Linkedin R2 Why I Turn Down Enquiries

Length: ~1,200 words

Last month a CMO from a 400-bed hospital in Mumbai called ICG. ₹12 crore in marketing spend. Board pressure. "Fix our marketing."

I turned it down.

This surprises people when I tell them. We are a growth business. We want clients. But after 8 years and 150+ healthcare engagements, I have learned that the wrong client engagement is more damaging than no engagement. To ICG. To the client. To the relationship between the two.

Here is the framework I use when I decide whether to engage — and why I think it is the honest way to run a consulting firm.

The 5 questions I ask every prospective enterprise client

Question 1: Is the problem clearly identified, or are they hoping consulting will identify it?

"Fix our marketing" is not an identified problem. It is a symptom presentation. A client who comes with "we have measured our real CPQL, it is 2.4× the market median, and we believe the attribution infrastructure is the primary cause" is ready for a consulting engagement. A client who comes with "marketing isn't working" is not — they need a diagnostic, which we offer, but they are not ready for a transformation programme.

The Mumbai CMO came with "fix our marketing." When I asked what specifically was broken, the honest answer was "I'm not sure." That is a diagnostic client, not a transformation client. I recommended they start with ICG's Growth Diagnostic as a standalone engagement. They wanted to skip straight to the programme. We parted ways.

Question 2: Does the organisation have the operational capacity to implement what we recommend?

ICG's engagements require operational change — not just campaign change. Beacon CAPI deployment requires developer resources or IT collaboration. CRM reconfiguration requires patient coordination process change. The GP referral programme requires a named person in the hospital to manage the GP communication channel. The Hawk re-engagement sequences require patient coordination team adoption.

If the organisation does not have the operational bandwidth to implement these changes alongside their daily clinical operations, the engagement will stall at Phase 2. I have seen this happen. It is expensive for both parties.

Question 3: Is the leadership genuinely curious about what the data shows, or do they already know what they want us to confirm?

The most difficult enterprise clients are those who have already decided the answer and want a consultant to validate it. "Our Meta Ads are the problem — please confirm this and we will restructure our agency accordingly." When the diagnostic instead shows that the CRM infrastructure, not the Meta Ads, is the primary problem — and the client's leadership is not open to that finding — the engagement becomes adversarial.

I ask this question directly in the diagnostic call: "If ICG's Phase 1 diagnostic shows that the primary problem is not what you currently believe it is, how will you respond to that finding?" The answer tells me whether the leadership is genuinely curious or pre-committed.

Question 4: Is the engagement size aligned with the scale of the problem?

A hospital group with 4 hospitals and 600+ combined beds, spending ₹4 crore on marketing with broken attribution, should not be engaging at the Starter tier. The problem is large enough to require the full Growth OS — Beacon, Hawk, YODA, Agency OS, specialty-by-specialty campaign architecture. Asking ICG to "just fix the Google Ads" for this organisation is not a bad request — but it is not a request I can honestly take, because fixing Google Ads without fixing attribution will produce a Google Ads improvement report, not a hospital growth transformation.

I tell the client this. Sometimes they hear it. Sometimes they want the Google Ads fix anyway. In those cases, I usually recommend an appropriate single-channel agency rather than ICG. We are not the right answer for every problem.

Question 5: Is there a real decision-maker in the engagement?

The graveyard of consulting engagements is full of projects where the person who hired the consultant had no authority to implement the consultant's recommendations. I ask explicitly: "Who will make the final decision on the Beacon CAPI deployment? Who will approve the CRM reconfiguration? Who will attend the quarterly strategic reviews?" If the answers are multiple layers above the person I am speaking with, the engagement will move slowly and implement partially.

What I am actually looking for

The 1 in 5 that I engage looks like this: an organisation that has measured its real CPQL (or is genuinely curious to do so), has operational capacity to implement infrastructure change, has leadership that is curious rather than pre-committed, is engaging at a scale appropriate to the problem, and has a decision-maker actively involved in the engagement.

These organisations get extraordinary results. The 4 in 5 that I turn down — or redirect to a more appropriate entry point — might also get good results eventually. But not from ICG, and not right now.

I would rather turn down 4 clients and genuinely transform the 1 than take all 5 and deliver mediocre results across the board.

That is not a growth strategy that most consulting firms would endorse. It is the one that has kept us at zero formal NMC complaints across 150+ engagements for 8 years.

→ Fractional Chief Growth Officer for Healthcare