Broadening the Differential: A Lesson in Agile Thinking
I've been spending time with colleagues lately exploring the concept of agility in the research literature. And as a result, I keep finding the need for it everywhere.
This week alone, our house build presented a wiring issue that no longer aligned with the original lighting and door-swing plans just as sheetrock was about to go up, so we adjusted to the next-best option. A role-play script for an upcoming recording project arrived later than expected, requiring contingency plans. Interview schedules for a key leadership position collided with prior commitments. Adjustments were made that were the least disruptive. And when the small regional airline schedules weren't yet published for my dad's return trip, we booked the outbound flight and blocked the calendar for the rest.
Earlier in my career, many of these situations would have felt like insurmountable obstacles rather than realities to adjust to.
None of those situations required abandoning the goal. They required adjusting the path.
Many of us were trained to believe there is one "right plan" and that success depends on executing it well. But in a complex world, effectiveness depends more on the ability to absorb new information, revisit assumptions, and recalibrate without losing sight of the purpose.
Agile performance (mindset + processing + behaviors) isn't about moving faster.
It's about adapting the approach without abandoning the purpose.
Agility requires us to revise assumptions when new information emerges. I learned this in a much harder context.
About sixteen years ago my daughter experienced a delay in diagnosis while living away at college.
Her physician had trained at a prestigious institution, seemed caring, and was clearly working hard
The initial diagnosis made sense. Until it didn't…
As new information emerged, the diagnosis became the lens through which the new information was interpreted. Each symptom was viewed through the existing explanation rather than prompting a fresh look at the differential diagnosis.
As a mom, I didn't want to overstep and become that parent calling about her college-aged child.
At least not initially.
When I eventually did reach out, my concerns were dismissed. Even sharing that a specialist colleague with expertise in the condition felt referral was indicated did not change her mind.
Fortunately, a fresh set of eyes from an urgent care family doc, led to getting the ball rolling with the right subspecialist treatment she needed. And she did well.
Looking back, I don't think this was a failure of caring or intelligence. I think it was a very human example of how difficult it can be to broaden the differential once we've settled on an explanation.
I've come to see this as more than an isolated clinical situation. It demonstrates the importance of rethinking when new information emerges, not only in this case but in clinical practice more broadly. And it's not unique to medicine. It shows up in careers, relationships, and assumptions about ourselves.
The house build required adjusting the plan.
My daughter's diagnosis required adjusting the explanation.
Both required the same underlying capability: the willingness to rethink when reality offered new information.
One reason agility is so difficult is that humans become attached to explanations that once made sense. In medicine we call this anchoring. Once a diagnosis is declared, new information often gets filtered through it rather than prompting a fresh look.
Perhaps this is one of the most important forms of agility: the willingness to ask, What else might be true?
Reflection: Where in your life might it be time to broaden the differential?
Responses