Scope creep in physician consulting jobs: How to avoid it, address it, and even benefit from it

Last updated Jan 11, 2021 | Published on Jan 18, 2021

Scope creep. Many physician consulting jobs and freelancing work are at risk of this phenomenon, which can cause frustration and eat into profits. This article describes what scope creep is and how to prevent and mitigate it when doing any type of work for a client.

What is scope creep?

The scope of a project or a consulting engagement is the requirements, deliverables, and/or outcomes agreed upon by a consultant and a client. In true consulting jobs, this might be limited to investigating a given problem and providing written recommendations. For a freelance medical writing project, this might include a written document and two rounds of revisions, for example.

Scope creep is a term used to describe the tendency for a project’s requirements to increase throughout the duration of the project. This can mean an increase in the number or magnitude of deliverables, additional revisions or feature requests, or any “asks” by the client that aren’t within the boundaries of the agreed-upon project.

Many physicians in clinical practice may be familiar with scope creep in the context of EHR implementations. Scope creep runs rampant in IT engagements, as clients often want customizations and add-ons. In a healthcare setting, there so many different user types, specialties, and departments, each of whom have slightly different processes and needs leading to differences in what they want in an EHR. If the software vendor isn’t careful and organized, the scope of an implementation can creep beyond what was originally anticipated – but the revenue will remain the same.

Solo physician consulting jobs are not immune to similar creeps in scope.

Scope creep can cause a number of problems:

  • Extra costs
  • Tension in the client-consultant relationship
  • Time delays
  • Incohesive work products
  • Consultant frustration and fatigue

Consulting projects can be quite successful with certain changes to requirements or scope, as long as these changes are formalized and are implemented with effective communication between the consultant and the client. When changes are unaccounted for or unmanaged, that’s when they become scope creep.

It’s easy to blame scope creep on the client. It might feel natural to think the client is demanding or that they’re intentionally trying to take advantage of you. In reality, scope creep is as much the consultant’s blunder as it is the client’s.

There is an art to balancing good service and preserving your time and your bottom line as a consultant or freelancer. This involves both prevention and mitigation strategies.

Strategies for preventing scope creep

1. Understand your client’s needs

Understanding what your client needs is the most important and effective way to prevent scope creep. There can be a sense of urgency among both clients and consultants to get a project started quickly and to get a contract signed ASAP. Don’t rush this part.

Take the time you need to find out why your client is hiring you, what they want and need (which might be two separate things), what their budget and time frame are, and what their expectations are.

Starting on the same page doesn’t mean you’ll remain on the same page, but it certainly increases the chances that you will.

2. Develop a contract with a detailed statement of work

Once you fully understand the client’s needs, you can develop a proposal for how you’re going to address their needs. Use a written contract with a statement of work (SoW). This is the document you can go to later to show the client what is and is not part of the agreed upon project.

Don’t leave room for misinterpretation.

Some freelancers include a section in the contract about “unforeseen circumstances,” including how they will be addressed and how they’ll be billed. For example:

Additional services requests will be billed at the rate of $150 per hour.

Your contract can also include a list of what are considered to be “out-of-scope activities.” For a medical writing project, these might include graphic design or publication planning.

3. Start small with new clients

With new clients, you may not know what it’s going to be like to work with them. Consider breaking down a larger project into smaller chunks. Then you can revise your contracts, your approach to statements of work, and your fees for subsequent chunks. If need be, you can also decline any further work after the first small project is completed.

4. Form a project plan and schedule

You don’t need to tell your client every detail about when and how you’re completing your engagement with them. You’re a consultant, not an employee, after all.

What you should do, though, is give them a broad overview of how you plan to complete the engagement and the schedule you’ll be using with the project broken down into parts. That way, if scope creep becomes an issue, you can refer to your plan and schedule to demonstrate how a new or changing request doesn’t fit in.

5. Set boundaries

Scope creep sometimes arises because there are multiple stakeholders from the client side weighing in. Every stakeholder might not always run an idea past their internal team before going to the consultant with a request. You can prevent this by setting boundaries as to with who and how your communications with the client take place.

