives in Boston. I’m lucky if I see her once a year in person, but we chat on video a lot, and I speak to her probably once a week and email her multiple times a day. That’s something quirky. One of the things she is, is incredibly talented, and what she wants is part-time work. I think there’s a lot of value to find someone who’s exactly the right fit and think about what can you flex, so you get this great person.
MK: What does she do for me? She runs the office in the sense of she does client work and runs the office. The office, which is everything from schedule and travel and all the formatting of every document … I’ll call that running the office. Then client work … I do a lot of workshops and international meetings, and she does all of my logistics. She speaks three languages. Again, go military spouses. A lot of those logistics involve being [inaudible 00:10:15] clients. The other aspect she does is a kind of Internet research. She understands a lot about the clients and the projects and what I’m actually working on, so I can say, “Ooh, I just found this out. Can you find information about a particular competitor or their actions in this marketplace?” She’s pretty sharp on search.
Will: That gets even into a little bit of associate type of work. We’re now recording this interview here in December. We’ll probably publish it in January. Tell me a little bit about your process here in December for doing a year-end review, and what are some of the things you’re going to be doing in January?
MK: Sure, so what I like to do in December is wrap up the year and really assess what I’ve done this year. I have five questions that I ask myself, and I … not super deep. I look and say, “What worked?” So what did I do this year that worked? I can give you some examples of these.
MK: The second thing is what did I do differently, and how did that turn out? If we’re not challenging ourselves and stretching ourselves in new, different ways, I think the consulting business is almost going to get away from us. My third question is what was the most fun part of my year? Obviously, I’m asking myself that, so I can keep finding more fun. Four is what did I learn this year? Maybe I learned from me about my business, myself, maybe about my clients. Maybe I learned a whole new topic or a theme. The last thing is did I meet my goals? In January, I will set some goals.
MK: What I do is I use December for the assessment, and then I truly believe that, just because I’m not working on a problem, my brain is still working on it for me, which is great. I can put that to one side, and say, “Brain, just keep busy on that,” and when I come back to the office in January, I know that somehow it will have percolated through, and then I can sit down and set some goals in January. I don’t know what my goals are going to be in January, but that’s what I’ll be doing, I suppose, when this airs in January.
Will: Can you tell us a little bit about how that goal-setting process works, maybe hark back to January 2018? Do you have different categories for goals? Are they numerical or qualitative? Tell us a little bit about that process of goal setting.
MK: Yeah, so I usually have a goal around clients, clients that I really want to serve. Maybe there’s a target client out there that I haven’t served. I’ve often got a particular client that I’d really like to work with on a particular project. It’s a content goal. I do have a number goal. I look at the total profitability of the firm, and I look at total revenues, and then total that comes to me. Yep, I do have the number goal. I have a fun quotient. It’s not super numerical, but I actually look at the end of each month and say, “Okay, how fun was this month? How much did you enjoy what you’re doing?” Then, I don’t think too deeply about it, and then at the end of the year, I say, “Okay, so of these 12 months, when were you having a good time and why? Does that help you set this next fun goal?” Those are the three areas that I look at.
Will: What were some of the fun highlights of 2018?
MK: Personal fun, I’ll start off with. I did this river cruise to the South of France, where it was all about food and wine. I actually arranged this trip for eight people in under 24 hours. That was fun, too. My husband had a double knee replacement and decided that I would take care of him at home, and when he was home for two days, deeply heavily drugged, said, “Oh, I love you so much. What can I do for you, to say thank you?” To which I said, “Let’s book a trip.” I chose this trip, this river cruise, and he said, “Call our friends.” I had everyone make a decision in 24 hours or less, because we got a really good deal, because it was the end of the fiscal year for this cruise company. That was pretty fun. Summering in Maine is also very fun.
MK: I would think, work-wise, I created a new workshop for clients that has just had some great receptivity about really predicting where the marketplace is going to go and how competitors are going to act, and therefore, what does it mean for their business? How can they refine their strategies and their implementations? That was really fun because, I think, clients got engaged in a really new and different way. It was great that they reported such insights from it. That was fun.
