The major metaphorical image of the term diagnosis goes back to early medical practice. People feeling ill seek out a physician who listens, observes, takes a history, and does tests to clarify the patient's symptoms and current state. The physician then interprets the information gathered, comparing it to the current model health, and names the illness to complete the diagnosis. The physician then prescribes some treatment that enables the patient to regain his or her health. OD diagnosis is generally understood to parallel medical diagnosis We should take note of what is presumed in this metaphor. Ill health prompts the visit to the physician, who is an expert, who gathers information, and who uses a model of normal health on which to base his or her diagnosis elements congruent with the early use of OD consultants by managers for reestablishing desired levels of internal efficiency and effectiveness and short-term development. As is well known, however, management, consultancy, and OD have all loosened their adherence to even general one-best-practice ideals.