Instead, I hate the idea of McKinsey: specifically the idea that flooding clients with people who are ‘simply’ really, really smart ignores the simple, headsmackingly obvious truth that experience counts. (To a woman – and for some reason, most of the people I know and like who were once in McKinsey are women – these people are whipcrack smart, hope-my-kids-grow-up-like-that smart. And young. Smart and young. But that’s not a reason to hate anyone. Envy, sure, but not hate). And I hate the way that that idea has infected, infested Pharma, strangling it of innovation and smartness. Which other industry could boast such a collection of really highly educated experts and then proceed to strangle it with really dumb process?

The McKinsey way (not perhaps the way that they describe it in the book) suggests that every problem is like another one, and that its solution lies in process. Oh, they love process. The kind of process that anyone who’s smart enough can run. The kind of process that will suck in the experience that already exists in a company, mangle it until it looks less recognisable, throw a lot of time and energy into market research and, one large bill later, some really smart people will give you ‘the answer’.

So what? I hear you wonder… Well, the ‘so what’ is that while the processes are great at giving an answer, it is rarely the answer. But by then, you’re several months in and several big numbers of dollars later, and, well, it may be your fault if you disagree with ‘the answer’ so better to go with the flow... This is not the fault of the smart people. It is the fault of an organisation that believes that process is something that you, like some observer of a 1960s mainframe computer, should sit back and wait on, while permutable really smart people tend to the machine. Just… don’t… touch… the… machine…

Without respect for the craft you have a building that might look like a strategy, but it’s made of breeze blocks and glue, ready to fall apart at the first test.

Mike Rea

So, I’m calling this emperor naked. Without respect for the craft, the discipline of strategy, you have a building that might look like a strategy, but it’s made of breeze blocks and glue, ready to fall apart at the first test. Appears robust and hefty, but is like the first of the three pigs’ houses. And what is getting blown away every time the wolf puffs are the things we care about – the great drugs, the innovative companies.

I have yet to see a McKinsey answer fall outside a camp of ‘d’uh’ (‘really, it took all this time and money for you to tell us that..?’) or ‘huh?’’ (‘what? No, really, what do you mean..?’). That’s the thing about processing strategy. You get the same answer if you run the same process. Without creativity and experience, you don’t get strategy. So, if you specifically exclude both, what do you expect is going to happen? Anything good?

It is at this point that I should declare that it’s not just McKinsey – it’s all the generalists, the management consultancies. I just chose them because they’re the lead dinosaur in the pack. Actually, scratch that – they’re like parasites on that lead dinosaur: dependent on, but responsible for, its death. Parasites that can turn saprophytic…

One memorable interviewee for a role with us: something senior in the ‘Market Access’ department at McKinsey. Really smart. But, seemingly really incapable of explaining exactly what he did. ‘Can you explain Value Proposition to me?’ I said, expecting at least that would be a home run for him. (He, by the way, is not one of the ones that I like. But he’s also not a woman). Nothing. Nada. Some waffle and some diversion, but no Value Proposition explanation. Turns out that it isn’t something the ‘Market Access’ team there does. ‘How might one get Market Access if one doesn’t have a Value Proposition?’ I asked. ‘Well, you’d do MR with payers and…’ We didn’t get far after that. (That didn’t stop him asking ‘I’m about to be made Partner here at McKinsey. What could you offer?’ ‘Well, we don’t have hierarchies – you’d be expected to deliver to clients, not manage other people who do.’ ‘So, what, no Partner positions?’ Maybe not so smart, after all).

But doesn’t that just illustrate how wrong the idea of McKinsey is? That you could take any old TPP that your client gives you, ask a hundred payers what they would pay for it, package up the deductive result and then hand it over as ‘strategy’ demeans the discipline, the craft of strategy.

And, it illustrates another thing: that if you promote someone out of a job they’re starting to get good at, for the sake of ‘career progression’ you just promoted them into a job they may not be able to do. Which both diminishes the role you’ve just given them, and means that any chance to develop calluses on your strategy hands is lost. This chap wasn’t a master of Market Access, but was promotable, presumably on the back of being able to sell lots of ‘Market Access’ to an industry that thinks it needs that kind of advice (or is just afraid to rely on its own opinion about how to do what used to be called ‘the basics’). Any recent book on the subject will tell you that what used to be called ‘intuition’ is the result of people who know what they’re doing, doing that thing over and over, practicing it, finding out what works and what doesn’t. Rely on the over-confident ‘intuition’ of a really smart young management consultant all you want, but don’t go expecting great things. Seriously, would you rely on someone who learned to fly a plane during an MBA course, who learned an operation by doing it once at Harvard, who learned to drive by watching his older brother do it (even if he was conferring with several other people who’d also watched their brothers)? There’s a reason those KOLs and people in the labs have been doing it a long time, and will carry on doing it – you get better at stuff when you do it a lot, and that’s not what the management groups are set up for.

Look: I know that some people use them because it is easier to use McKinsey (or one of the other management groups) than to a) not have any answer yourself, or b) have an answer that might be wrong, so it’s better if they say it – if it’s right, fantastic, you’re a star for managing the project, if it’s wrong, well, you’d think McKinsey would get it right, huh? Safety in numbers, and all that. Well, without a plan, 10 men can see no further than one. In the ‘no-one ever got fired for buying IBM’ paradigm, people don’t get to question the sense in buying McKinsey.

So, 'hate'? A bit strong? You decide for yourself, but I happen to have a passion for the Pharma industry, and it is currently clogged up like an overgrown lake – the bits that McKinsey hasn’t touched yet, like Discovery, provide a lot of fresh water that has nowhere to go because the bit the management groups have tied up is failing, hidebound with templates, processes and acronyms that sap value, sap life and sap innovation. Process hates innovation the way that pigeon holes hate irregularly shaped parcels. So, yes, I hate it every time an interesting drug is squeezed through some Target Opportunity Profile to fit a Target Product Profile where its edges are knocked off to be put in front of a rented physician who is asked some really not-smart questions to provide an ‘expected’ NPV that elevates the same old same old over the new to put one more interesting drug into an uninteresting Phase III to die a painful death (before or after launch) – all while patients are out there wanting/ demanding better drugs for the thousand conditions they still have.

Ideas are powerful. If it’s possible to love an idea, it’s possible to hate one. And I hate the idea of strategy as a thing you can hand over to any bunch of really smart people to come up with, because, well, the evidence is in, and they can’t. Are we missing some drugs now that could have lived if this idea, the idea embodied in McKinsey, hadn’t been abroad? Most definitely. And I hate that.