The Eye Doctor Who Looked Deeper
Why leaders can’t afford to treat symptoms without searching for causes
When I was younger, I went to my eye doctor regularly for exams and to purchase contact lenses. My former doctor — a bit old-fashioned by today’s standards — always checked my blood sugar during those visits. At the time, it didn’t seem necessary. I was there for my vision, not a diabetes screening.
But in hindsight, he was being thorough. Deteriorating eyesight can be a symptom of diabetes. He wasn’t just treating what was right in front of him — he was looking for the cause.
My new doctor doesn’t do that test. The exam is efficient, focused strictly on eyesight, and perfectly valid. But the difference between the two approaches is striking. One addressed the symptom. The other searched for the cause.
That distinction matters far beyond a doctor’s office. It matters in how we lead our organizations.
Symptoms vs. Causes
Merriam-Webster defines them this way:
Symptom — “subjective evidence of disease or physical disturbance; broadly, something that indicates the presence of bodily disorder… also, something that indicates the existence of something else” (Merriam-Webster).
Cause — “a reason for an action or condition; something that brings about an effect or a result” (Merriam-Webster).
Organizations are no different. When performance slips, the symptoms are readily apparent. Together we’ve all encountered them:
- Financial: lack of profit, runaway variable expenses, high days’ sales outstanding, or revenue that isn’t profitable. Leaders often respond by chasing more sales — but more unprofitable revenue only deepens the problem.
- Workforce: high turnover, a surge in grievances, frequent discipline, or a need for constant retraining. Many leaders double down on recruiting campaigns when the deeper issue may be cultural or a flawed pay structure.
- Operations: buses in poor condition, breakdowns on the road, cleanliness complaints, or chronically low on-time performance. The instinct is to schedule more maintenance or inspections, but often the cause lies in planning, processes, or resource allocation.
- Customer: rising complaints, growing numbers of refunds, low conversion rates from sales leads, or poor service ratings. These issues often reflect gaps in training, unclear standards, or leadership that fails to reinforce what constitutes “good” behavior.
- Safety & Compliance: high accident rates, hours-of-service violations, or repeated need to retrain on basics. Leaders frequently add another round of training — but the root cause may be pressure from scheduling, or a culture where rules are bent to meet deadlines.
Every one of these is a symptom. And just like with blurred vision, the temptation is to address only what we can see.
Treating Symptoms
The natural reaction to symptoms is to act quickly:
- Launch another recruiting drive.
- Add more training sessions.
- Spend money on bodywork or cosmetic fixes.
- Push harder for revenue.
These actions can provide short-term benefits. In some cases, they’re essential to keep things moving. But if we stop there, the same problems resurface. Sometimes they come back even bigger and costlier than before.
That’s because the real problem is rarely the symptom itself.
Addressing Causes
The deeper leadership challenge is to ask: Why are these symptoms showing up in the first place?
- Recruiting challenges may point to cultural or leadership issues.
- Compliance gaps often reveal accountability problems.
- Service complaints may reflect unclear standards or inconsistent reinforcement.
- Rising costs may indicate inefficiencies built into the system.
Symptoms are signals. They point us toward the real work. If we never address the causes, we may win a few short-term battles but lose the long-term health of the organization.
A Leadership Discipline
This is where discipline and shared accountability matter. Anyone can respond to the loudest problem of the day. Great leaders — and great teams — step back, look deeper, and ask better questions.
When symptoms surface, we can ask ourselves:
- What’s behind this problem — not just on the surface, but two or three layers down?
- If we fix this today, what will prevent it from happening again tomorrow?
- What in our leadership, culture, or systems could be creating this pattern?
These aren’t easy questions. They take time and courage. But they transform how we lead. Instead of chasing quick fixes, we begin building solutions that last.
Final Thought
It’s easy to spend our energy treating symptoms — the issues that shout the loudest: missed deadlines, high turnover, shrinking margins. They matter, and they demand attention.
But lasting progress comes when we pause long enough to ask: What’s driving these symptoms in the first place?
Looking back, my old-fashioned eye doctor may have been ahead of his time. He knew that treating vision changes without asking why would miss the bigger picture. In leadership, it’s the same. When we only treat the symptom, we risk overlooking the cause — and the deeper health of our organizations.
Brian Dickson is the owner of Bus Business Consultants and author of Ground Transportation Insights on Substack. Drawing on leadership roles in motorcoach operations and Disney’s Guest Transportation, he helps operators improve performance, culture, and growth—Bus Business Consultants: Driving Performance, Culture, & Growth in Ground Transportation.
This article was originally published on October 7, 2025 on Ground Transportation Insights.
The views expressed are those of the author alone and do not necessarily reflect the position of the American Bus Association.
