Chapter 6: Diagnosing Root Causes

“If I had an hour to solve a problem and my life depended on the solution, I would spend the first 55 minutes determining the proper question to ask, for once I know the proper question, I could solve the problem in less than five minutes.” — Albert Einstein

Most problem-solving efforts fail because they address symptoms rather than underlying causes. Like a doctor treating a fever without identifying the infection, we often implement solutions that provide temporary relief but allow the core issue to persist. This chapter explores how to use questions to diagnose root causes and address problems at their source.

Moving Beyond Symptoms to Causes

The first challenge in root cause analysis is distinguishing between symptoms and underlying causes. These questions help make that critical distinction.

Essential Questions:

“Is this the problem itself, or evidence of a deeper issue?”
“What had to happen before this problem occurred?”
“If this problem were resolved, what other problems might still remain?”
“What conditions allow this problem to exist?”
“Would solving this completely prevent recurrence, or merely treat the symptoms?”

Example in Practice:

A healthcare system was struggling with high readmission rates for cardiac patients. The initial framing focused on improving discharge instructions, assuming patients weren’t following care guidelines. However, when the quality improvement team asked, “Is this the problem itself, or evidence of a deeper issue?” they decided to interview recently readmitted patients.

These conversations revealed that most patients understood their care instructions but faced practical barriers to following them—lack of transportation to pharmacy or follow-up appointments, inability to afford prescribed medications, or inadequate support at home. By recognizing high readmissions as a symptom rather than the root cause, the team developed a comprehensive post-discharge support program that addressed the actual barriers patients faced. Readmission rates declined by 38% within six months.

Application Exercise: Select a persistent problem you’re facing. List all the visible symptoms, then for each one ask: “What would have to be happening beneath the surface to produce this symptom?” Create a map distinguishing between observable symptoms and potential underlying causes.

The Five Whys Technique and Beyond

The Five Whys is a deceptively simple but powerful method for tracing a path from symptoms to root causes through persistent questioning.

Essential Questions:

“Why is this happening?” (First why)
“Why is that happening?” (Second why, based on the answer to the first)
“Why is that happening?” (Third why, continuing the chain)
“Why is that happening?” (Fourth why, going deeper)
“Why is that happening?” (Fifth why, often reaching root cause)

Example in Practice:

A manufacturing company was experiencing high defect rates in a key product line. Using the Five Whys technique:

Why are we seeing high defect rates? Because components aren’t fitting together properly.
Why aren’t they fitting properly? Because they’re not being made to consistent specifications.
Why aren’t specifications consistent? Because machine settings drift during production runs.
Why do the settings drift? Because operators adjust machines when they notice minor variations.
Why do operators make these adjustments? Because they’re evaluated on throughput, not precision, creating an incentive to keep machines running rather than stopping for recalibration.

This analysis revealed that the root cause wasn’t a technical issue but a misaligned incentive system. By changing performance metrics to balance quality with quantity and implementing standardized calibration protocols, defect rates dropped by over 60% within three months.

Application Exercise: Choose a recurring problem and apply the Five Whys technique. Write down the problem statement, then ask “why” five times, with each answer becoming the subject of the next “why” question. Note where the questioning leads and what root causes emerge.

Systems Thinking Questions

Many complex problems arise from interactions within systems rather than from single causes. These questions help reveal system dynamics that contribute to recurring issues.

Essential Questions:

“How might different parts of the system be contributing to this problem?”
“What feedback loops are at play here?”
“What delays exist between actions and consequences in this system?”
“What might be the unintended consequences of our current solutions?”
“Where are the leverage points where small changes might produce big effects?”

Example in Practice:

A city was struggling with chronic traffic congestion despite multiple infrastructure investments. Traditional analysis focused on adding more road capacity. However, when transportation planners asked, “What feedback loops are at play here?” they identified an important dynamic: each road expansion temporarily reduced congestion, which then induced more people to drive, quickly returning to congestion levels similar to before the expansion.

This systems perspective shifted the focus from treating the symptom (congestion) to addressing multiple leverage points in the broader transportation system. The resulting integrated strategy included congestion pricing, improved public transit, mixed-use zoning to reduce commute distances, and staggered work hours for city employees. These interventions, designed to influence different parts of the system simultaneously, created more sustainable improvement than any single infrastructure solution could achieve.

Application Exercise: Draw a simple diagram of your problem situation, identifying key components and how they interact. Where do you see reinforcing loops (where conditions amplify themselves) or balancing loops (where conditions self-regulate)? How might understanding these dynamics change your approach to solutions?

Mapping Cause and Effect Relationships

Visualizing the relationships between causes and effects can reveal insights that verbal analysis might miss. These questions help create useful causal maps.

Essential Questions:

“What are all the potential causes contributing to this effect?”
“Which causes might be connected to each other?”
“Which causes have the strongest influence on the outcome?”
“What are the most distant causes that still influence the situation?”
“Are there multiple paths leading to the same outcome?”

