Answer 5 Questions to Solve Any Problem

Kaizen, or continuous improvement, is a very interesting Japanese productivity philosophy. It helps minimize waste related to time, money or effort.

One component of Kaizen is the “5 Whys,” which can be used to explore the cause-and-effect relationships of any problem. This concept can be used by major corporations (Toyota is notorious for that) as well as veterinary practices.

The 5 Whys sequence is a technique that can virtually solve any problem. Here is a common illustration of this sequence in action:

Problem: Your car won’t start.

Why #1? The battery is dead.

Why #2? The alternator is not working.

Why #3? The alternator belt is broken.

Why #4? The alternator belt was worn out and not replaced.

Why #5? The car was not serviced according to the manufacturer’s maintenance schedule.

So the lack of proper maintenance seems to be the cause of the problem. Almost invariably, the 5 Whys lead to a broken system. In this case, the person in charge of the car’s maintenance failed or wasn’t properly trained.

Let’s take a common veterinary situation: no matter what you do, you are behind schedule. You feel efficient, yet it seems that you always see clients 15 minutes after their scheduled appointments.

Alone or with a few key people, you describe the problem:

• The vets are frustrated because they’re always late.
• The clients are frustrated because they’re waiting longer than expected.
• The receptionists are frustrated because they have to deal with angry clients.
• The nurses are frustrated because they constantly have to fix mistakes made by the assistant.
• The assistant is frustrated because she thinks she’s doing a good job, yet nobody seems to be happy with her performance.

Let’s put the tardiness problem through the 5 Whys process.

Problem: We constantly run behind schedule.

Why #1? Why are we constantly behind schedule?
Because clients aren’t being brought into the exam rooms when veterinarians are ready for them.

Why #2? Why aren’t clients being brought into the exam rooms?
Because the exam rooms are not ready. They’re not being turned around quickly enough.

Why #3? Why aren’t the exam rooms ready?
Because the new assistant is too slow and doesn’t do it like the previous assistant had. She does things the way she did at her previous practice and thinks that’s perfectly fine. Everything has to be fixed after she is done.

Why #4? Why doesn’t the new assistant prepare the exam rooms correctly?
Because she wasn’t trained properly.

Why #5? Why wasn’t she trained properly?
Because we were so busy when she was hired, that we didn’t fully train her to complete her tasks correctly and efficiently.

The result of this little exercise led to the root cause of the problem. It’s not a personality or attitude or IQ issue. It’s a training issue. Now, the new assistant can be trained properly. She can do exactly what is expected of her. In turn, the initial problem (We constantly run behind schedule) will get resolved. Bonus: future assistants will also be trained more effectively.

Note that if the answer to the first “Why” had been “because clients are always late,” it would have led you down an entirely different path and toward a completely different solution.

The 5 Whys can be applied to virtually any problem you are facing:

• to make a financial decision with less emotion
• to help with a personal or family situation
• to make a career change that doesn’t rely on a gut feeling
• to solve a workflow problem in the practice
• to improve a physical or mental health situation.

Give the 5 Whys a try. The root cause is a broken process. Once it has been identified, it can be fixed once and for all.

Phil Zeltzman, DVM, DACVS
Meredith Jones, DVM
Co-Founders of Veterinary Financial Summit