MK: I’ve also been working with the Gates Foundation, and it was really fun for me, because I’m thinking about predicting health care in a particular area in Africa in 2030. Will, I don’t know if you know, I great up in South Africa. Growing up in the ’70s in South Africa pre this new era of Africa, and now looking at it, it was just really exhilarating to see how far the health care has come in Africa, to think about what the Gates Foundation can really do in this particular area, so that was fun.
MK: I guess another example is I worked with a very interesting group, called HealthTech 4 Medicaid. People don’t realize that we have 80 million people on Medicaid. It’s probably our largest insured population in the country, and yet they don’t get the latest healthcare technology. This is a group of CEOs, who run companies with very innovative technology, and they want it to reach that Medicaid market. That was just a project that was exciting to work with, 30 CEOs that are really reinventing health care and want to bring it to that marketplace.
Will: You mentioned that you developed a workshop. Is that something that a client asked you to develop, and then you built it, or did you just have this idea of, oh, let me come up with this workshop, and then go and offer it and shop it around? How does that work?
MK: Yeah, so it’s a particular class of drugs, the therapeutic area, and the client’s question was … We should be leading this market, but we should be growing this market. Where do we think this particular therapeutic area will go? What they really wanted to know was what’s it all going to look like three years from now? If we knew that, what should our plans be right now? They didn’t say how to do this. They just said, “That’s what we want to know.” That’s a really big and difficult question.
MK: My point to them was you want to bring your team along with these insights. You don’t want us to go away as a team and create insights and present back to you. Let’s create a series of workshops, where we explore your brand and what’s working. Let’s explore where the marketplace is going, and let’s look at different aspects to create this. What does it look like in 2022? It was a series of workshops, and that’s how that came about.
Will: Now, tell me a little bit about the efforts that you’ve done to raise your visibility. You mentioned earlier that you’d written some books. If I recall correctly, a few years ago you told me that you had written a how-to-guide, I think, on the minute clinic type thing, and then actually that resulted in some … I’d love to hear about your writing, and how that perhaps has translated into project work.
MK: Sure, so retail clinics started in about 2005. There were maybe a handful of them. It was actually one of my not-for-profit clients that said, “Do you think that we could serve the Medicaid market in this way? Should we understand this better and bring it to FQHCs?” which are safety net clinics. I wrote a report on it, and it got quite a lot of attention. I translated that into being a national speaker on the topic. It was new enough that there weren’t that many people that could bring insight, but I was also coming at it, not as one of the retail clinic providers, one of the companies, if you will, marketing a company, but really explaining it to different groups, whether that would be explaining it to pharma or the National Association of Chain Drugs, so explaining it to the CVSs of the world, or working with, say, the Krogers and Publix and the grocers, and should they enter?
MK: I think it’s really important to think, okay, what’s new, number one, that really people need to understand, companies need to understand? Really start thinking about the audience. What do they want? Start with the speech, and see where the questions come. What is it people really want to know more about. Then I translated that into short whitepapers, and then several books. One book was written for the healthcare provider systems, so hospitals and people that provide primary care and specialty care. One was for drugstores and grocery stores, because there’s very different strategic reasons for those two entities to go into retail clinics. You had a great speaker on this podcast, I think a week or two ago, about how to write a book. I really liked one of the pieces, which is who’s going to read it, and why? Have that front and center. Why are they reading it? What question do they most want answered?
Will: Yeah, thanks for the shout-out. That was Robin Colucci, and I think that was episode 116.
MK: Yes.
Will: Yeah.
MK: Yeah, Robin. Robin was terrific. Sometimes I don’t binge-watch these podcasts. I guess I listen. I binge-listen, I guess, to these podcasts, and sometimes I forget who’s who.
Will: Everybody should binge-listen to … What is your morning routine?
MK: I meditate, I do some exercise, and I do a puzzle. I’m not particularly good at meditating, and I’ve decided to let myself off the hook a little bit, and I say, if I can get through five minutes, yay me. I used to think you’re supposed to meditate before coffee, and that never works, so it’s really coffee, meditate. I do a different kind of exercise every day, like a yoga, Pilates, cardio. One of my favorites is the YouTube Fitness Guru, Lucy, and I call it, “Do my Lucy.”
