• Management by Objectives
• Total Quality Control
• Re-engineering
• Six sigma
• Lean Manufacturing
• 7 Habits
• Servant Leadership

These treatments, and many others, are offered to any company, at any time. They might be appropriate at times if they deal directly with a client's problem. But medicine follows an ancient dictum: Primum Non Nocere - First, Do No Harm.

Is it possible that any of these treatments could be harmful? Could 2 aspirin cause unnatural bleeding? Could a management consulting process cause harm to a company?

Well, some honest pioneers in management consulting say so.

Michael Hammer went public with the startling observation that 75% of re-engineering projects fail. Recently he also said that six sigma kills innovation1.

It is true that many six sigma companies, and six sigma countries (Japan, Germany), experience falling productivity improvement rates.

The rules formulated by Peters and Waterman in their bestselling book In Search of Excellence did not stop several of their exemplary companies from going out of business.

Why would anyone submit themselves to a treatment without a diagnosis?

Perhaps because the diagnosis is always the same. You are judged to be in need of "whatever the current business fashion is". And because it's easier to follow than to take the lead, and if others choose the same treatment, it validates your own choice. All of this puts pressure on CEOs to DO something and not be different from others. Business fashions come in waves. From 1973 to 1995 the U.S. experienced a drop in annual productivity improvement from the post war 3% per year, to a 22 year long drought of 0.9% per year. In my opinion, the business sector lost its productivity focus during that period.

How hard is it to diagnose correctly the ills of a company, or a country?

Most people look for symptoms, and then intervene. They look for cost increases, sales growth, ROI, productivity, turnover rate, inventory build-up, capacity utilization, morale, R & D, leadership, and many other indicators.

And then the symptom is treated: Layoffs to improve almost every one of the indicators listed above. It's the modern version of bloodletting. Then apply the most recent business fashion to treat the rest of the symptoms.

A good doctor will go beyond symptomatic treatment. She will look for root causes: Is there a communication problem in the organization? Is the competition improving at a faster rate? Are we slipping in introducing new technology, employee training, R & D? Is there an imbalance between production and sales? Is our pricing wrong?

An organization usually will suffer from 5 to 7 "diseases". One is usually life threatening to the organization, and must be addressed first. It is imperative to find the root cause of that particular disease, and remove it completely. If you don't, it does not much matter if you address the other "diseases" or not. The organization will not survive.

For every 1,000 companies in the U.S., about 23 die every year. Ironically, that is about the same death rate we see for prisoners awaiting execution on death row.

Management consultants do not attend the business equivalent of Medical School. Some will learn to use a hammer and to them the world is a nail.

Others will be trained by savvy practitioners who know how to identify symptoms, and then address them. Perhaps the company will be better in the morning...

Then there are those who find their way to the underlying causes of the ills of a company. It is like a detective story-searching for clues, building a case, asking the right questions. The difference, I've been told, between good science and great science, is asking the right questions.

A physician is vastly helped by a good medical history of his patient. So is the management consultant. And when the root cause appears, the management consultant has a slight advantage over his physician counterpart.

For the management consultant, the root cause is always the same.

It is always a bad idea.

And that is why a good management consultant practices the genomic medicine of the future: Deep in the corporate genome he finds the mutant gene, the bad idea, and replaces it with a vital gene, a new idea.

The cure is instantaneous, and it may last forever.

And if it is done right, and forever, the organization will achieve what no doctor is able to guarantee any patient:

Immortality. One such organization is the Swedish company, Stora (now Stora Enso). It is 716 years old. And still going strong. Can a company, or an organization, be immortal?

Possibly.

The Catholic Church is about 1,000 years old. The Kikkoman Corporation (soy sauce manufacturer) is over 300 years old.

Let's look at two specific diagnostic challenges. One from medicine and one from economics.

There are 2 kinds of strokes: ischemic strokes and hemorrahagic strokes. Ischemic strokes occur when there is a blockage in a blood vessel, and they account for 83% of all strokes. Hemorrahagic strokes occur when a blood vessel ruptures.

There is a 3 hour window between the onset of an ischemic stroke and the possible administration of a life saving clot buster drug, tPA.

But if tPA is administered when there is a hemorrahagic stroke, the treatment may be fatal.

There are at least 2 kinds of deflation. One is created by a shortage of money. A phenomenon that caused the Great Depression of the 30's. GDP fell by as much as 30% in the U.S. at that time. Millions of people were unemployed worldwide as a result.

Another kind of deflation is caused by high productivity. Think Silicon Valley. This kind of deflation makes people better off, and needs no intervention.

To correctly diagnose the kinds of strokes and deflation that may occur is of vital importance in order to provide the right treatment.

My father was a victim of the Great Depression. This extraordinary and gifted man, with perfect grades from school, could not find work. Finally, my father and his 2 brothers found employment in a coal mine on the island of Spitsbergen, 600 miles from the North Pole. His youngest brother contracted tuberculosis as a result of the work there and my father never felt well after he returned home.

I saw him wither away. Doctors could not agree on a diagnosis. They decided to treat him for rheumatic fever.

My father suffered from systemic lupus erythematosus, an autoimmune disease. He died before an effective treatment could be administered.

Last summer I visited the family cemetery in my home town of Harstad, Norway. My mother is buried next to my father - she was the love of his life. She lived to a ripe old age, and missed him every day. My father died at 49 years of age.

Diagnosis is indeed very important. In a project, we spend half of our time and resources on that very important task.

There are times when we are tempted to do a shorter or a less thorough analysis. Sometimes at the request of the client.

At those times, I think of my father.