In today's New York Times there's an article about breast cancer diagnosis being prone to error. I read it carefully as one of my close relatives has just been told that she has breast cancer. What struck me about the article was the statement that there are
Reports in medical literature of a "wide array of variability" in interpreting breast pathology. "It is not a breach of the standard of care for one pathologist to have one opinion and another competent pathologist to have another opinion," the lawyers said.
"To recognize the problem requires you to acknowledge that there's room for improvement and that some of your colleagues are not really making the correct diagnosis," said Dr. Michael Lagios, a California pathologist"
To diagnose a breast cancer, pathologists look at slides mounted with thin slices of breast tissue.
… At larger hospitals, the findings are often presented to a tumor board, in which a team of doctors from various disciplines reviews the pathology report and develops a treatment plan.
A number of pathology practices around the country also specialize in rendering second opinions.
Dr. Ira J. Bleiweiss, chief of surgical pathology at Mount Sinai Medical Center in New York, said that ideally, all breast cancer diagnoses would be referred for a second opinion. He warns patients and their doctors: "Don't rush to the operating room." …
[The] director [of West Palm Beach V.A. Medical Center], Charleen R. Szabo, said in a statement: "Medicine is not an exact science. Treatment options are based on information available at a period in time. When additional information comes to light, altering the course of treatment may become necessary."
As I read the article I made the connection that that organizational development consultants are diagnosticians. Indeed a book The NTL Handbook of Organization Development and Change came in the mail today for me to evaluate, and Chapter 11 is called 'Organization Diagnosis Phase'.
Turning to this chapter I read that
'organization diagnosis is a collaborative process between organization members and the OD practitioner to collect relevant information, organize it, and feed the data back to the client system in such a way as to build commitment, energy and direction for action planning'
To me that sounded very similar to breast cancer diagnosis but there were two major differences. In breast cancer diagnosis the client is not an equal party in the diagnosis he/she is reliant on 'experts', but there is the opportunity for a second opinion. In organizational diagnosis the OD practitioner is collecting the data and then, according to this book, "diagnosing collaboratively". This is true up to a point, but in most cases that I've been involved in the OD consultant takes the lead in presenting a diagnostic report that offers an assessment of the situation and proffers a way forward. I wonder how many clients then think that they could get a second opinion on the situation from a different OD consultant?
So the questions this diagnosis connection raised in my mind was a) how expert are OD consultants when it comes to diagnosis -surely there is, or could be, just as much variability in interpreting organizational pathology as there is in breast cancer? b) How many OD consultants' clients ask for a second opinion on the diagnosis before 'rushing to the operating room' i.e. acting immediately. Indeed in the chapter I was reading the point is made that 'Today's faster-paced and global business environment pressures OD practitioners to minimize the diagnosis stage'.
Could it be that OD practitioners are misdiagnosing organizations a lot of the time? How would we know given that like medicine
"Consulting is not an exact science. Treatment options are based on information available at a period in time. When additional information comes to light, altering the course of treatment may become necessary."
(In this quote I just substituted 'consulting' for the orginal 'medicine'). But then I wondered how many organizations, with or without a second opinion, are willing to alter a course of treatment even when additional information does come to light. And how many organizationds ask for a second opinion on the original diagnosis further down the line? Would it alter the nature of OD consulting if it had some of the checks and balance that medical diagnosis (sometimes) brings into play?
Naomi Stanford 