Project Management

How IT consultants think

Prejudices, biases, or faulty thought patterns can potentially distort the consulting relationship and lead to prescribing solutions that are inappropriate for the client. Rick Freedman explores these issues.

In one of my very first columns for TechRepublic, way back in 2001, I made the following comments:

It's widely acknowledged that doctors, lawyers, engineers, and architects are professionals. Is IT consulting a profession? IT consultants also draw from a highly specialized body of knowledge that is sufficiently obscure so as to be understood only by a small cadre of specialists. Like doctors, lawyers, and engineers, we spend a significant part of our working lives explaining complex technical subject matter to clients. Our clients rely on the advice we give to be successful in their careers or businesses. We also have a responsibility to provide complete and correct advice.

Now, almost 10 years later, I've read a book that emphasizes the similarities between the roles and responsibilities of the doctor and those of the IT consultant.

How Doctors Think, by Dr. Jerome Groopman, delves into the thought processes of doctors as they meet a patient, evaluate that patient from their first encounter all the way through the clinical process, and as they diagnose and treat that patient. It also highlights the unconscious biases and thought patterns that can lead doctors astray, driving them to jump to faulty conclusions, to reach for familiar remedies, and to allow their judgment of the patient as an individual to sway their decisions about the right course of action.

Decision pathways

Why would I write a column for IT consultants about the clinical practices of physicians? Because the same sorts of prejudices, biases, or faulty thought patterns can also affect consultants, and have the potential to distort the consulting relationship and trick us into prescribing remedies that are inappropriate for the client. I believe that consultants, like other professionals, have a responsibility to examine their preconceptions and responses, and to make sure that the advice they give is based on a clear reading of the "patient's" best course of action, and not on unconscious triggers that may lead us, and our clients, down the wrong path.

Groopman, in writing his book, has the advantage of a tremendous field of research studying the diagnostic practices of physicians. For dozens of academic studies, researchers have followed doctors through their diagnostic process and tried to analyze and capture the internal decision tree that doctors follow. This is done to document "best practices" in order to improve outcomes, and to help doctors recognize some of the misleading pathways they may follow when the err.

A straightforward example that most consultants will recognize relates to the rapport between doctor and patient. In a study done by Judith Hall, a psychologist at Northeastern University, the simple matter of liking between the patient and the physician seems to have a significant impact on the ability to diagnose. Any consultant with field experience will confirm this -- difficult clients are much less prone, in my opinion, to get the same level of "care" and diagnostic effort than clients with whom we bond and develop mutual respect. "A doctor is supposed to be emotionally neutral, and we know that's not true", says Hall of her findings. Consultants should be neutral as well, but that can be difficult with badgering, complaining, uninformed, or know-it-all clients. This example is obvious, but some other forms of bias may not be.

Confirmation bias

Take, for instance, the pathway known as "confirmation bias." When this bias is applied to diagnostics, doctors see, or emphasize, only the symptoms that confirm their earliest diagnosis, and ignore symptoms that tend to refute it. Every consultant has met a colleague who comes to the engagement with a pre-conceived solution, only to find that every client is in fact a perfect candidate for their solution, by ignoring any contradictory evidence. Consultants have the responsibility to ensure that they're considering alternative solutions and not allowing their preferences to overrule their diligence.

Anchoring

A related prejudicial decision path is known as "anchoring," in which we take a shortcut to diagnosis by latching on to the first available solution to the problem, without considering multiple possibilities. I've unfortunately seen rookie consultants and IT engineers become anchored to a perceived solution, and then become so emotionally wedded to their idea that they'll spend longer trying to prove their original anchored response was correct than they would have spent exploring dozens of alternatives.

Availability bias

A related cognitive bias is known as "availability bias," in which a doctor quickly diagnoses a condition because it resembles a case they've seen recently, and so is most available to mind. This syndrome is just as likely to manifest in consultants as in physicians.

Framing

Framing, or diagnostic momentum, is another decision pathway that can lead to error. In medicine, every patient has a medical record that follows them from doctor to doctor, and that record often includes pre-formed diagnoses that can influence future encounters. If the previous doctor notes that the patient is "a dramatic personality who needs attention," how likely is it that the next physician will hear out their complaint and take it seriously?

This goes beyond personality; if a previous engineer tells a consultant that "this client's infrastructure is a mess and they don't upgrade their software to supported versions," how likely is it that the new consultant already has made a diagnosis before even encountering the client? Mature consultants take the opinions of colleagues into account, of course, but they also leave enough cognitive space to discover for themselves what the issue is, and to uncover a completely different diagnosis if that's what the situation reveals.

