Four Questions to Help Diagnose your Crisis Patient

May 27, 2019

Critical takeaways

  • Doctors have to sift through a lot of information quickly to get to a diagnosis and use a basic four-question model to do this.
  • Crisis communicators can use a similar set of questions to get to the root of the issue for a corporation facing a crisis.
  • These questions along with good pattern recognition will help rapidly identify the issue allowing you to take corrective quickly.

Recently, I visited my doctor for my annual physical and, during the course of the conversation, I asked him how doctors get to a diagnosis. I was curious as to what happens between meeting a patient for the first time and figuring out what’s at the root of their troubles. I’d been mulling over how we at Kith diagnoses the root problems that might affect a corporation and was curious about how other professions make their diagnoses.

Luckily, my doctor is very patient with this patient’s questions and explained a straightforward four-step process he uses.

How a doctor reaches a diagnosis

The first thing that he asks is what is the chief complaint? Why are they here? What’s the key issue that brought them in? Then he asks about the history of this illness or situation. How long have they had it? How long have they been feeling this way? Next, he looks at their overall medical history and what’s going on holistically with that individual. Finally, he asks about previous surgeries or major interventions they’ve had.

He explained that this relatively simple four-step process is the foundation for how doctors diagnose illness. Moreover, this approach, simple though it is, gets them the right result in the majority of times.

I loved this simple approach and saw lots of overlaps in how we ‘diagnose’ the issues facing our clients. I did a little bit more research when I got back to my office and turned up two other techniques taught in medical school: differential diagnosis and pattern recognition.

Differential diagnosis starts by identifying as many potential candidates for the disease or the condition affecting the patient as possible.  Once all the possible candidates are listed, the doctor uses a process of elimination to whittle things down to a much smaller list. This forms the basis for lab tests or additional investigation to identify the root problem.

Pattern recognition is very close to my heart and we’ve written about it a great deal. I believe that our pattern recognition abilities are one of the key strengths of Kith. We use this all the time with our clients and it’s one of the things that I think makes us really good at what we do.

But I also know that it’s a skill that takes time and energy to develop and it’s the same with doctors. They grow their ‘library’ of situations and templates over time through their experience and research.  This lets them spot patterns and linkages which in turn allows them to identify the root of a problem that might be overlooked otherwise.

But how does this apply to a crisis communicator?  

Paging Dr. Comms

Often, the root cause of a crisis is fairly obvious: the FBI is at the door; the corporation is getting attacked by third-party NGOs;  there’s significant litigation looming. In these cases, the diagnoses don’t take long and we can swing into action quickly.

But what do we do when we get a sense that the headline issue isn’t the actual problem? Or when we feel we might not have the whole story?

This is where the four questions that my GP uses are very applicable to crisis communicators. These four questions will give you a solid foundation for crisis diagnoses. Couple these with good pattern recognition and you will quickly get to the root of a problem to let you get started with your response planning ASAP.

What’s the chief complaint?

First and foremost ask ‘what’s the problem you are facing?’ What’s the event or headline that led to them contacting Kith. Why do they feel that they are in a critical moment or crisis? Maybe something they read in the paper or heard from another firm is giving them pause for thought and they’re being proactive. Basically, what’s the issue that’s front of mind for them?

What’s the history of illness?

Next, the crisis communicator should investigate the history of the ‘illness’. Is the current situation part of a pattern or something recent? Has the organization been burnt by something in the past or did they just stub their toe recently? Was there a series of small issues that bubbled up into this larger issue? Even a series of apparently unrelated issues in the past might help us to spot a pattern so it’s worth spending some time investigating the firm’s crisis history.

How’s their overall health?

The next thing to understand is the organization’s overall health.  This is where the crisis communicator has to understand the organization as a whole even if you’re a staff member: you have to take a holistic view of the firm. What are the shared values of the company? What’s their overall strategy and business intent? What systems are in place to allow the firm to communicate effectively and make decisions quickly? What does their style of leadership look like?

Asking these questions lets us do two things.  Firstly, we understand what the business does and what general state it’s in. The overall business environment could be part of the root cause of what’s going on and it will definitely impact the response.  Secondly, we are also getting to know what the response capability looks like so we can determine what existing systems we can use and what we will have to put in place ourselves. This part overlaps heavily with our new crisis readiness diagnostic which I’m going to talk about soon in a separate piece but the key thing here is to get a sense of the ‘patient’s’ overall health.

What previous interventions have taken place?

Lastly, what ‘surgeries’ or major interventions have taken place in the past? How previous crises were handled could have sown the seeds for what is happening now or might influence how the company approaches this event.  If previous crises resulted in mass layoffs, legal action against staff or left significant issues unresolved, these are all going to affect how the current situation is viewed. And a company that lurches from crisis to crisis may be suffering from shell-shock and unable to respond effectively.  Again, knowing the history of what has taken place beforehand is vital in making your diagnoses.

Similar to my GP, these four questions allow you to work through a lot of information very quickly to come up with a diagnosis for the situation.  Coupled with good pattern recognition, this gives you a great tool to quickly get to the root of what’s troubling an organization so you can start planning and initiating the response.

The differential approach

However, this might not cover every eventuality.  Similar to your GP, there may be times where these four questions can’t get to the root of the problem and a deeper, more thorough set of tests are required. Where the four questions fall short, I find that a much deeper, intense period of discovery is required and I rely on a version of the differential model doctor’s use.  I start by thinking about what all the possible issues could be, relying heavily on pattern recognition. I whittle down the list and run mini-tests and investigations to see if I can get to the root of things. This can be a challenge as time often isn’t on our side so this deeper dive might be taking place while some defensive ‘shoring of the timbers’ is underway to buy us some time.

Nevertheless, I find that these situations are few and far between and the four questions get us where we need to be pretty fast. Give these a try the next time you have to diagnose a situation to let you get to the root of the issue quickly, home in on what’s really required and start treating your corporate patient as quickly as possible.


Filed under: Blog


Bill is a reputation management, crisis communications and professional development expert, keynote speaker, Wall Street Journal Risk & Compliance panelist, and best-selling author of Critical Moments: The New Mindset of Reputation Management. He has more than 25 years of global experience managing high-stakes crises, issues management, and media relations challenges for both Fortune 500 companies and winning global political campaigns.