What is Design Thinking (and what it means for Healthcare)


Design Thinking is notoriously difficult to define. When you look it up on the internet, there are a broad range of definitions and opinions on what exactly it is. To make things worse, the word thinking in design thinking has a tendency to become the focal point of the phrase.

People often describe design thinking as being only about thinking, but let’s not forget that the phrase also has the word design within it.  Design is notoriously difficult to define itself, but it includes the actions we make as we create new worlds for ourselves.

Design thinking, in other words, encompasses much more than our thinking abilities, it also encompasses how we act in the world.


Due to this broader scope, I believe that is better to frame design thinking as a worldview. A worldview is set of values and beliefs that human beings and communities of human beings possess that influence they perceive, interpret and, subsequently, act within the world.

Worldviews are often hidden from people’s awareness of themselves. This hidden dimension is what often makes them so difficult to articulate, and so easy to confuse with one another.

As I speak to you about worldviews today, I’m going to be speaking to you in generalities, but I want to take a moment to digress and say that worldviews are not black and white. They are gray.  My use of generalities is to simplify the discussion and my communication of it, but it is not intended to be used as an ultimate truth.


To start off, we’re going to investigate what the thinking portion of design thinking and how it relates to two dominant worldviews that exist within society today.


While there are many worldviews prevalent within society, the two that are most relevant to our discussion today, and that I believe are particularly dominant, are modernism and romanticism 1.


The modern worldview became a more dominant worldview with the enlightenment. Once humans had determined the course of the planets through Newtonian physics there was a new confidence and optimism in our ability to solve all of our earthly problems.

This worldview is strongly objective. It believes that humans have conscious and rational reasoning. We are driven by common laws, one of them being self-interest, and our behavior can be standardized and predicted once we find thoroughly understand those common laws. This has been the dominant influence over science for the past few centuries.


The romanticist worldview began one to two centuries after the modern worldview. It was a reaction against modernism. Humans were not deemed to be rational, or driven by reason but rather had an inner subjective connection with the world that could not be easily explained. Humans are driven by empathy that is intuitive, unconscious, and irrational.

We are unpredictable and holistic with the rest of the universe and each other, possessing emergent behaviors that a reductionist approach can not find. This is the worldview that has dominated art and this is the worldview that DT is typically dominated by as well.

Interestingly, science is increasingly embracing this perspective as well within areas such as neuroscience, behavioral economics, and moral psychology.


As you can see, these two worldviews are completely opposite from one another, and have been clashing for the better half of the last several centuries. Modernism, however, has ridden off of the success of traditional science and has been largely adopted by our applied disciplines including business, technology, and healthcare.


As I mentioned previously, worldviews also affect the way we act. Not only do we get different insights into our products and services based on different interpretations, we also get different actions.


People with a romanticist worldview are more likely to have a discovery-based skill set. To the romanticist, everything is subjective. There is no one solution that must be found, rather all solutions must be discovered and explored.

People with a modernist worldview are more likely to have a delivery worldview 2. To the modernist, there is only one definition of truth and one ultimate solution. This solution must be discovered by weeding out the incorrect options.

As I mentioned earlier, design thinking is associated with the romanticist worldview. Not surprisingly, design thinkers have a tendency to possess a discovery skill set. They focus on divergent ideas and solutions and are continuously exploring the solution space. Scientists, engineers and physicians, meanwhile, have a tendency to utilize the delivery skill set. They focus on convergent ideas and solutions and are often driving towards something tangible that can be implemented.


The impact of the modernist worldview on how we create our products and services can not be understated. Since the industrial revolution, we have embraced the modern worldview to such an extent that we have focused almost exclusively on the objective realities of technology, what is feasible, and on business, what is viable. This objective view focuses little on the subjective impact our products and services have on human beings.


In the last several decades, however, the romanticist worldview has been not so quietly interjecting itself via design, art, and, now, design thinking. It has demanded a world that is more balanced, more subjective, and more humane. One that represents the world of human desire via our cognitions, perceptions, emotions, and actions within our individual lives.


This interjection of the romanticist worldview via design and design thinking has increasingly led to a perspective where our products and services should be created as a harmonious balance between desirable, feasible and viable; a combination of business, design, and engineering thinking.  This perspective leads to a larger and more balanced perspective that integrates the objective and subjective; the modernist and the romanticist.

I really want to stress the importance of this balance, however, as it doesn’t always occur.  People who embrace a design thinking worldview, the romanticist worldview, can be just as dogmatic about their perspective as a scientist can be about the modernist worldview, demanding that new products and service focus exclusively on human needs.


Any dogmatic approach will severely compromise the potential and quality of solutions you can develop because diversity will always lead to better results.  One need only look at our diverse planet to see that diversity is what is necessary to create an adequate “fit” within the different contexts of our environment.

