The Doctor Will See You Now: How Kith Serves Clients

May 9, 2019

David Maister is regarded as one of the world’s leading thinkers on consulting firm structure and positioning. For decades, Maister studied the business of consulting and his writing and ideas form the foundation of what we now recognize as modern management consulting.  What makes Maister so compelling isn’t just the quality of his thinking, but the innovative examples and comparisons he draws from all walks of life.

One I particularly enjoy is his explanation of a consulting firm’s services, illustrated by different types of healthcare services.

We recently had a team strategy retreat for Kith and this model came to mind while we were reviewing our services and how we tackle client engagements. I wanted to share our thinking with you to give you some insight into how we view our work as a crisis communications and reputation management firm.

Plus, it’s a good excuse to explain why we named ourselves Kith.


Maister’s Model

Maister’s healthcare model takes four different healthcare providers and places the kind of care they deliver on two axes: level of engagement and degree of personalization. The four practice types that Maister uses are a pharmacist, a nurse, a brain surgeon, and a family doctor.


services model

Each one of these practices is a critical element in the overall field of healthcare but each has a unique relationship with the client based on the level of client contact and the degree of personalization required. Sometimes, a patient will only need help from one of these people but, over time, they might find themselves visiting each specialist as their needs change.  For acute cases, they might need a mix of specialists as part of a comprehensive treatment plan.

These different types of relationship, and how a patient’s needs can change over time, resonates with my experience of how consulting firms help companies. Similarly, our support to clients will vary, depending on their needs and situation.  

So which Kith specialist is most suited for your needs?


Take Daily On An Empty Stomach

The pharmacist’s practice is rooted in the notion that the client is getting a highly standardized service but doesn’t need a whole lot of counseling, consultation or contact. The patient needs their prescription delivered in a highly controlled and precise manner to achieve the desired result required.  So while the exact prescription will differ from patient to patient, each dose of a particular drug must be exactly the same. Neither the pharmacist nor patient wants or expects there to be a high degree of interaction or customization: that takes place elsewhere. The focus for the pharmacist is providing a very standardized product as efficiently as possible with minimum client contact.

At Kith, we adopt this role when people ask us to benchmark their readiness, to conduct research or to analyze messaging. They provide the research question and we provide the required output as quickly and as efficiently as possible, using our standardized processes. Similar to the pharmacist, our work isn’t effective if the methodology differs report by report. These engagements are usually faster with a definite start and finish and a single, distinct deliverable.

This mix of low-contact and high-standardization places this work in the top left of the quadrant, next to the pharmacist.


Let’s Check Your Vital Signs

The second category is that of the nurse. His work is still highly standardized but differs from the pharmacist due to the high level of patient interaction.  So although the nurse is working through a series of standard processes, his communication with the patient is key to his success. Moreover, the insights gained during these interactions, coupled with the data collected, are vital to determining what the next steps should be.  The nurse isn’t just there to take your blood pressure or to dispense a pill. They are also there to counsel and guide the patient, to explain what is happening and to lead them through what can be a confusing or difficult situation. Moreover, the nurse is also there to guide and counsel the physicians who may become involved later.

For us, this is most akin to our work developing and delivering crisis simulations. We have a proven model for crisis simulations and these are highly templated and structured for maximum effectiveness.  However, we also need a great deal of input from the client. Unlike the pharmacist, we can’t just fill a standard prescription for ‘one crisis simulation to be taken annually.’ Rather we need a high degree of collaboration to make sure we meet the client’s needs and to ensure that the simulation delivers the required outcome.  We spend time getting to know the organization and helping them understand what we’re going to deliver. Importantly, a lot of the value of the simulation comes afterward, once the data and feedback – your organization’s vital signs – has been collected. Similar to the nurse, we use this data to guide and counsel the client and the ‘doctor’ who might get involved later.

However, despite the standard process for our simulation, there’s a real focus on the client and their needs placing this in the top right quadrant of the graph, right next to the nurse.

So the pharmacist and nurse are similar in that they follow a fairly structured, templated approach to healthcare although the degree of client interaction differs significantly.  Similarly, our benchmarking and simulations are standardized but the amount of interaction differs significantly. These similarities and differences are flipped when we turn to the other two categories: the brain surgeon and family doctor.


Scalpel Please

You probably can’t get much more personal or specialized than a brain surgeon. Not only will each patient present with a different need, but there will be subtle differences between each person meaning that each case needs a highly specialized,  individual approach. However, that doesn’t mean that the brain surgeon needs to spend a lot of time with the patient beforehand. The patient might meet with the brain surgeon in advance and she would explain the procedure and what to expect, but there’s a high likelihood that they wouldn’t meet again until the operation was complete.

This approach isn’t dissimilar to how we support clients who suddenly find themselves in a crisis and want to turn a large part of the response over to us.  They outsource the ultimate responsibility for communications, message development or media monitoring to us and want minimal day-to-day interaction. It is very much a case of them asking us to just find the right solution and fix the problem. This is usually for unique, one-of-a-kind situations where we might stand up a war room, serve as a spokesperson or act as the lead strategist. However, unlike other engagements, we work in semi-isolation, walled off from the remainder of the organization.

This work as an outsourced, independent expert requires significant amounts of customization and personalization but with relatively low levels of client participation placing us alongside the Brain Surgeon in our diagram.


The Doctor Will See You Now

Finally, contrast this to the family doctor.  Here, the patient is intimately involved in problem-solving and decision-making. There’s no ‘cookie cutter’ solution and the doctor needs the patient to share their thoughts and feelings about what is happening.  They also want the patient to be part of the discussions when it’s time to make a final decision about the course of treatment. This is highly personal medicine that will only become more personalized as the relationship develops until the doctor almost becomes part of the wider family unit.

These long-term relationships are where Kith thrives and this sense of family and friends is what we seek to build and why we took the name Kith.  We aren’t sharing Thanksgiving dinner (yet) but we get pretty close to our clients. We are with them for the long-term, maybe beginning in the role of pharmacists or nurse but, over time, our relationship becomes more profound, closely resembling that of the family doctor.  In this way, we are still working on highly customized solutions to the client’s problems, but we are also fully integrated into their decision-making and execution processes. There isn’t any ‘them and us’ in the room: we are there through thick and thin.

This puts us in the high personalization, high engagement quadrant of the graph, next to the doctor.


What We Don’t Do Is Equally Important

It’s quickly worth noting that although these four cases cover most eventualities, there are things that we won’t do for expediency or to make a quick buck.  For example, slipping into pharmacists mode and supplying an off-the-shelf crisis exercise isn’t in the client’s best interest, nor ours. We have to have that collaborative ‘nursing’ relationship if we’re creating an effective crisis simulation: there’s no one-size-fits-all exercise we can run.

So I hope that sharing how we think of ourselves has allowed you to understand how we engage with clients and which relationship is most appropriate for your needs.  Starting on the right foot at the outset and understanding what’s involved will get you the right care and the right service for the right price at the right time.

And over time, we hope to count you as part of our family, part of our Kith.


Filed under: Blog


Bill is a reputation management, crisis communications and professional development expert, keynote speaker, Wall Street Journal Risk & Compliance panelist, and best-selling author of Critical Moments: The New Mindset of Reputation Management. He has more than 25 years of global experience managing high-stakes crises, issues management, and media relations challenges for both Fortune 500 companies and winning global political campaigns.