Assessment

The ‘A’ in SOAP stands for assessment.  This may be a single assessment if our subjective and objective work has really narrowed the field of possibilities and no dangerous diagnoses remain on our list, but more often, it is a differential diagnosis.  I think that a broad differential diagnosis is not kept in mind often enough in medicine and certainly not in life.

One of the most common problems diagnosticians have is that of premature closure, or the narrowing of diagnostic possibilities too early in the process of evaluating a problem.  In medicine, this leads to delays in the diagnosis and treatment of the true underlying issue, which at best is costly and at worst, deadly.  We can see this pattern in our home lives and in many other industries.  For example, if we decide that our bored child feels that way because he hasn’t got enough exercise recently, we may make a plan to go on a bike ride together.  The true problem may be that he pulled a muscle climbing over a fence but is scared to tell you about it.  The bike ride may actually worsen his injury and cause more harm than good.

Consider the problem of being overweight.  Some people decide that they are overweight because they eat too much and don’t exercise enough.  This is simplistically true, but it often comes along with a whole host of other assumptions – that they are lazy, that they lack self control, that they are not disciplined etc.  The truth may be that they have an underactive thyroid, or that they have never learned how to feel their feelings and therefore use (unconsciously) eating as a mechanism to distract from that or that they use weight to protect themselves from undesirable attention.   Premature closure in the area of being overweight leads to yo-yo dieting, failure to seek medical attention to rule out contributing medical issues, failure to identify emotional work which may need to be done in order to approach weight in a more productive way and of course failure to achieve a healthy weight.

In business, failure to keep a broad differential diagnosis for why a product is not selling or a strategy is not working leads to very expensive detours.  If the true cause of a problem is not on your list, you will be very unlikely to solve it.  Especially in business, creating the differential for the problems you are having likely needs to be a team effort.  Impressions from all areas of the business may need to be collected and synthesized before the problem can be truly understood.  In order to foster an environment where this can happen, all parties need to be in touch with their creative selves, free from fear that if the problem turns out to be caused by something they are doing that this will lead to retribution and recriminations.

Comments

I would love for you to leave a comment about a problem you are working on understanding better and your thoughts on this series of posts.