Early on the second day of a client engagement, I found myself at the dentist's. The nagging tooth ache that we thought a filling fixed had gotten worse; I needed to be "on" in a couple hours, and was leaving town early the next morning. X-rays were inconclusive about whether a root canal might be in order, so in the time available the dentist got busy grinding and polishing, both of us hoping that adjusting my bite would solve the problem. To distract myself, I got to thinking about how my situation is like some organizations - in pain, and uncertain about what it will take to make the pain go away and be healthy again.

Symptoms

A slight wheel vibration, squeaky part or strange engine sound usually gets worse and causes greater, more expensive damage if ignored or untreated.  I have to admit, I dislike the prospect of dental work enough that I engaged in some magical thinking when my tooth started aching: "Oh, it's probably nothing serious and will go away." It didn't, and that's why I scheduled an emergency visit to my dentist. Customer or employee complaints, unwanted turnover, declining quality or chronic cost overruns are likewise potential symptoms of systemic problems. It's better and less costly long term to face problems squarely than to engage in magical thinking in hopes that they will go away.

Diagnosis

It's tempting, and sometimes makes sense, to start addressing problems with easier, quicker and less expensive options than might be required. Maybe ibuprofen or chewing on one side for a while will solve a toothache. Maybe a training program or time off will alleviate problems at work. When ibuprofen for a toothache or time off in the case of work problems doesn't do the job, it's time to consider the likelihood of more serious problems and more effective solutions.  I couldn't correctly diagnose my toothache, just like it's difficult for managers by themselves to determine root causes of their organization's ills. The operative term here is "root causes." I can't count the number of times that a client initially describes why I'm involved as a "communication problem." Objective assessment work has revealed disagreements about strategy, old "scars" or resentments never addressed, critical skills gaps, unfair treatment, and in some cases bona-fide personality disorders. In-house or outside organization development practitioners are options for objectively diagnosing organizational pain; valid survey methodology is also an effective organizational diagnostic tool.

Treatment

The longer a serious tooth problem goes untreated, generally the more decay that sets in; eventually one could be dealing with an abscessed tooth - really bad news. Continued neglect often leads to health problems elsewhere, and in worst cases can be fatal; the American Academy of Periodontology has correlated poor oral health with rheumatoid arthritis, some cancers, diabetes, respiratory infections pregnancy problems and heart disease. Untreated organizational issues can likewise spread - from group to group and from morale to the balance sheet. More often than not organizations are victims of their own weak spots or untreated dysfunctions than of external forces.

Addressed early, many organizational issues get resolved; communication improves, personnel "rough edges" are smoothed out, appropriate structural changes are made, strategy is adjusted, etc.  Fortunately the dentist's bite adjustments resolved my toothache; if it hadn't, a visit to the endodontist for a root canal would have likely been the next step. When might a "root canal" be right for an organization, and what would that look like?

A conventional root canal is oral surgery.  An organizational "root canal" is surgery of sorts too; it must be properly diagnosed and executed. As it turns out, our tooth roots are pretty deep and complex; decay must be "rooted out" wherever it exists, otherwise problems persist and get worse. An organizational root canal requires changing enough so that before long it's not back to business as usual. Tough decisions and choices need to be made and executed. That could involve a radically different strategy and re-designing an organization to execute that strategy; it might involve eliminating or replacing personnel who are very valuable otherwise but too disruptive or disrespectful; it might involve wholesale changes to systems and processes that require further significant organizational re-tooling.

Perhaps long-term organizational health requires a well-planned and executed culture change, transitioning from one that no longer works or won't work for long to new mindsets, systems, practices and personnel. That is a daunting and long-term process, and a subject for a separate article.

Just like regular care and attention to oral health minimizes the likelihood of need for oral surgery, regular care and attention to organizational health will likely preclude the need for an organizational "root canal." Prevention is the best medicine.

A healthy outside starts from the inside.

Robert Urich

A wise doctor does not mutter incantations over a sore that needs the knife.

Sophocles

"Design is inevitable. The alternative to good design is bad design, not no design at all." (Douglas Martin)  

I recently had the opportunity to participate in an excellent webinar about "Service Design" by John Wooden and J Hruby of Fredrickson Communications. Many of the principles that were shared for designing excellent service experiences correspond with my work positioning integrity as a practical strategy for organizations:

Use a whole perspective. John Wooden, Fredrickson's Director of Usability Services, discussed the importance of designing service experiences with not just customers and service users, but those who deliver the service, in mind. If processes are easy for one group but not the other, outcomes will be less than optimal and likely even fail. Similarly, if a process has a slick front door via a website or application, but is really just a digitized version of a process that is outdated or otherwise inefficient, there's only so much that can be done to make the experience a good one.

The best product, service experience and organizational designs appeal to us physically, mentally, emotionally and even spiritually, or artistically - to the whole person. Apple product success is due not only to functional excellence, but to artful design and its "coolness" factor. If we must wait in line for a service transaction, an experience that is appealing - or at least not unpleasant emotionally and aesthetically is preferable.

Merriam Webster's definitions for "integrity" include being "whole", or "complete." Those are important characteristics of not only design integrity, but of leadership and organizational effectiveness. How many times have organizations or leaders missed the mark because they neglected to adopt a "whole" perspective? Examples include neglecting key stakeholders, overlooking or discounting contrary opinions or missing critical market signals.