The Five Whys: A Logical Approach To Problem Solving In The Podiatry Practice

I would venture to say there are a number of us who have occasionally struggled when it comes to solving a problem and finding the right answers is not always easy. Neither is worrying about it or ignoring it. In fact, it’s true that running away from a problem essentially increases the distance from a solution. The surest way to escape from a problem is to solve it. The question becomes: how do we do that?

It is entirely possible I’ve been hanging around my grandsons a little too much, because personally, I think that in their infinite young wisdom, toddlers are actually on to something. Their inquisitiveness, which sometimes comes across as slightly irritating, actually has merit as a full-fledged, logical interrogative approach to problem solving. It involves simply asking “why?” over and over again until you expose the principal cause of the problem. Now the suggested strategy is to ask the burning question at least five times (an arbitrary number that in most instances seems to do the trick). However, I’ve experienced success with fewer/additional inquiries so it is best to focus more on the technique rather than the number.

It is not unusual to find that some problems are multilayered, having a related root cause. If you can kill two birds with one stone, consider it a bonus. Such is the example below.

Problem: Our patients keep arriving late, causing us to always run behind schedule.

Why?  

1) We never say anything to them. We see them regardless of what time they arrive.  

2) They face no consequence for arriving late for their appointment.

Why?

1) If they do come on time, we’re usually not really ready to see them.

2) We’ve never taken the time to educate patients about our schedule.

Why?

1) Our doctor cannot effectively see six patients every hour and still stay on time even though we schedule that way.

2) We don’t consistently follow our own policy.

Why?

1) We schedule according to the six available slots per hour in our appointment book.

2) Our policies are outdated and carry little weight.

Why?

We never stopped to determine how long each patient really takes. If we did, we could schedule more sensibly and stay on time. Furthermore, if we stay on time, applying reasonable late policies (consequence) would influence patients to arrive on time.

Resist attempting the “Five Whys” approach on your own. Why? It is far more beneficial to get team input and support. Why? An office problem calls for an office solution. Why? If it affects your office, you should consider adding it to your next staff meeting agenda. Why? You have to identify by consensus, an office problem, frame it in one sentence and outline it in question-answer format as shown above. Why? This allows you to visualize the problem, formulate necessary action steps, delegate responsibility and develop a solution.

As I’m writing, my recollection as a child is when I asked why repeatedly. My dear mother’s response was: “Y? Because Y is a crooked letter!” Apparently, I was an inquisitive child.

Recap: Asking why is step one. The problem shouldn’t control you and commitment to this simple exercise gives you influence over the problem. You should try it. Why? To succeed!