You may want to request to communicate with a single person at the client company. Or, request that the project manager at least be copied on all email communications. Additionally, you can request to have regular update calls with the team. You can also set boundaries related to how and when you make yourself available to them (ie, not at 3:00 in the morning).

6. Anticipate changing needs and requests

In doing the same type of consulting or freelance work for multiple clients, you’ll start to get an idea of the type of scope creep that pops up. As soon as you start to see a trend, begin to anticipate this by adjusting the information you provide to clients up front and the wording you use in your contracts.

Certain features or “gold plating” can even be included in your project proposals, so that clients clearly see that they are not included in the base service and can decide at the outset if certain features are needed.

7. Standardize your processes

Develop standard processes that you use for your freelance projects or consulting engagements. For instance, you might require that the client sign off on different components of your work as the project progresses. Or require a formal regroup any time new staff become involved. You can also create a formal project close-out form or process so that all stakeholders express agreement that a project is over.

While physician consulting jobs are services rather than products, it can be helpful to “productize” your services as much as possible.

8. Do a self-evaluation at the completion of an engagement

After everything is said and done, it’s worth taking a few minutes to reflect how a project went from your perspective as the consultant. What went great? What was a learning experience that should prompt you to change something the next time around? This helps scope creep become less creepy the more work you do.

How payment structure can influence scope creep

Taking steps to prevent scope creep isn’t about nickel and diming your clients.

That said, physicians typically undertake consulting or freelance work to either help them reach financial independence or out of a desire to use their skills to help people or organizations. Preventing scope creep assists with both of these: It ensures that you’re adequately compensated for the work you perform, and it helps you to address the client’s needs in a manner that fully utilizes your expertise in a well thought-out, organized manner.

You can set high fees in anticipation of scope creep, though this may limit the number of clients or engagement you get.

For physician consulting jobs that are done at an hourly rate, scope creep tends to be less of an issue. You simply bill for the time you spend on a project. However, per-project rates are better than hourly fees for many types of side gigs (especially medical writing). If you have a client that you know is “wishy washy,” you may want to consider hourly work. Otherwise, in most cases, I don’t recommend resorting to an hourly rate to avoid scope creep.

Strategies for mitigating scope creep

Despite your best scope creep prevention efforts, you may find yourself in a situation in which scope creep emerges. This is where strategies for mitigating scope creep can be helpful.

1. Change the statement of work

A great response to a client’s request for something outside of the scope of the engagement is:

Yes, I can do that! We’ll just need to adjust our contract, as that wasn’t included originally.

Once the client hears this, they will either realize that their request is outside of the project scope and say “never mind,” or they’ll work with you in adjusting the agreement.

It’s important to understand that customer needs actually do change. It may not be that your client is rude or disorganized. Their needs may have simply changed for any number of reasons.

2. Follow a clear process

If they want to move forward in revising the contract, be sure you fully understand their additional request or how they’re needs have changed so that – hopefully – this revision will be the only revision. Then, renegotiate the terms.

Develop your own process for how you make this happen. By being consistent in your actions and communications, you’re more likely to gain the client’s respect and have documentation of why and how various decisions were made.

3. Set things straight at the first sign of scope creep

You may be able to identify the cause of scope creep as soon as it happens. If so, take steps to make sure that any underlying issues are addressed before it happens again.

For example, if new client requests began popping up right after a change of staff within your client’s company, perhaps it’s because you didn’t take the time to have an introductory call with the new staff member who became the point person for your project. He or she might not understand the project background or didn’t know about previous conversations that took place.

4. Maintain a mindset of a partnership

In the setting of scope creep, it can be tempting to think about “you” versus “them” as your bottom line gets eaten away. Remind yourself that both you and your client have similar goals. They have a need, and you have the expertise to assist them with it.

5. Accept your decision

Whether you respond to a request by taking on extra work, revising your contract, or saying “no,” be accepting of your decision after it’s made. Don’t do the extra work begrudgingly. Do it with the same level of thought and effort that you do the rest of the project. The high quality of your work will be apparent and will probably be appreciated.

