The short version-
Innies work within an organization, while the outies are brought in for projects
Handwork is when the consultant is creating, producing work, wireframes, etc.
Brainwork is when the person is hired to give advice, more like a strategy consultant.
The difficulties arise when either a company doesn’ t know which kind of work they need, or they hire someone to do handwork, when really they need brainwork, or the person hired to do handwork has a great ‘brainwork’ idea but isn’t listened to. Even worse, the person is hired at brainwork prices but ends up wasting their talents on handwork.
It is up to the project managers and hiring managers to be sure they not only know what the project and team need, but also that they hire the right person at the right rate.