Worldviews affect the way we interpret our world. By utilizing these diverse perspectives, we get diverse interpretations about what the world is and what it should be. This leads to an increased number of insights into what our products & services should be and how they should work and helps us ensure that the multiplicity of contexts we are supporting are accounted for.


While diversity is great for deriving more innovative solutions, it can also cause conflict. As I mentioned before, these two worldviews understadn and act in the world in contradictory ways.

I believe that many of the conflicts that occur within organizations and societies are due to people not realizing they are approaching problem-solving, and the subsequent solution space, from these two completely different perspectives.

To make matters worse, we have a tendency to try and sweep this conflict under the rug because we all dislike conflict. It makes us uncomfortable. The key to successful innovation, however, is to disregard this fear and to embrace the differences. We must explicitly engage these two perspectives in a discourse with one another 3.


This discourse begins with listening. We have to hear what our customers and industry experts, from both of these perspectives, are trying to tell us about their worlds. We can do this in a variety of ways such as observing them in our hospitals, having them test our products, reviewing the latest things they’ve created, and engaging them in a group conversation. This is what we typically call research, but it is research that is both qualitative and quantitative.


Once we’ve heard and seen what customers and industry experts are doing, we synthesize their visions and our own into one and begin to bring that vision to life via prototypes and concepts. Ideally, we sustain our discourse with our customers and experts by co-creating these prototypes and concepts.


Finally, we deliver those prototypes and concepts by transforming them into tangible and concrete products and services. Again, we should maintain our discourse with our customers and experts by providing them with initial access to the new products and services and by continuing to ask for their input and advice. The individuals in our discourse can often become wonderful advocates for us 4.


Having seen that DT represents a different worldview and how that worldview can help us derive a different set of solutions, we can now understand why it is important. DT, representing the romanticist perspective can fill a much needed void in our healthcare products and services that have been largely neglected and that aligns much better with how our patients view health.

Our current actions and thinking around health have largely been derived from the Modernist worldview.

Over my past 5 years at Mayo, however, we’ve learned from hundreds of research studies that our patients have evolved beyond this modernist perspective and view their health through the romanticist lens.


Patients view their health as being far more holistic than their providers. Health is about living a full, and rich, life. This life is one that is more than the absence of disease. It is about flourishing in multiple areas such as my job, my family, and as an individual.


Flourishing is not only about helping each of us as individuals. It is also about cultivating and promoting flourishing throughout the community. Patients know that health goes beyond our physical bodies and is embedded within our environment.

As healthcare providers, our patients want us to be community activists. How are we helping create a healthy community. Health is more than medicine and treating disease. It is about promoting wellness in our grocery stores and on our streets. It’s about community planning and community politics.


As we help our patients flourish, they don’t want it to be treated like participants in a scientific study. They don’t want the cool and distant doctor that observes their patients, analyzes their symptoms, runs diagnostics, and prescribes treatment.

They want you to know them at an emotional subjective level. They want you to be involved in their lives and know who they are. They want you to be their friend.


Our patients don’t want us to monitor their physical progress and development. They want us to be committed to their personal growth; their mental, physical, and even spiritual development. They don’t want us to focus only on their weaknesses, they want us to focus on their strengths.

How are you making your patients stronger? How are you taking the best of them and making it even better? Are you acknowledging how far they’ve come? 


Ultimately, our patients want us to genuinely care about them. To care about someone is to have a relationship with them, and they want a relationship, a real relationship, with their providers. Healthcare today is not about caring in their eyes anymore.

What happened to the doctor that knew them? That knew their community and their children? What happened to the word care in healthcare?


Our patients want a fundamentally different relationship. One that is no longer about their physician having full control over a limited aspect of their health. The want to have a dialogue with their physician, an ongoing conversation about their health and about their life.

Support for the unilateral relationship with a physician is over. It is time for healthcare to embrace a bilateral relationship and commitment with our patients. 


In summary, the relationship our patients want is a deep, personal, relationship. One that is about commitment, friendship, community, and growth.  Many physicians I’ve spoken to about this have immediately said “impossible” or “too difficult”. Excuses I often here are that is is too emotionally draining or too time-consuming. My response to that is twofold:

  1. This type of excuse is driven by fear. We are increasingly afraid to have emotional relationships with others. Yes, it is difficult to make these types of connections with people that are sick or dying. It is also, however, rewarding. The deepest relationships are the most meaningful.
  2. It has been done before in this field and is being done in others. There was a point in time, not too long ago, where physicians made house calls. They knew their patients, and they knew their community. They depended on both for their survival every day.

We can bring this type of relationship back to our patients. We can create a system that no longer thinks of our patients as machines that can be standardized and controlled, but one that instead thinks of our patients as the emotional, relationship-driven, and empathetic people they are.Hi Everyone! I apologize for the long delay in posting. I’ve been busy doing several conference presentations, including this one that I conducted in