Don’t settle for one ‘why?’
Don’t settle for one ‘why?’
Learning to ask about the ultimate cause when something goes wrong in your business.

A deep human need, perhaps the one that stands us apart from animals, is the need to understand why things happen. Throughout most of history and all of pre-history we saw magic and vengeful gods as the usual suspects. Now we like to think of ourselves as rational beings interested in facts.

But only up to a point. Curiously, even though dentists are trained in evidence-based science and presumably enjoy it, they behave like everyone else when it comes to business. They unintentionally demur from observation. When something goes wrong they are satisfied with the proximate cause and don’t ask about the ultimate cause.

For example, if Karen your business manager quits you might say, “She always thought she wasn’t paid enough, that’s why she left,” and it may be true, but by stopping your investigation there and not delving into further complexity you are missing richer, valuable insights. You’ve settled for the proximate cause.

A proximate cause is the one immediately responsible for causing an event. Wikipedia cites a ship sinking. Proximate cause: hole under the waterline. Ultimate cause: the ship hit a rock. If you dig deeper, the ultimate cause becomes a proximate cause for a further ultimate cause.

Why did the ship hit the rock? Because it didn’t change course. Why? Because the ship was under autopilot and the autopilot’s data was inaccurate. Why? Because the shipwrights made mistakes in the ship’s construction. That’s three more whys.

As you dig it gets harder, more complicated, and there is less and less direct evidence at hand. So it’s understandable when people prefer to settle for a simplistic explanation that enables them to move on without losing face and easily communicate what has happened in a soundbite.

Yet fighting these urges can produce amazing results. The guy who famously really got this was Taiichi Ohno. He pioneered a new production system at Toyota in the 1950s that encouraged workers to ask “why?” five times when something went wrong. Ohno saw a problem not as negative but as “a kaizen [continuous improvement] opportunity in disguise”.

He told his workers: “Observe the production floor without preconceptions. Ask ‘why?’ five times about every matter.” Imagine if you did this in your dental practice. What would you discover?

Once a dentist and I were in discussion at a tradeshow. She pointed out to me that “dentistry is really simple, it’s just about bums on seats”. Well OK, maybe. Without patients there is no business. However, as dentistry is evolving from the single-handed practitioner to effectively run organisations with genuine profitability, I’d suggest there’s much more to it. As the scale of businesses increases so does the opportunity for reward, but so does the complexity and risk, and if you don’t embrace it you’ll never know what you’re missing.

If you’re interested in a deeper dig into your business to start your own kaizen culture we can help you take the first step — get in touch to see how call 01872 300232 or email us at

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By Dan Fine Management Consultant
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