Finally, know when your client is simply asking for a favor that is outside of the project or engagement. The client may realize that a request is not within the statement of work. They may not be intending to add bloat. They may be simply asking for a favor because they value your expertise and your insight – a favor that you may want to do for them to strengthen your relationship. Differentiating between the two rather than assuming the worst will benefit you in the long run.

The hidden benefits of scope creep

Scope creep is exasperating while it’s taking place. Nonetheless, in many situations, you can benefit from it. Here are several ways:

  • Expand your portfolio or skillset. Scope creep may involve you stepping outside of your comfort zone, doing a type of work or task that you haven’t done before, or learning a new skill in order to meet the client’s needs. While this may be unanticipated and unwanted in the midst of an engagement, your new experience and skills can be used to your advantage for future projects.
  • Improve your communication skills. Your project’s scope creep likely took place because either your verbal or written communications (or both) with the client weren’t ideal. You can learn from this and improve your communication skills in subsequent projects.
  • Strengthen your relationship with the client. When you “overdeliver,” the client will be pleased. By accepting some amount of scope creep, you’re increasing the changes that they’ll be satisfied with the results and want to work with you again in the future. Just be sure that you follow the scope creep prevention strategies described above for your next engagement.
  • Optimize your processes. Addressing scope creep gives you an opportunity to reflect on the processes you use in your work and optimize them for your future work.

Calling off physician consulting jobs when scope creep gets out of hand

In the vast majority of physician consulting jobs, the scope creep prevention and mitigation strategies described above will be more than enough to set a project on the right track. From time to time, though, you may get a project for which the scope creep gets out of hand and becomes seemingly unstoppable.

It’s okay to say no.

There is nothing wrong with tactfully telling the client that their request is outside the scope of the project.

That said, you should offer a way to help the client with their request. There are a few ways to do this:

  • Suggest making a revision to the statement of work
  • Recommend an alternative to the request that is not outside of the project scope
  • Make plans with the client to include that request in your next engagement
  • Provide information or training that would allow the client to complete their own request

By using these tactics, you’re providing viable alternatives and assistance, rather than a simple refusal.

If even these techniques don’t curb the scope creep, make a note to yourself that perhaps this particular client may be better served in the future by a different consultant.

Scope creep while working with a team

This post focuses on scope creep that arises during physician consulting jobs and freelancing work, in which you’re most likely working solo. But it is also rampant in team projects or any business that does consulting-type work for client organizations. These include the work done by business consulting firms and health IT companies as just a couple examples.

For physicians working on this type of project, there are a couple additional things to keep in mind:

Any team member can let scope creep into a project. For this reason, it’s important to have a project manager, or at least a designated point person to whom client communications are directed. In most cases, this shouldn’t be the physician on the team. In a team setting, you may have the luxury of limiting your involvement to providing medical or clinical expertise. When you receive a communication or request from the client side that smells of scope creep, deflect it to the project manager.

As the medical expert on a team, you may be communicating directly with high-level leaders and decision-makers within the client organization. Their status doesn’t mean you need to automatically say yes to their requests.

There are as many opinions as there are members on a team. What one member considers to be an acceptable client request might be glaring scope creep to another team member. Differences in opinion result from different roles, experience levels, involvement in prior projects, and methods of working. To limit the impact of these differences, ensure that all team members are informed about the project scope of work up front. It’s also helpful to have a team meeting to kick off the project and get everyone on the same page.

Creep can be insignificant in the grand scheme of things

In freelance and consulting work, some projects are home runs. Others are financial losses, which you can call “learning experiences” to try to make yourself feel positive about them. Considered together, however, all of the projects or client engagements you complete over the course of the year most likely represent a successful, profitable side gig. When this is the case, don’t get down on yourself about a bit of scope creep. Consider your consulting business or freelance portfolio as a whole.

Some projects will cause you grief, but enough other projects will feel like a walk in the park to make up for it. One project may feel like it wasn’t worth your time, but others will leave you impressed with the value of the service or expertise you can provide.

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