The most obvious examples of pathological problems are: uncontrollable negative cash flow, continuous emigration of key human resources away from the organization, unresolved quality problems, rapidly declining market share, and tremendous drops in the company's capacity to raise financial resources. Organizations with those problems can't afford therapy because therapy takes time, and time is a resource those organizations do not have. Instead of an organizational therapist, the board should hire an organizational turnaround specialist who can temporarily take on the chief executive officer's role, and perform whatever 'surgery' is necessary.