Solve Any Problem By Asking 5 Simple Questions

Learn how to apply the “5 Whys” concept to problems that arise within your veterinary practice.
Phil Zeltzman, DVM, DACVS, CVJ, Fear Free Certified
Published: January 10, 2018
Lean management is a concept embraced by businesses striving to minimize waste related to time, money or effort, and maximize productivity. This concept is also related to Kaizen, or continual improvement, a Japanese productivity philosophy. One component of the Kaizen philosophy is the “5 Whys,” which can be used to explore the cause-and-effect relationships of a particular problem. This concept has been used by major corporations, like Toyota, but is applicable to veterinary practices, too.
The “5 Whys” sequence is a technique that can virtually solve any problem. Consider this simple example:

Problem: The car won’t start.

Put this simple problem through the sequence.
Why #1? The battery is dead.
Why #2? The alternator is not working.
Why #3? The alternator belt is broken.
Why #4? The alternator belt was worn out and not replaced.
Why #5? The car was not serviced according to the manufacturer’s maintenance schedule.

It seems the lack of proper maintenance is the root cause of the problem. Almost invariably, the 5 Whys lead to a broken process. In this case, the person in charge of the car’s maintenance failed or wasn’t properly trained.

Now consider this veterinary example: You can’t help but notice that day after day, no matter what you do, you are behind schedule. You feel efficient, yet it seems you always see clients 10 minutes after their scheduled appointments.

First, gather your management team and explain the problem:
  • The veterinarians are frustrated because they're always late.
  • The clients are frustrated because they're waiting longer than expected.
  • The receptionists are frustrated because they have to deal with unhappy clients.
  • The veterinary technicians are frustrated because they constantly have to fix mistakes made by the assistant.
  • The assistant is frustrated because she thinks she's doing a good job yet nobody seems to be happy with what she does.

Here is how to examine this particular problem using the 5 Whys process.

Problem: The veterinary practice constantly runs behind schedule.
Why #1? Why are you constantly behind schedule?
Answer: Because clients can’t be brought into the exam rooms when veterinarians are not ready for them.

Why #2? Why can’t clients be brought into the exam rooms?
Answer: Because the exam rooms are not ready. They're not being turned around correctly or quickly enough.

Why #3? Why aren’t the exam rooms ready?
Answer: They aren’t ready because the new assistant is too slow and doesn’t do it like the previous assistant had. She does things the way she did at her previous veterinary practice and thinks that’s perfectly fine. Everything has to be fixed after she is done.

Why #4? Why doesn’t the new assistant prepare the exam rooms correctly?
Answer: She doesn’t because she wasn't trained properly.

Why #5? Why wasn't she trained properly?
Answer: She hasn’t received the training required for her to learn how to complete her job role correctly and efficiently.

The result of this little exercise led to the root cause of the problem. Now the new assistant can be trained properly and do exactly what is expected of her.

Again, the root cause is a broken process. Now that it has been identified, it can be fixed once and for all.

Note that if the answer to the first “why” had been “because clients are always late,” it would have led you down a completely different path and toward an entirely different solution.

Dr. Phil Zeltzman is a board-certified veterinary surgeon and serial entrepreneur. His traveling surgery practice takes him all over Eastern Pennsylvania and Western New Jersey. You can visit his websites at and


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