12/17/2008 05:12 am ET | Updated Nov 17, 2011

The Right "Solve"

To do anything, you must decide. What action you choose depends on what outcome you want. There are four possible outcomes -- four "solves" -- from which you can choose.

The following wisdom comes from Russ Ackoff (is anyone surprised?) writing about problems in the business world. His approach to decision-making applies just as well to personal situations and to sickness in our healthcare system.


You can absolve a problem. You choose to do nothing and simply grant forgiveness to the people and the process. This is forgive-and-forget.

You can solve things. You choose to make things better than they were or are. Solving a problem improves the outcome. This is a very common choice. Frightened people scream that we need an answer right this minute. Then they offer a solution that is, they say, the best we can do under the present circumstances. Examples include the possible economic "bail-out" or proposals to refinance healthcare.

You can resolve a problem to achieve the best possible outcome, not just a better one. Resolving means the outcome is the best possible result under any circumstances. Most people see this as the ultimate answer.

Though we always accept a solution for our problems or a resolution of our difficulties, what we should demand is for our problems to be dissolved.

Dissolving a problem means that you change the circumstances -- you adjust the process or system -- so that the problem can never happen again. You "dissolve" the conditions that made the problem possible in the first place. In medical terms, this is curing the patient.

Consider this example. A patient is given a drug to which she is allergic that causes the problem: trouble breathing. You can choose any one of the four "solves" below.

If you absolve, you forgive the doctor, nurse, pharmacist and drug company.
If you solve, you give a second drug that improves breathing.
If you resolve, you give a different drug that completely counteracts the first drug.
If you dissolve, you install an automatic, computer-based system that makes it impossible for anyone to give any patient a drug to which he or she is allergic. (Of course, you also give the counteracting drug.)

Are we going to dissolve the problems in our healthcare system, or
are we going to settle for resolution, solution, or -- heaven forbid -- absolution?