Example in Practice:

A technology company was experiencing declining employee satisfaction despite multiple engagement initiatives. The HR team used cause-and-effect mapping to analyze survey data and exit interviews.

They began by asking, “What are all the potential causes contributing to low satisfaction?” They identified factors including workload, compensation, career development, and management relationships. Then they asked, “Which causes might be connected to each other?” This revealed that excessive workload was limiting time for career development activities, creating a compound effect.

The causal map helped them identify that rapid growth had created a shortage of experienced project managers, which led to poor work allocation, causing both the workload issues and blocked career paths. By prioritizing the development and hiring of skilled project managers, they addressed a root cause that was influencing multiple problem symptoms. Within a year, employee satisfaction scores improved by 22%.

Application Exercise: Create a fishbone or cause-and-effect diagram for your problem. Start with the effect (problem) at the right, then draw major cause categories as branches to the left. For each category, identify specific factors that contribute to the problem. Look for causes that appear in multiple categories as potential root causes.

Practice Exercises: Root Cause Analysis

Exercise 1: Symptom vs. Cause Differentiation

Write down a problem you’re currently facing
List all observable symptoms of this problem
For each symptom, ask: “What could be causing this?”
For each potential cause, ask: “Is this a root cause or another symptom?”
Continue until you’ve identified potential root causes
Test each root cause by asking: “If this were resolved, would the original problem disappear?”

Exercise 2: Current Reality Tree

Identify an undesirable effect you want to address
Using “If…Then” logic, identify direct causes (“If A exists, then B occurs”)
For each cause, repeat the process to identify its causes
Continue until you’ve mapped multiple levels of causation
Look for places where multiple effects stem from the same cause—these are often leverage points for intervention

Exercise 3: Systemic Force Field Analysis

State the problem situation clearly
List forces maintaining the current state (why does it persist?)
List forces pushing for change (what’s creating pressure for improvement?)
For each maintaining force, ask: “What’s the source of this force?”
Identify the most powerful maintaining forces that could be influenced or reduced

Case Study: Diagnosing the Root Cause of Customer Churn

The Streaming Service Retention Challenge

A subscription-based streaming service was experiencing alarming customer churn rates despite offering competitive content and pricing. Initial analysis focused on visible symptoms—customers citing “lack of value” as their reason for cancellation. The company’s first response was to add more content and reduce prices, but these expensive initiatives produced only marginal improvements.

The breakthrough came when a new chief customer officer insisted on a rigorous root cause analysis. Instead of accepting “lack of value” at face value, the team applied multiple questioning techniques:

First, they used the Five Whys with recent cancellations:

Why did customers cancel? Because they didn’t perceive sufficient value.
Why didn’t they perceive value? Because they weren’t watching enough content to justify the cost.
Why weren’t they watching enough? Because they couldn’t easily find content they would enjoy.
Why couldn’t they find enjoyable content? Because the recommendation algorithm prioritized new releases over personalized suggestions.
Why did the algorithm work this way? Because it was designed to promote the service’s latest content investments rather than user preferences.

Next, they created a cause-and-effect map that revealed additional factors, including a confusing user interface that made browsing difficult and inconsistent streaming quality that frustrated viewers.

Finally, systems thinking questions identified a vicious cycle: as engagement declined, users provided less preference data, further degrading the quality of recommendations and accelerating the cycle toward cancellation.

Armed with this root cause understanding, the company implemented targeted solutions: they redesigned the recommendation algorithm to prioritize user engagement over content promotion, simplified the user interface based on customer journey mapping, and improved technical infrastructure to address streaming quality issues.

The results were dramatic—churn rate decreased by 32% within two quarters, despite making no changes to content offerings or pricing. By addressing root causes rather than symptoms, the company achieved better results at lower cost than their initial approaches.

The Lesson:

This case illustrates how methodical questioning can reveal that the stated reasons for a problem (“lack of value”) often mask deeper root causes. By resisting the temptation to immediately implement solutions based on surface-level symptoms, organizations can identify and address the true drivers of undesired outcomes.

Chapter Summary: Root Cause Diagnosis Framework

Effective root cause analysis follows this questioning sequence:

Symptom Identification Questions: Clarify what’s observable versus what’s causal
Causal Chain Questions: Trace the path from symptoms to underlying causes
Systems Analysis Questions: Examine how system structures contribute to problems
Relationship Mapping Questions: Visualize connections between causes and effects
Verification Questions: Test whether identified causes truly explain the observed effects

This framework ensures you’re solving the right problem rather than treating symptoms—addressing the infection rather than merely reducing the fever.

Five Questions to Transform Your Problem Diagnosis:

“What’s happening that shouldn’t be, or not happening that should be?”
“Why is that happening? And why is that happening?” (Repeat three more times)
“How might different parts of the system be interacting to create this situation?”
“What would have to change for this problem to be impossible?”
“If we successfully address this cause, would it prevent the problem from recurring?”

In the next chapter, we’ll explore how questions can help us shift perspectives, allowing us to see situations through different lenses and discover insights that remain hidden from a single viewpoint.

Next Page: Chapter 7: Shifting Perspectives