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Business Process Design -
The Art of Consulting As An Epidemiologist

One of the pleasures of working as an epidemiologist is the amount of learning you undergo in other fields in order to practice epidemiology. So it is with the business of epidemiologic consulting. Business theorists, like linguistics theorists, speaker of four steps (or speech acts) in the design of the business process - a design that brings business full- circle, completes the process, and brings business back. Linguists speak of requests, promises, performatives, and declarations as fundamental speech acts. These are also the fundamental processes of epidemiological consulting, as they are of business itself. Doing the job is often the least of the work; attention paid to the preparation of each phase will help ensure success. Many projects where the work is done correctly are nonetheless failed projects, because of the lack of attention to the four phases.

Preparing a Request

Prospective clients generally know their concerns but often do not know what an epidemiologist does and how he/she can help them satisfy their concerns. During this phase, the epidemiologist's role is to understand the client's concern and to teach the client how to ask an epidemiological question that addresses their particular concern.

Preparing a Promise

Not all epidemiological requests can be handled by every epidemiologist or every epidemiological group. We each have our areas of refined skills. Elements of a full promise include the capacity to complete the project at the skill level required, by the time specified, presented in the manner necessary, and within financial bounds feasible for the client. Each aspect should be included within the promise made to the client while the epidemiologist can promise sound work that meets the standards of professional rigor, one cannot promise the results of one's study or what effect the knowledge of those results will have on others.

Performing the Work

Consultants generally have years of experience "doing the work" prior to entering the consulting field. They bring their skills with them and do not foresee problems in practicing them elsewhere. Consultants frequently enter the private sector expecting to practice the same procedures they used in the public or academic sectors, frequently lacking the resources that were previously available to them. The performance standards include both professional quality and those specified above (the element of the full promise). Furthermore, if the feasibility of conducting specific aspects of the project change over time, the client must know how they will affect the original promise.

Declaring a Completion

Performing the work does not alone complete the project. Completion of the project includes the delivery of a report in a form that the client can understand and use, the mutual fulfillment of financial obligations, and, most importantly, the ascertainment of the client satisfaction. The form of the report will depend on the forum in which it is to be presented. The client may desire That the results of the study be presented to a number of different audiences. Thus, delivery of report may take several forms simultaneously. Additionally, all clients have their clients - a boss, an organization, a funding source. The consultant must listen for, and respond to, both the concerns of the clients and those of the client's clients. The declaration by the client of completion of the project, and satisfaction with that completion, opens up the opportunity for the assessment of subsequent needs.

We've described the four phases of the business design process of consultants as we see it and practice it. Some consultants specialize in specific phases of this process, while others (like ourselves) have designed their services to include the full circle. What one wants to offer in the marketplace depends on one's own skills and one's personal preferences. As the general community becomes more familiar with the power of epidemiology to produce comprehension and direction in areas of uncertainty, the demand for epidemiological consulting services will increase both in breadth and depth. Understanding the design of business processes allows one to choose both those services one wishes to provide, and those one does not. Opportunities exist to specialize in any of these phases or to service all, independent of the area of specific technical knowledge.

Stephen H. Lamm, M.D.

Consultants in Epidemiology & Occupational Health, Inc.

        2011 The Epidemiology Monitor

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