Find and fix problems, not symptoms

I’ve had my share of medical interventions over the last ten years – sometimes, I feel like I’ve had more than my share. My experience with the medical practitioners I’ve interacted with is that they tend to focus on the symptom the patient presents with. That is what they treat, particularly as that is often their specialisation. A knee surgeon will look at the problematic joint because that is where the patient reports the symptom. That makes sense, right? Doesn’t it? What does this have to do with the broader work and life sphere? What if this is the wrong approach?

I’ve written in other blog posts about how our biases shape our worldview and responses. This area has been beautifully explained in Danny Kahneman’s “Thinking, Fast and Slow” and many other equally relevant behavioural psychology and behavioural economics works. We use our experience and our mental shortcuts to make quick determinations so that we don’t have to waste valuable resources on a problem we already know the answer to.

Often this works well. For example, typically, we take the most efficient route from home to work without thinking about it every day. We know that traffic will be heavier on certain streets, and we avoid them at certain times of the day. We don’t sit into the car every morning and make a conscious decision to follow our usual route – we’re often halfway to work before we think about driving.

In the medical arena, when a patient presents with an inflamed, irritated, or debilitated knee, a knee surgeon will focus on that joint. They will order x-rays and perhaps MRIs and determine whether more direct surgical intervention is required. The patient may or may not get relief over time from the symptoms, but the surgeon will have treated the immediate crisis. This commentary is not a criticism of the medical profession but an observation – patients are often treated as a presentation of symptoms and not a holistic system. But people are not symptoms, and symptoms are not the root cause of an issue. In the case of knee pain, the problem might be due to poor footwear, an opposite side hip dysplasia, or a gait issue caused by lower back misalignment. Over time, biomechanically incorrect use of the knee joint will cause wear and tear, which leads to the symptoms. Again, what presents is the symptom, not the root cause.

In other areas of work and life, the same is often true. For example, in the technology arena, production outages of a system are often attributed to human error. An operator makes a change, and the system breaks. The operator may have failed to check inputs or follow documentation adequately. The prescription is often “more training” or “four-eyes checking” to address the issue. My contention, however, is that in this case, the problem may not be the operator – human error is a symptom. Instead, the problem may be with the complexity of the system design, that the operator has been working 12-hour shifts, or that there is insufficient automation to assist them.

We are often presented with symptoms rather than root causes in our personal lives. If my teenage daughters suddenly start behaving in a more challenging way than expected, it can be easy for me to dismiss it as them “just being rude”. My reaction to that diagnosis is unlikely to be favourable. I need to continuously bear in mind that a teenage brain is an incredibly complex system attached to other highly complex systems that are in an enormous state of flux all the time.

It is hard to look for and find the real root cause of an issue. It takes real effort, diverse inputs and critical thinking. It requires us to look past the surface and ask next order questions. Instead of just asking the typical “why” question, it can also be helpful to ask, “what might I be assuming that is preventing me from seeing what is going on?”. Or “who can I bring in to help me understand this problem?”. We have to take the time to make an accurate diagnosis of important problems. The next time you are presented with something genuinely impactful, it may be helpful to ask yourself, “am I looking at the problem or just a symptom?”. That question alone may help us make better decisions.

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