MK: Then I do a puzzle every morning. I always think that it’s like the warmup for the brain, right? What I bring to work every day is the brain, is my ability to solve problems. Now, most days I do a crossword. If I don’t have quite enough time, I’ll do a more complex Sudoku or any kind of puzzle. Sometimes I just do the jumble, whatever’s there. I think these puzzles really teach you a lot, and they give me great reminders during the day on problem solving.
Will: MK, tell me about the puzzles, and what do crossword puzzles teach you? How does it help you start your day?
MK: Okay, so first of all, it tells me, question my assumption. All right, today’s crossword, I just realized, had … The clue was uniform color. I thought it meant color that’s all the same. I was trying to think about words, same color, same color. Then I got a little clue, V, and I realize, ah, no, it means a uniform color, like a military uniform, insert olive. Now, this is the way it teaches me. What do I actually know is true, right? It could’ve been olive, but it could’ve been other things. That was something I have to … not necessarily a data point.
MK: What do you know is true? For example, if there’s a clue Provo’s state, it has to be Utah. Today, it was the safety elevator inventor. It has to be Otis. Then you say to yourself, “Okay, what do I actually know is true versus what do I think is true?” I think that questioning assumptions is so important. We have so many … It’s so easy to think it’s a dogma, right? I just believe it to be true, but having that ability to question is really important.
MK: I like the other one, which is, okay, just start somewhere. You don’t have to start at number one. Just start somewhere and, number four, just keep going. I think the other thing is even a small clue of one letter can help, so find the small clue. My last one is you really don’t need to know everything. There was one clue, [Athleta’s 00:23:20] son, in some reference to Greek. I don’t know. I didn’t know it. I don’t need to, because I could fill in the information from the other words and the other angles. I just feel like it gets your brain going to just do a puzzle a day.
Will: That’s how you get started. You know, I love that part about attacking it from at least any angle. So often, it’s hard to start a particular, some projects, right at the natural beginning, but you try to start chiseling away at it where you can, right?
MK: Yep, just chisel away. Just keep going.
Will: A few years ago, you gave training at one of the events that I helped organize, and you gave some awesome training on negotiation.
MK: Yeah.
Will: What are some things that you’ve learned about negotiating with clients that maybe you do differently now than you did when you got started?
MK: That was a fun workshop, Will. Umbrex workshops are something I really look forward to. Negotiating … What I did there is I created six cases. The client knows something, and the consultant knows something. What I was trying to get people to do, and something that I’ve learned over the years, is keep asking questions. Don’t make the assumption that you know the size of the project, the outcome, who should be involved. Keep asking the questions, and really listen for why is the client undertaking this project.
MK: The other thing about negotiations is what is it that I’m not willing to let go of? What is super important to me and an absolute must-have, and what’s the part that I can give way on? I don’t know that that’s unique in negotiation, but I think those are the reminders. I will say, Will, one of my favorite programs on negotiation is something you brought us at Umbrex, from your business school professor.
Will: Yeah, that’s Negotiable. You can find that online, and I will include a link to that in the show notes. It’s some online negotiation learning by Professor Daniel Ames at Columbia Business School. Thanks for mentioning that.
MK: Yeah, no, it’s a terrific program. I’ll tell you something else about negotiation. This makes for a great … This is a bit random. It makes for a great workshop exercise. Even though you’re not trying to learn negotiation or teach negotiation, maybe you want to get people thinking and reminding them that everyone brings something unique and valuable to a workshop. For example, under that Negotiable program, there’s a little negotiation on a fishing trip, Michael and his two friends. If you do this, you’ll find out that Michael wants to go fishing. His friends sort of do, but not really. They approach a fisherman, and the fisherman says this.
MK: I put people in pairs, and then I say, “So what are you going to do? What question will you ask the fisherman?” What happens is maybe you’ve got a workshop of 12 people, so you’ve got six pairs. Well, they all come up with a pretty different answer. Now you’ve heard what everybody else might ask. You get a little bit more information, and then again, in pairs, what would you say? Really, the insight people get is, first of all, on negotiations, which is good in a workshop, because there’s always going to be some trading, if you will, on shared agreement, but it also really reinforces that, as a team, it takes all of us, not just one of us, and all of our perspectives to reach a good outcome, so just a different way to use that negotiation course.
