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Why you shouldn’t ever start an organisational development process without conducting a proper diagnosis


Brain surgery or aspirin? Treating a patient without a diagnosis

Medical scenario 1:

Diagnosis first, treatment second

Diagnosis first, treatment second

You have been suffering from severe headaches for the last two months. You are worried, so you go to see a doctor and tell him your symptoms.

The doctor listens carefully to your woes and then announces: “What you need is brain surgery.”

What do you think of this suggested course of treatment?

Apart from being rightfully shocked, you would probably be a bit sceptical. How can a doctor possibly know what the cure is without conducting a diagnosis first? How does he know what is causing the problem? What is the justification for this drastic action?

Let’s have a look at a different scenario, this time a less radical one.

Medical scenario 2:

This time you go to see a different doctor about your headaches. After listening to your symptoms she makes the following suggestion: “You should take some aspirin.”

Would you be satisfied with her professional advice?

Still not? What’s wrong now?

Is it possible that the suggested course of treatment feels somewhat superficial? Somehow it doesn’t seem to address the real issue, the cause of the headaches…

How can a doctor suggest any course of treatment without understanding the causes behind the symptoms first?

So the general rule is: diagnosis first, treatment second.

This seems so obvious in medical cases such as the ones above. Yet in the case of organisational development and managers often make the same mistake: they detect the symptoms and they come up with the treatment. All without making a proper diagnosis first.

Corporate examples of treatment without diagnosis

Let us see what treatment without diagnosis looks like in the corporate world.

  • Symptoms: People at the company have seemed very demotivated lately. Engagement is generally low, and a number of key experts have left the organisation in the last half a year. There is some friction between departments. The general atmosphere has been very tense.
  • Solution 1: “Let’s fire manager P.”
  • Solution 2: “Let’s take everybody on a team building session.”

Do either of these solutions sound familiar?

Solution 1 is the classic brain surgery scenario: Instead of analysing the symptoms let’s do something radical.

Solution 2 is like prescribing the aspirin: A superficial treatment that might cause some temporary relief.

So what is the right solution?

The answer is: you don’t know yet. Not without a proper diagnosis. So let’s not to jump to conclusions; instead let’s make an effort to understand the root causes behind the symptoms.

In the example above, lack of engagement and tension between departments in an organisation can be attributed to many factors. As long as we can’t see clearly what is causing the problem, as long as we don’t understand how employees actually feel – why they don’t feel motivated, why they are frustrated with each other – any attempt at “treatment” will be hit and miss.

Why waste our time faffing around with a diagnosis? Let’s get something done!

If you are the manager of your organisation and things are not looking good, naturally you want to act. And act quickly.

Faffing around with an organisational diagnosis can often seem like a waste of time.

However, the good news is that if the diagnosis is done well, it will save a lot of time and money in the long run. You can avoid all the unnecessary brain surgery and ineffective aspirin treatment by taking the time and effort to really understand what is going on in the organisation and then choose the solution which best addresses the root of the problem.

How to diagnose

Diagnosis is, by definition, finding the causes behind the symptoms. So how can we do that? How can we look under the surface?

This is never easy. If you have been working at a company for a while, you will no doubt have become somewhat blind to many aspects of the corporate culture. You are so used to the way things are in the organisation that it is hard for you to begin to question them. In order to see more clearly you will need the fresh eyes of an outsider.

  • Seek input from newcomers or from others outside of the organisation. New colleagues who have just joined the company can offer new insights into old issues. Keep asking for feedback from them: how they see the organisation, what their first impressions of the company are, etc. Another way to gain new insight is to ask external consultants to conduct a diagnosis. Your insider knowledge of the organisation combined with the consultants’ experience with other organisations can help you see beyond the symptoms.
  • Get systematic and focused data. Another reason why management and HR often fail to see the root cause behind the symptoms is that they simply rely on personal impressions. Even though personal impressions are a very important source of information, in a big organisation they can’t replace real data. You might be able to use some of the information from existing surveys (e.g. annual employee engagement surveys, customer satisfaction surveys, etc.). But even better are targeted questionnaires that ask “just the right questions” and which will enable you to see the big picture more clearly. Of course, you need to know what the right questions are – and this is where an external consultant can again help. Interviews and focus group discussions with selected colleagues can also provide you with information. This data can provide you with solid evidence on which to base your diagnosis.

What comes next?

When the doctor finds out what is causing the symptoms, she will have a much better idea as to how to treat the illness, how to make the patient’s “organisation” better.

But even then she can’t just shove the medicine down the patient’s throat. The doctor needs to sit down with him to explain her findings, to gain the patient’s trust and agree on the course of treatment. Because no matter how brilliant the diagnosis is, if the patient refuses accept the findings, or if he refuses treatment, there’ll be no improvement in the patient’s condition.

After having conducted an organisational diagnosis, you are in the same position. Unless you communicate with managers and employees of the organisation honestly and openly about both the symptoms and the diagnosis, the danger is that your “patient” will simply spit out the medicine.

So once you have got the diagnosis, communicate your findings, use your data and your diagnosis to create a willingness for change, and only then work out the actual course of treatment together with the close involvement of key stakeholders.

Even the most brilliant medical diagnosis can’t treat an illness. For a successful recovery good communication, trust and the involvement of the patient is critical.

The same goes for any organisational change process.