понедельник, 17 апреля 2023 г.

Diagnosis and Treatment in Leadership

 







I’ve long valued Bryan Whitefield’s insights and guidance on risk and adaptive leadership matters, and his recent article (highly recommended) on diagnosis and action at the Self and System levels, reminded me of another broad parallel I had noticed between health service and leadership concepts and processes.


Diagnosis Precedes Action in Leadership

Whether you are planning to lead on tackling a problem in your organisation or an opportunity to improve your own leadership, diagnosis comes first. A mechanic should not start stripping the engine before conducting some diagnostics. Nor should you buy a personal development book without asking yourself what type of book might serve you best.

In The Practice of Adaptive Leadership, Heifetz et al makes the point very clearly that there are two core processes to leadership. Diagnosis and action. And that diagnosis precedes action. They present a 2×2 matrix showing the four different positions you could be taking in your leadership role. I have gone one step further and named the quadrants with the key action you should be undertaking in each. See Figure 1.


I remember one poignant moment early in the program that brought home to me that I was in a leadership DEVELOPMENT program, and not a program to reward only my exceptional leadership.

We were split into teams and I was picked by the team as team leader. We also had to pick a deputy leader. I quickly nominated a person in the team who I liked and had developed some respect for. There was immediate rebellion in the team and I was quick to learn that while they had elected me their leader, they had not elected me as universal decision maker on all things affecting the team.

The learning curve had begun. I was in a Leadership DEVELOPMENT Program and the diagnosis had started!

Stay safe and adapt – quickly.

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The ‘standard’ treatment process used by health practitioners includes diagnosis as one step in a sequence, preceded by taking a history of general health and other significant developments from the patient. Having identified the patient’s context and purpose in attending for treatment, the examination can be completed, with an eye to identifying the root causes of any presenting condition, along with any other issues not necessarily identified or recognised by the patient.

Once these processes have been completed, a diagnosis may then be determined, and in the light of that, a proposed treatment plan or options for treatment can be presented to the patient before obtaining consent to proceed with treatment. Following treatment, the practitioner and patient review the outcomes, and this forms part of the context for the next visit at some future date (where appropriate).

In my experience, governance and management approaches to strategy, risk, and execution issues involve a similar sequence of steps and processes – albeit with different names, and some additional considerations and activities required for each of these domains.

I have found it helpful in discussions with some of my mentees and clients who have a health background, to use the treatment process as a metaphor for their non-profit governance and/or management roles. Given the simplicity of the model, it may be relatable by people in other fields as well.


The chart above includes simplified parallel sequences for each of Treatment, Strategy, Risk, and Management Decision Processes. ‘The map is not the territory‘ (Alfred Korzybski ) is certainly true of these flowcharts, as they reduce a multitude of process variations into a ‘straight line’ summary – and such simplicity rarely exists in reality. Nonetheless the comparability of methods used for different purposes illustrates the importance of gathering and analysing all relevant data (looking for the ‘signal in the noise’) before completing a diagnosis of the problem or issue.

This stepwise approach is also similar to the knowledge management model DIKW (modified by my addition of the Decision, Action, and Reflection levels), illustrated in the header image above.

If your directors are not familiar with strategic, risk, and decision process steps, you could try using a metaphor such as the health treatment process to introduce them to the core concepts.

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