Consulting is a dangerous business – maybe never more so than now

If I asked you to name one of the most dangerous healthcare companies in the world (assume ‘dangerous’ refers to potential long-term damage to doctors and patients), which company would you choose? OpenAI. Meta. Google. Apple. Any EMR software vendor on the planet. Any pharmacy benefits manager in the universe. Any health insurance company in the galaxy.

Go on. Keep thinking. Probably a ton of companies that I haven’t mentioned and an equal number that I’ve probably never even considered.

Some US state attorneys general and the US Justice Department want us to believe that the answer to the question is McKinsey & Company. Old news you say. Indeed. You are right. McKinsey has paid nearly $1bn in settlements for its role in the opioid crisis over the last few years.

Over the last few months, however, there has been a resurfacing of news related to the company during that crisis. In April 2024, several news outlets reported that McKinsey was under criminal investigation by the US Justice Department for helping clients devise ways to accelerate opioid sales.

There are plenty of examples that shed light on the company’s questionable business practices and motivations. In 2021, Multnomah County in Oregon, the state’s most populous county, which includes the city of Portland, sought to hold fossil fuel companies and their ‘misinformation agents’ accountable for the unprecedented 2021 heat dome that saw temperatures in the county reach 116º Fahrenheit (46.6º Celsius). One of those misinformation agents was McKinsey.  According to another lawsuit, Paine Schwartz drained over $24m in cash from the largest peach farming outfit in America in less than four years and used its control of that company to enrich McKinsey, which had long-standing ties to the investment firm. The company has also been implicated in racketeering lawsuits, settled lawsuits over excessive fees and worked with Big Tobacco (need I say more).

Consulting is a tough business at the best of times. You’ve got to earn your fees and then you must earn more fees. And to earn more fees, you need to think about new tactics and projects that could potentially earn you those fees.

Let’s be clear: I’m not a lawyer. I haven’t seen the charges or accusations, or any paperwork related to these cases. And most importantly, I’m not trying to defend any criminal behaviour if it took place.

However, on the basis of what’s been reported, which is that these companies helped their clients maximise the sales of opioids and develop predatory and deceptive marketing strategies, there must be incontrovertible evidence that this was done with malice and with the full knowledge that this was harmful or lethal to patients.

Otherwise, we have a problem.

We have a problem because we must go after all the aforementioned fossil fuel companies and their misinformation agents for failing to inform us about the ravages of climate change brought on by their industries. And we must also go after all the social media companies and their misinformation agents for creating addictive social media platforms and helping to fuel and maximise the screen time of young adolescents, which we know is harmful to a developing brain.

We must put the food industry and its coterie of consultants and ad firms in our crosshairs too because they’ve been feeding us deceptive marketing strategies for decades about the role of trans fats and fructose and other lethal ingredients in its products. Let’s not forget that we’re definitely going to have to sue the fast-food companies and their merry band of ‘misinformers’ too. Haven’t they been knowingly brainwashing us to fuel the sales of their hamburgers, fries and desserts, despite knowing about the ever-growing obesity epidemic?

Maybe we should sue the cell phone manufacturers and their misinformation agents too. Encouraging us with free minutes and cell phone plans that have no limits, while knowing there may be a potentially lethal link to low levels of radio frequencies. And we should definitely go after every municipality and county and their consultants for ‘luring’ us to live in their communities while continuing to ignore the known health concerns with lead- and asbestos-lined water pipes that deliver the drinking water in those very same communities.

You all get my point.

Healthcare is a high-profile area. No matter what happens, if it’s related to healthcare, it is sure to garner attention. So be it. If this is our new standard, then let’s make sure it’s applied fairly across the board.

References are available on request.