Do You Give Them What They Ask For? Or What They Need?

As a Healthcare IT consultant, I am approached many times a year by clients with opportunities to help them implement or optimize new systems or technology.  As a result, I am often faced with the dilemma,  “Do we give them what they ask for? Or do we give them what they need?”

Just over two years ago I received a call from a Health System client that described their situation as desperate, they needed to replace their PACS System immediately.  I took the call optimistically because I have led teams that have helped 100’s of clients with their PACS “issues” in the past 15 years.  I was confident that we could help this client, though I was skeptical that their most pressing problem was that their 7 year old PACS system needed replacement.

I scheduled a few “discovery” calls with key leaders in radiology and IT and fortunately for me (and I think the client as well), we came to the agreement that there were other issues/forces that must be considered simultaneously with their end-of-life PACS.  Among these were:

  • Their health system was aggressively  acquiring physician practices and IT and radiology were having trouble keeping up in terms of integrating the acquired practices imaging systems (PACS, RIS, etc.).
  • Their radiology group provided outstanding 24×7 coverage but turnaround times were severely constrained by manual dictation processes.
  • Most of their imaging IT systems were several versions behind those currently supported by their respective vendors.
  • The technology available in the imaging IT market supported full integration and collaboration within and beyond their health system, but their current systems were configured as “radiology” systems.
  • Imaging was silo’d by radiology, cardiology, oncology, OB, etc.
  • They felt totally unprepared for any imaging requirements as a result of meaningful use and would need to integrate over 10 departmental PACS systems with their new EMR.

So you can see, if I pressed forward with a project to simply replace their PACS (incremental change), the client would have missed the opportunity to make revolutionary changes in their imaging and IT capabilities.  Fortunately, the client was in lock step with the need for REVOLUTIONARY change and we set forth together to create a three-year strategy for imaging IT.  As a part of the strategic planning, we interviewed over 100 key stakeholders who helped identify and prioritize the forces/issues listed above.  It turned out that replacing their PACS was their 4th priority and my team is helping them go live with their new PACS over the last few weeks.  We will continue to help them execute their three-year strategy and they have much more flexibility and agility as a health system, imaging service and IT system provider than they would have had if they had simply replaced their PACS.

After reading this you clearly know what my answer is… GIVE THEM WHAT THEY NEED!  Make REVOLUTIONARYchange!   You should know that it is much easier to give them what they want and it takes significant finesse and patience to guide “your customer” (whether internal or external) to revolutionary change.  Feel free to contact me if you are having challenges finessing the situation at your organization or client to make revolutionary change.

Picture Credit: My Modern Met blog

About the author


Joe Lavelle

Joe Lavelle is the Co-Founder of intrepidNow. Prior to that Joe was an accomplished healthcare IT executive and career coach with a record of successfully meeting the business and technology challenges of diverse organizations including health plans, health delivery networks, health care companies, and several Fortune 500 companies.

Joe is also the author of Act As If It Were Impossible To Fail, available on Amazon.


  • Joe,

    Excellent thought-provoking post. I always enjoy reading your real-life examples, especially when they have a happy ending! So let me ask you your opinion on the same situation if you were not able to come to a consensus with your client about what they really needed. As a Healthcare IT consultant, what’s the best approach if your client (due to pride, inexperience, or a variety of other possibilities) insists on staying the course?


  • Nice example Joe, which reflect the experience of many of my clients in widely different fields.

    It comes down to the old saw doesn’t it?

    First, to build trust, you have to show them that you understand what they want.

    Then, you have to work out what they need.

    Finally, you have to get them to want what they need!

    Malcolm @malcolm12boxes

  • Great question Gwen!

    Sometimes it can take months for a consultant and a buyer to figure out if they are the right fit for each other. I have learned to identify the signals of success and failure earlier and earlier in the relationship building process and I am not afraid to politely decline to participate in a project that we can not achieve significant tangible benefits (ROI) for the client. For example, I rarely compete for work where an RFP is involved because their is little opportunity to differentiate my teams’ exceptional abilities to recast the problem statement for a better client outcome. My teams have always focused on higher end consulting where we help to define the project and the benefits.

    There are many successful firms that differentiate themselves on their ability to staff assignments at competitive rates for as long as a client will have them and doing whatever the client will have them do … but that is probably another post that has been brewing in my head…. Understanding the Different Types of Consulting Firms.

  • Hi Macolm – Thank you so much for your comments! You are absolutely right; unfortunately I have found that is a low percentage of buyers that really understand how to use a strategic consulting firm. I think they may be learning the wrong behaviors from firms that identify themselves as consulting firms when they are more realistically contract “staffing” firms.

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