2021 has already been a banner year for ghSMART and Clearview Healthcare Partners, which displaced Putnam Associates as the top boutique consulting firm in North America. In particular, ghSMART boasted the most satisfied employees, while Clearview Healthcare Partners excelled when it came to leadership and promotions. The Keystone Group also continued its march into the Top 5, while the Bridgespan Group nearly slid out of the Top 10.