• Have a clear idea of the tasks you would like accomplished.
• Be objective and realistic in your expectations related to the amount of time, cost and staff that will be required. A single individual may require some secretarial backup, or physicians' assistance particularly in the recruitment process.
• Find someone who has done this task before. Don't let the consultant learn on your group.
• Use an appropriate consultant. Do not assume that an experienced attorney, for example, can develop internal policies and procedures for the day to day IPA activities. Likewise do not expect experienced consultants to draft organizational documents or provide the last word in antitrust issues. Out of town consultants are not necessarily better. Physician consultants are not necessarily better nor worth more than experienced local individuals, although in some cases they may be.
• Beware the consultant who has something to sell besides advice and guidance. It is not uncommon for consulting firms to diversify into capitation management or practice management services. A consultant who can remain objective in the development and completion of your group and it's ongoing functions is an absolute requirement.

Once you have identified the individual or individuals that seem appropriate for your task(s), consider these additional factors:

• Is his/her personality, temperament and work style such that the group can establish a rapport with them?
• Does he/she listen to the group and its desires and concerns or does the consultant merely tell you how things need to be done?
• Is the proposed reimbursement appropriate? Expensive is not necessarily better; neither is inexpensive necessarily cost effective. Generally, healthcare consultants charge in the range of $80.00 to $150.00 per hour or $20,000 to $35,000 to develop a group or IPA.
• Payment issues should be identified and clearly spelled out up front. When will the consultant bill? How quickly will payment be made? What other expenses will the client be responsible for. How will charges be substantiated? Itemized? Receipts required?

At the start up of the project, ask the consultant to develop a work plan and a time line. This will enable the group to identify the steps involved, the time frame for completion of each task and the ability to stay on track.

And finally, it is critical for the consultant to work directly with the Physician, Administrator or group or committee. Do not delegate the office manager or interim director or manager to coordinate the project or act as the "go between". This can create a political situation that may not be in the clients' best interest. A wise consultant knows to stay out of politics or special interests.