The Five Whys is a series of questions to analyze the cause and effect relationship. The goal is to find a solution to a problem. Sakichi Toyoda initially developed it for the manufacturing methodology of Toyota Motor company. The Five Whys helped Toyota become the automotive powerhouse today in terms of quality in engineering and manufacture.
The primary goal of the Five Whys is to get to the root cause of the problem. It consists of asking, “Why?” until you get to the root cause of the problem. The answer to “why?” forms the next question. The “five” is the average number of items to ask before you get to the root of the problem, but sometimes it can be more or less. Not all root causes are from one origin. Sometimes there is more than one.
The Five Whys can also be applied to medicine to know the problem and implement a solution to the last answer.
Let us take, for example, a 70-year-old woman who was brought to the emergency room with severe pain of the right hip.
First why: Why is her right hip hurting?
Because she has a hip fracture
Second why: Why does she have a hip fracture?
Because she fell
Third why: Why did she fell?
Because she passed out
Fourth why: Why did she pass out?
Because her heart was beating too fast (ventricular tachycardia)
Fifth why: Why is her heart beating too fast?
Because she had a silent heart attack a few days ago and the rapid heart rate is a complication
Sixth why: Why is the heart attack silent?
Because the nerves that detect chest pains are damaged.
Seventh why: Why are the nerves damaged?
Because she has diabetes.
In this simplified scenario, the 70-year-old lady will need a hip operation to make her walk again. She will also need a pacemaker and medical treatment for the recent heart attack.
If she only has hip surgery, then the underlying problems will remain and cause her to fall again or possibly lead to death soon.
Frequently the answer to the question may be more than one, and all of those answers will generate their own whys and should be answered. Sometimes the final why may have no instant solution. In this case, the answer to “Why does she have diabetes?” may be moot because this poor lady already has diabetic complications. The immediate priority is that she should have reasonable diabetes control. As long as there is an actionable answer to the why question, then it should be addressed.
The Five Whys Should Be Applied to All Diseases
The Five whys should also be applied to common diseases like obesity, diabetes, hypertension, metabolic syndrome, kidney disease, and heart disease. The answers to the “why questions” are multiple and complicated and can involve insulin resistance, cardiac compliance, cytokines, etc. But most of the time, it all boils down to an improper diet and a sedentary lifestyle.
Medicines are only there to help.
The treatment focus should not be on medications to control the “numbers” like blood sugar or the LDL level or blood pressure but also enough exercise and lose excess fat inside the abdomen. Medications are prescribed only to help. The heavy lifting rests with how the body will heal itself. If there is a full dependence on medicines, then the root of the problem will not be solved.
A healthy lifestyle can address the answer to the final why.
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Related Readings:
- Health Advice from “The Art of War”
- O.O.D.A. Loop Health Applications
- The Kaizen Way to Fasting
- The Five Whys
- The 80/20 Rule for Health
- The 80/20 Rule in Diseases
- Management Principles Applied in Medicine
- The Benefits of Resistance Training
- The Surprising Benefits of Sweating
- The Good and Faithful Servant
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- Photo by Dewang Gupta on Unsplash
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