Will: Are there any books, MK, that have particularly affected your thinking?
MK: In terms of consulting, two consulting books jump to my mind. One is in the 26th edition … I think I have edition 2 and 26, which is Flawless Consulting, and it’s by Block, and the other one is David Fields. I am a very big David Fields fan. If you go to an Umbrex event, you’ll often see him there. I like his Guide to Winning Clients. I also loved his guide for executives hiring consultants. It’s not a book, but just a shout-out to David Fields, because I encourage a lot of people, who want to go into this line of work, to sign up for his blog, and he posts about two or three times a week. By the way, he posted on fun earlier this week, and it was a good reminder what makes consulting fun. Those are some books. The other blog I like is Susan Drumm, also an Umbrex member. She writes under Meritage or Meritage, depending on where you sit in the country, Leadership, and Susie’s blog is terrific, as well.
Will: MK, you have been doing this for a while. I know a lot of people will approach you and ask, “MK, you’ve been doing this since 2002. What advice do you have?” What advice do you have?
MK: Three things … Create a deliberate plan. Don’t just let this happen to you. Create a plan of what you’re going to offer to what client. Be really clear and very deliberate in what you’re going to deliver, and to whom, and how you’re going to deliver it distinctively.
MK: Two: Craft and control your own story. Someone will always try to explain what you do, but make it easy for them to explain to others what you do, so you are in control of your story. My last thing is bring your whole self to this business, your whole self. One part says … One part of me is I’m a sommelier. I’m a certified wine educator, and I actually bring that to clients. They talk about why that’s of passion and interest to me. They start to understand a little bit more about who I am and what I can bring.
MK: Recently, because I have so many global clients, I do wine tastings, where we compare old world wine and new world wine, and it’s not about good and bad taste. It’s about different philosophies. When you bring your whole self, I think you’re bringing an empathetic you. You’re bringing a listening you, but you’re also leveraging all of the other skills and talents you have, and so I always like to find out what somebody’s whole self really is. I love to ask them how they intend to bring that to their business, to their clients.
Will: I love that. Say a little bit more about these wine tastings. Is that where you do that with your clients? Would it be at the office or at the … Just how does that happen?
MK: I do a lot of workshops, as I mentioned, and so we’re offsite. Because I have global clients, I usually get the question from the Americans, “Why are the Europeans doing that?” Or the Europeans say, “Why are the Americans being annoying?” We’re always trying to find new and innovative ways to bridge that cultural gap, and so what I do is I’ll create a selection of eight wines. Four will be old world, so they might be from France or Italy or German wines. Then I’ll create four from the new world, usually American, but sometimes I’ll bring in an Argentinian or a New Zealand or something like that. We talk about how that one grape is really different, and how the climate and the terroir has impacted it, but also the philosophy.
MK: Here’s something quirky. In America, we celebrate winemakers. We love to think about what a grape can be, and we love to celebrate a winemaker and what they can bring. The Europeans have the opposite approach. They think that the wine should reflect the terroir, the place, and so they celebrate the place and the tradition, whereas we celebrate what it could be. I think both are great, and they’re both wonderful, but it starts to bring new insight at a business level. This is what I mean by bringing your whole self. It can be really fun to do some wine tasting with your clients. I would highly recommend it.
Will: Yeah, I’ve seen people with a passion for video or for film, really incorporating some photos or even video in consulting projects, or people who can sketch or draw actually doing some art or doing some gallery walks. I know [Ravi Rao 00:32:01], who’s very strong kind of an actor and screenwriter as well as a consultant, will sometimes do some role playing or some skits, so I think it adds a level of authenticity and just bringing your whole person as a way of delivering so much more value than saying, “Okay, I’m just a brain walking in the room, that had been mass produced by McKinsey,” but you’re a real human being, right?
MK: I think you’re exactly right, Will.
Will: Well, MK, thank you so much for joining. You’ve been doing this for a long time, and really loved hearing your advice today and your end-of-year plans, setting goals, proposals. I love to hear how your practice has evolved. It’s just fantastic to catch up with you. Thank you so much for joining.
MK: Will, it’s been fun. It’s really been great. I wish you a wonderful 2019.

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