Conclusion

With all of the similarities in ways in which physicians and IT consultants can go wrong, there's one big difference: Lives are not typically at risk when we misdiagnose. From the standpoint of professionalism, however, that distinction is less meaningful than it appears. Lives may not be at risk, but reputations and relationships (on the client and the consultant side) and livelihoods might be.

Professionalism requires us to ensure that we consider our own erroneous pathways and preconceptions, and that we come to each engagement from as neutral and unbiased a position as possible. I found it comforting to know that the medical profession is astute enough to recognize that they are human and bring their own prejudices and faulty perceptions to the patient interaction; I hope that consultants, as well, can be mature enough to examine our own preconceptions and try to bring our clearest judgment to the client relationship.

Get weekly consulting tips in your inbox TechRepublic's IT Consultant newsletter, delivered each Monday, offers tips on how to attract customers, build your business, and increase your technical skills in order to get the job done. Automatically sign up today!

About

Rick Freedman is the author of three books on IT consulting, including "The IT Consultant." Rick is an independent consultant and trainer, working, through his company Consulting Strategies Inc., to help agile teams and organizations understand agile...

12 comments
ruodhi
ruodhi

encouraging thoughts.

zeroconfig
zeroconfig

Never. I'm M.D. and an IT Consultant as well so let's start it this way: 1) medicine is hierarchical, IT is not. 2) medical pathways are fixed to standards and there is no such thing like a nitty greaty black box feature 3) one M.D. has several patients while several consultants have one project 4) in medicine you'll never try to tear out the whole blood vessel system, in IT it is common. No way, this is schmuck

RayJeff
RayJeff

Confirmation bias, Anchoring, and Framing. I've come across those 3 in a same subset of IT discussion group I'm a member of when a member would ask a troubleshooting question. And the first few persons who would respond, would respond with the same solutions every single time, without making sure they have a full understanding of the problem. Even though the symptoms may seem the same for every problem, it doesn't mean that it is.

koredyte
koredyte

a good consultant is one who first considers himself as the client before he recommends ideas...this is a very rare quality in modern IT consultants...therefore, as far as i am concerned, a consultant is one who has solutions to the issue at hand... Olukorede Aguda

eternal_life
eternal_life

as active in both areas I find it so very suitable for my personality

slm
slm

...we'd all be dead.

casey
casey

While this topic has an interesting spin, the behaviors represented as "decision pathways" are not unique or limited to professionals; all people bring these biases (and more) to bear on problems they are trying to solve. And don't forget that biases are most often presented not by consultants (or doctors), but by clients (and patients), often to their own disadvantage.

Beoweolf
Beoweolf

Consultants are NOT, one-size-fits all. I do agree that consultants often have a preference for certain solutions, often based on particular products, processes or procedures. to me, that is not always a bad thing! After you have been in a business for a while ... naturally gravitate to, depend upon and recommend solutions which you found work well. But this does not relieve the contracted, from interviewing several contractors, consultants - then making a choice based on his needs, his budget and his evaluation of the ideas presented. As an example; if I were trying to purchase a farm truck - it is unlikely I would make my 1st and only choice to be a new Cadillac or Mercedes! No matter what the salesperson said or promised - it is my responsibility to use a bit of discretion before signing on the dotted line. At the very least, the idea(s) presented should pass the "smell" test. An over ambitious, over-engineered (or under-powered) solution for that matter, should be reviewed, researched by the client, before acceptance. I've known any number of fellow consultants who have sold a pre-configured solution to a client rather than make exceptions for a particular clients real needs. As a comedian once said, "you can't fix stupid". A CIO, system administrator has a responsiblity to finding, advancing the best solution. He is the arbitor who knows his system needs best and that responsiblity should not be compromised by the opinion of any ONE consultant. I would never accept a critical decision based on the salemanship of ONE consultant (or one Dr. for that matter). The best Dr. often advise their clients to seek a second opinion, if there is any question of the proposed solution.

techrep1000
techrep1000

Considering the potential impact (positive or negative) of their decisions and recommendations, physicians and technology consultants are frequently underpaid, overworked, and under-appreciated.

Mantronix!
Mantronix!

yup, download two programs and call me in the morning... That's why it's always a good idea to network with fellow consultants - you can bounce ideas around with them. Interesting, that's what Dr. House does with his colleagues on TV...

Sterling chip Camden
Sterling chip Camden

... and often harder to identify than other fallacies. Whenever I find myself thinking "It HAS to be ..." then I start inspecting for one of these. Ask the question, "what if it isn't?"

santeewelding
santeewelding

For putting a point to it. You are not only an MD, you are a logician.

Editor's Picks