Principle-Centered Leadership

by Stephen R. Covey

Diagnose Before Prescribing


We must first understand the problem before
we can effectively address the solution.


Think of the simple, self-evident principle of quality: Diagnose before prescribing. How many managers and executives have been guilty of rushing to implement solutions before really understanding the problem? We are so sure, so often, that "based on experience" we understand the "root cause" of the dilemma or opportunity we face, that we immediately prescribe the right cure or action plan.

Let's suppose you walked into an optometrist's office complaining of headaches and slightly blurry vision. How comfortable would you be if the optometrist immediately said, "Here, try these glasses; I think this prescription is just what you need."

What's wrong with this scenario? It's obvious: We wouldn't trust an optometrist or other professional who prescribed before diagnosing. Before we trust the prescription, we must trust the diagnosis.

The fifth of the Seven Habits is, "Seek first to understand, then to be understood." All quality measurements and process improvements are based on this principle: We must first understand the problem before we can effectively address the solution or opportunity.

The traditional tools of quality analysis-control charts, Pareto diagrams, fishbone diagrams, scatter plots and others-are used to first understand the problem or system, the nature of the root cause and the cause-effect relationships. Once the requirement to understand first and prescribe second is established, it is hard to understand how such a simple principle could be violated.

And yet, has it been that long since business began to really listen to their customers to first understand their needs?

Today and in the future, even broader applications of seeking first to understand, then to be understood will be required for ever-increasing quality performance. Business, educational and other institutions will need to develop comprehensive Stakeholder Information Systems to gather 360° feedback from all key stakeholders.

Who are all the important stakeholders to your organization? What are their primary needs? How well are the results you are producing-and will produce in the future-meeting their needs? Not your opinion-but theirs.
Organizations will need more than ever to understand and prioritize their stakeholders' needs. Consistently gathering, honestly interpreting and then acting positively on this data takes great courage, commitment and creative synergy. The quality of our relationships also requires practicing the principle of "diagnose before prescribing." In our families, among our friends and at work, we usually don't really listen with the intent to understand. We listen with the intent to reply.
Especially under stressful circumstances, when discussing complex issues with our loved ones, the way we "listen" is to "prescribe before diagnosing." We jump to conclusions, attack the speaker's views and defend our own conclusions before really deeply understanding. We interrupt with our own commentary, complete the speaker's sentences, jump to agreement or disagreement, give advice and ask probing questions that the speaker may really not want to answer. This scripted behavior does not build trust in our relationships any more than would a physician prescribing medication before giving the physical exam.

The "root cause" of our behavior is the unconscious paradigm of, "I already understand you, so I don't really need to listen to understand you." We need to retrain our very thought processes. In every conversation, every discussion, every meeting, we need to adopt the paradigm of, "I probably don't really understand you, and I need to listen."

Empathic listening is a powerful proc-ess to greatly enhance the quality of our interpersonal verbal communications and relationships. It includes the essential attitude of, "I truly respect and want to understand you." It favors summarizing, at appropriate times, both the content and feelings of the speaker. We "close the loop" in communication-the speaker knows the listener has understood through the listener's focused demeanor, body language, word choice and periodic summary of what the speaker says. Listening empathically provides "psychological air" to the speaker, encourages openness and builds trust.

Try it today. Critically assess your own listening habits, professionally and personally. Do you listen with the intent to reply, instead of to understand? For higher quality and trust, seek first to understand. Diagnose before you prescribe.


About the author
Stephen R. Covey is chairman of the Covey Leadership Center and author of Principle-Centered Leadership and the 7 Habits of Highly Effective People.

Keith A. Gulledge is vice president and senior consultant with Covey Leadership Center's Professional Resource Group.
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