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Why Doctors Need a Different Kind of Problem Solving:

Written by Didier Rabino | 12/5/25 6:27 PM

How Lean Helps Clinicians Fix the Systems Around Them — Not Just the Patient in Front of Them**

In every hospital I’ve ever supported, one truth stands out:

Doctors are extraordinary problem solvers.

Their ability to diagnose, make rapid decisions, respond under pressure, and integrate complex information is unmatched in any industry. Their training and experience equip them to handle life-or-death ambiguity with clarity.

But there’s a second truth that many leaders overlook:

The problem-solving skills that make physicians exceptional clinicians are not the same skills needed to fix broken processes and healthcare systems.

And because healthcare organizations often don’t recognize this distinction, they unintentionally place clinicians in a position where their natural problem-solving strengths don’t translate to the improvement challenges around them.

When that gap goes unaddressed, it leads to frustration, rework, inefficiency — and, over time, burnout.

This article explores why this happens, what doctors are actually trained to do (and not do) when it comes to problem solving, and how Lean methods provide the structure needed to improve systems, reduce burden, and make care safer and more reliable.

The Clinical Problem-Solving Tools Doctors Master

When we talk about physicians as “great problem solvers,” we are usually referring to two highly specialized approaches to clinical reasoning: the Hypothetico-Deductive Model and Evidence-Based Practice (EBP).

These are essential tools — but they are designed for diagnosing and treating patients, not diagnosing and treating the systems that support care.

1. The Hypothetico-Deductive Model: Rapid Clinical Reasoning

This is the intuitive, iterative approach clinicians use every day.

A patient presents with symptoms.
The physician quickly forms a set of hypotheses.
They order tests, analyze results, refine the list, test again, and ultimately land on the most likely diagnosis.

This method relies on:

  • Pattern recognition
  • Clinical intuition developed through experience
  • Fast decision-making under uncertainty
  • Prioritizing life-threatening conditions first
  • Adjusting based on real-time feedback

It is powerful. It is fast. And it saves lives.

But this model is not designed for understanding root causes of systemic failures, nor for creating long-term solutions in workflow, communication, or operational processes.

2. Evidence-Based Practice: Choosing the Best Treatment

Evidence-Based Practice (EBP) integrates:

  • The best available scientific research
  • Clinical expertise
  • Patient preferences and circumstances

EBP is the foundation of safe, consistent, high-quality care.

However, EBP also focuses on individual patient treatment decisions, not on analyzing variations in supply delivery, handoff miscommunications, discharge delays, unsafe workflows, or inconsistent procedures.

In other words:

Doctors are trained to solve problems in patients, not problems in systems.

This is not a limitation. It is simply the reality of medical education and clinical practice.

So, Why Do System Problems Persist?

Because hospitals often assume:

“If doctors are great problem solvers, they should be great at fixing processes too.”

But the two domains are completely different:

Clinical Problems Process/System Problems
Diagnose illness Diagnose process breakdowns
Individual patient focus System-wide focus
Act immediately Study, observe, analyze
Prioritize intuition + experience Prioritize data + team learning
Fast iteration Structured experimentation (PDCA)
Life-saving urgency Process stability & prevention

Expecting clinical problem-solving tools to solve operational failures is like asking a world-class surgeon to fix a broken MRI machine with a scalpel.

Different problems require different methods.

The Real Source of Clinician Frustration: System Problems

Most of the pain points that drive burnout are not clinical issues at all.

They are system issues:

  • Missing or incorrect supplies
  • Delays in labs or imaging
  • Communication breakdowns
  • Handoffs that lack standardization
  • Excessive documentation burden
  • Redundant steps no one can explain
  • Staffing mismatches
  • Inconsistent discharge processes
  • Equipment not where it should be
  • Policies that contradict each other

And these issues rarely get solved because the people experiencing the pain aren’t equipped with the tools to fix the system around them.

Doctors can see the symptoms of system failure…
They can feel the consequences…
But they aren’t given a method to understand the “why.”

This is where Lean plays a transformative role.

Lean Gives Doctors (and Teams) a System for Solving System Problems

Lean problem solving does not replace clinical judgment.
It is not a competing philosophy.
It is a complementary capability — one that reveals why processes break and how to prevent it.

The key Lean methods that help clinicians include:

1. Root Cause Analysis

Instead of jumping to solutions, teams learn to ask:

  • What is the actual problem?
  • Where did it occur?
  • What conditions enabled it?
  • What patterns or trends are visible?

This shifts the focus from firefighting to understanding.

2. Visual Management

Lean makes problems visible in real time:

  • Flow boards
  • Handover checklists
  • Supply kanbans
  • Standard work displays
  • Escalation mechanisms

This allows frontline teams to see abnormal conditions before they become patient risks.

3. Standard Work

Physicians often dislike the idea of “standardization,” but standard work:

  • Reduces variation
  • Improves reliability
  • Frees cognitive load
  • Protects time for clinical judgment

It’s not about scripting decisions — it’s about giving the team a consistent baseline.

4. PDCA Cycles: Plan–Do–Check–Act

PDCA introduces a scientific, structured way to test changes safely and learn quickly.

Doctors appreciate PDCA because it mirrors the scientific method:

Hypothesis → Experiment → Observation → Adjustment.

5. Cross-Functional Problem Solving

System issues rarely live in a single department.

Lean helps teams:

  • See end-to-end processes
  • Understand handoff failures
  • Map patient journeys
  • Reveal where misalignments occur
  • Create shared accountability

This breaks down silos — one of the biggest drivers of frustration for clinicians.

Why Doctors Often Love Lean Once They Experience It

At first, physicians sometimes view Lean as an “operations project,” something far removed from patient care.

But when Lean is done correctly — with respect for people, focus on learning, and engagement of clinicians — they quickly see the benefits:

1. Less Friction in Daily Work

Lean removes avoidable frustrations such as:

  • Hunting for equipment
  • Searching for information
  • Waiting for orders
  • Chasing missing results
  • Repeating documentation

This directly reduces burnout.

2. Safer, More Reliable Care

Standard work, visual controls, and feedback loops reduce variation and errors — a priority that aligns perfectly with clinical values.

3. Better Teamwork and Communication

Lean systems strengthen:

  • Huddles
  • Escalation pathways
  • Cross-functional collaboration
  • Psychological safety
  • Shared problem-solving

Doctors often comment, “Why haven’t we worked this way sooner?”

4. More Time for Patients

When the system works, clinicians gain back time for meaningful care — one of their greatest sources of professional satisfaction.

The Real Opportunity: Combining Clinical Expertise With Lean Thinking

Imagine a healthcare system where:

  • Clinicians use their diagnostic strength to see patterns in workflow failure.
  • Teams have simple tools to fix problems close to the work.
  • Leaders coach instead of command.
  • Processes are designed around safety, flow, and respect for people.
  • Burnout decreases because the system supports — not fights — the clinician.
  • Every improvement becomes a learning opportunity.

When clinicians apply Lean thinking in addition to clinical reasoning, the results can be extraordinary.

Not because Lean teaches them how to think.
But because Lean helps them see and solve the problems that medical training never covered.

So Here’s the Question for Your Organization

Doctors already know how to solve clinical problems.
But do they — and all caregivers — have the tools to solve system problems?

Your question of the day:

How could adding Lean problem-solving frameworks to doctors’ clinical expertise help uncover where processes break, reduce frustration, and make care safer and more effective?

If your teams are exceptional clinicians but still struggle with system issues, the problem isn’t the people.

It’s the system.

And Lean provides the roadmap to fix it — respectfully, sustainably, and in a way that strengthens the purpose and joy of caring for patients.