During initial engagement you are often talking to somebody who appears to actually know their stuff - you hire them and find that this knowledgable person has moved on to the next big sales, and you've got the B or C team.
This was for a contract where we made it very clear that quality/skill was paramount and we would happily pay above market rates forever if they could maintain it. Of course they got greedy and lost the deal entirely.
I haven't seen this yet in doctors offices. I see a doctor at an office specialized in an area (say gastrointestinal), they wouldn't switch and need the consent of the doctor to switch to another doctor in the same practice.
Just go to a massage therapist or a physical therapist (depending on your actual needs).
Take for example in Germany a huge percentage of doctors are into homeopathy and other alternative treatments. I think this is a byproduct of the germ vs terrain school of thought and the revolution of microscopes, antibiotics, and the fact that the Allies won WW2 meant that germ theory won and terrain theory largely was brushed aside. Though not all German doctors are willing to give it up yet. Terrain theory is not always wrong, Japan figured out that lack of B1 was killing a large number of their sailors and fixed that with diet.
My focus is on genetics and dysautonomia, which if you do not have the statistical tools we have today will often look like subtle imbalances caused by environmental factors supporting the Terrain theory. A substantial percentage (~5%) of the population has some level of undiagnosed dysautonomia, probably due to an undiagnosed inherited genetic anxiety disorder. These are exasperated by environmental factors. There is an assumption that humans are generally healthy unless perturbed but for this subset of the population they really should be medicated and stay medicated. The problem is the lack of skill in systems engineering and statistics means doctors are usually unable to find the right medications (they tend to prefer stronger ligands and I think weaker ligands should be preferred) or the right dosing (I think patients should generally be in charge of their dosing and take medication based on how they feel once educated on how the feedback loops work).
The fact that some subsection of medical science can know the right answers but medical science as an institution does not, it has evolved in the past and it will continue to evolve, should indicate that what is currently believed is not based entirely in scientific discovery but massively influenced by schools of thoughts, artifacts of history, fashions, and luminaries. Much like humanities, individuals can inhibit exploration of alternative ideas and science can’t progress past them until they’re out of the way.
I used to tell the prime contractor to just be honest. They couldn't even do that. Most of my business now comes from clients of A who have been burned badly and now physically meet the person who will actually be doing the work.
EDIT: I am _very_ sad that link rendering truncated "murder plot" from that
The only use I have is so that cowardly executives can do what they already had planned to do but now can point to a bunch of paper that nobody will actually read in detail.
After the B team set everything up, they didn't even get the Z team. A few months in, it turned out NO ONE was logging into their ticketing system at all, so there were hundreds of tickets their engineers had created with no acknowledgement. Just lol.
And no, you don’t pay partner rates. The client generally knows that to do commercial pressure you need to get info about team size, put it in the contract, and then negotiate on blended rate so it is close to what the market pays for the junior.
So the choice is trying to hire a bunch of individual contractors and forge them into a team, or hire a pre-built team for a period of time [1]
[1] Sometimes it's sold as a re-built team - but in reality it might be hired in exactly the same way by the consultancy....
I’ve seen too many cases where people suffer the consequences of their own ideas being implemented (large or lower scale), convinced that if we just turn this knob a little more, it’ll finally work. Because of that, I don’t spend much energy on them anymore.
To give an idea, we have a big scandal right now related to IBM and other contractors charging the Quebec government a lot of money for defective software for the car licensing and insurance website (SAAQClic). The final cost of the SAP based product was 1.1B CAD$. Meanwhile, they hired a new head of digital services at SAAQ, a job that would involve potentially dealing with future fallout from that fiasco, in addition to new projects etc. The posted salary range was 140k - 180k CAD$. I know many engineers in Quebec working on eg standard web applications etc making more money than that! They aren’t leading 1B$ product development!
In government you have to remember that it’s people playing with other people’s money, thinking all along that it’s their money, i.e., a sense of entitlement. So you end up with many of the same kinds and types of deep problems that you see in things like investment frauds, trust fund babies, spoiled children, and drug addicts. It’s probably not a coincidence that those often heavily overlap, including among bureaucrats and people dependent of government money.
We are talking about a militating of resources and from that comes a whole cascading effect, e.g., the children of someone who has actually produced something well through the effective and productive allocation of resources, resource maxing, so to say; will produce far better progeny than someone whose efforts have never led to anything productive as a bureaucrat that simply brushes one billion dollar failure after another under the rug while coping with ever more vociferously proclamations of how important and good of a job he does.
A good case in point is how America is $38 trillion in realized national debt, all while the “boomer generation” is at the same time declaring how wonderful things are, regardless of the political party. Those two things cannot be reconciled and will not perdure.
This really becomes a problem when you have individual agencies making decisions on contracting resources even though they don’t have anyone qualified to vet the resources they are bringing in. If each agency had a decent to good lead architect around the $200k range they could save so much money on less than necessary contracts and cloud development “deals”. But that pay band tops out around $140k.
The only folks making good money at the state government level are sports coaches and medical directors. The pay for public employees is public so it’s easy to confirm.
At the beginning of a project, the government could spend above market for a great architect to lay down the data model and put some patterns in place which could then be reasonably well maintained by below market rate staff, but there are rules and public pressure.
Interestingly, my local govt hired Deloitte to put in a serverless AWS-based application that could have been a simple CRUD app hosted on a medium EC2 instance. It cost $1.5 million and didn’t work, in addition to the hundreds of thousands per year in cloud costs.
Could have been a Django app with Celery. The cost could have been in the low thousands per year.
It could even have been done with a succinct AWS serverless system.
But that’s not the schmooze that can impress high level stakeholders, themselves less familiar with good design patterns, and win the contract.
This is an important reality in consulting. The consultancy cannot keep their best people sitting idle while the clients spend months completing the paperwork.
And it's not just a billability issue. The A team people don't like being underutilized and will find seek employment if they're kept idle too long.
That said, savvy clients will include "named key resources" in the contract to ensure continuity between the sales team and the project team.
Also having frequent rounds of firings impacts company culture - making it much more transactional ( everyone for themselves ) - some companies value their employees and culture and the collaboration and long term thinking that can bring.
One option that's increasingly common is hiring people on fix term contracts - however that does create a sort of divide.
What does happen is that you were pitched/sold by a perfect PowerPoint presented by a senior partner/manager, but all the work afterwards is done by the 26-year old fresh-out-of-MBA consultants. The partner is still responsible for the project, but mostly on a “I'll review your work later from an expensive restaurant I'll bill the client for”.
They'll also invent the wildest things when it comes to tech work. I was working as an expert on software development and integrations, and often had to tell clients that what the consultants promised is simply not possible.
I'd get them up and running and then put together a plan to fix them up, but then some junior got assigned that job. The client then gets mad at me for not helping them anymore.
If it's a small firm or a 1 person contract then sure.