I went to the doctor a few months ago because I was exhausted and not sleeping well. I, like most of us with internet access, looked up my symptoms in addition to talking to a few people and had, without a doubt, decided that I needed a sleep study. Luckily for me, my doctor didn’t listen to my self-diagnosis and instead asked additional questions about my health. Because of the answers to those questions she thought it could be hypothyroidism and ordered a test.  The test revealed that it was a thyroid problem.

If you look at the symptoms for hypothyroidism you will realize that any of them individually or just a few together could really be anything.  Here is a list from mayoclinic.com

• Fatigue
• Sluggishness
• Depression
• Increased sensitivity to cold
• Constipation
• Pale, dry skin
• A puffy face
• Hoarse voice
• An elevated blood cholesterol level
• Unexplained weight gain
• Muscle aches, tenderness and stiffness
• Pain, stiffness or swelling in your joints
• Muscle weakness
• Heavier than normal menstrual periods
• Brittle fingernails and hair

Some of the symptoms listed, such as dry skin, seem more like an annoyance than anything related to something serious. I would never think to bring up many of these symptoms if I thought I had a sleep disorder because they didn’t make sense with what I thought the problem was. Once my doctor confirmed that I had a thyroid condition it became clear to me that these other symptoms were related and with the proper treatment my quality of life has changed.

What does this story tell us as designers?

It tells us that users tend to self-diagnose with their health and are likely to do the same with issues related to products and processes. Much like with their health care many users are not knowledgeable enough to fix their usability problems or even to diagnose them correctly. I have had countless interview subjects tell me that they know exactly what the company should do to fix the software and everything will be fine. Sometimes I get clients who try to diagnose the problem and are very confident they know what it is.  Many are surprised to learn differently when the data is collected. If we do what the users and clients say based on their perspective of the situation we might miss the real diagnosis. They can’t be relied on to see the related issues in the same way that I couldn’t know that something seemingly trivial like dry skin could be relevant to my doctor’s investigation.

My doctor was able to test her theory about the few symptoms I confessed by running a test.  She needed more information than what I told her because I couldn’t be relied on to reveal everything that was relevant. Designers need to “test” users to find out the rest of the story by observing them doing their work and not just listening to what they tell us. If my doctor had only listened to me and just completed a sleep study we may have found a treatment that worked a little, but I could have been back in the office for every other symptom, trying one thing after another and spending a long time not getting better. Many times we, as designers, do just that.  We treat one usability issue and make the product a little better but then our users come back with other issues that are related. If we had probed a little more in the beginning we could have fixed them the first time.

What we do is not as high risk as health care and we don’t suffer the same consequences if we diagnose a problem incorrectly (though there have been cases where poor usability has caused a serious accident), but we do owe it to our users and our clients to improve the user experience as best we can. If we don’t improve a product well enough, the health of the company is at risk and it could lose customers and/or revenue.

The real lesson here is to remember that we are the experts with the outside perspective. We have the know-how to do it right the first time by investigating the symptoms, seeing the bigger picture and offering a proper diagnosis.