Digging to the Real Root Cause.

Author:Bott, Bill

I'm a sucker for all of the medical dramas on television. If it takes place in a hospital, chances are my wife and I will give it at least a couple of seasons. And from "ER" to "Gray's Anatomy" to "Scrubs," there is one plot line that always sucks me in: we have been treating the symptoms so aggressively, we missed the real illness. It is the show that usually starts out with a younger patient making their tenth trip in for help from a young doctor so busy with every patient that they rush to treatment options and then they are off and running ... until after the commercial break, when the patient, despite the best efforts, is not getting better, but is getting worse. It is not until the last five minutes when a hero finally emerges and points out what seems so obvious: we need to look past the fever, past the cough, and past the pain, and start attacking the real culprit. Only then is the patient saved and we can all rest easy until the next episode.

Now I am not a doctor, and I do not even play one on TV, but I have seen this story play out in human services again and again. Unfortunately, we are still waiting for our happy ending. If we had our own show, it would probably look like this ...

Opening Scene: The lobby of a benefits office

A social worker is unlocking the door and there is already a line out front. A young mom enters in with her two children, a backpack full of toys, and a Scooby Doo lunch box; they plan on being here through lunch. An old man shuffles to the window with an old folder, eyes darting behind the counter trying to find someone to help him. The line of people continues to stream in, one after the other until the lobby is full. We hear numbers being called, the clicking of keyboards, and a frustrated supervisor warn, "OK folks, it's already going to be one of those days." Roll opening credits.

Act 1: Meet Joan

She is a seasoned case manager who is desperately trying to meet with as many people as she can this morning. She knows her stuff, is able to direct clients to a variety of services, and works hard to understand each individual's needs well beyond the duties described in her job description. Still, she feels unfulfilled. This is not why she went into social work: to move people through the line as quickly as possible. She remembers when her family came to America with little more than the hope of a better life. It was the caseworker who helped her get into school, helped her father find work, and helped her...

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