“It is only in our decisions that we are important.”
Jean-Paul Sartre
We all make decisions every day. Some are trivial. (Tuna fish or egg salad for lunch?)
However, many other decisions are of great significance. Moreover, the cumulative result of your decisions largely determines your ultimate destiny.
A newly minted dermatologist might ponder such decisions as: Should I do a fellowship? Should I open a practice or join a multispecialty clinic? Where do I want to live?
A veteran, established dermatologist might think about such items as: Should I hire a partner? Do I need an additional nurse, medical assistant or receptionist? Should I sell products in the office?
Needless to say, I’ve made my share of decisions. Some have turned out splendidly, while others … not so well.
I’d like to offer a few thoughts on making crucial decisions.
Certainly, one way to make “good” decisions is to avoid making “bad” ones. Characteristics of decisions which often turn out to be disadvantageous include the five following types:
“Shoot from the hip” decisions are made instantaneously and without much (if any) deliberation. General George Patton once said, “When a decision has to be made, make it. There is no totally right time.” Endless delay does amount to procrastination. Nonetheless, truly critical decisions should engender an appropriate amount of deliberation.
Bandwagon and lowest common denominator decisions lead us to simply do what others have chosen to do without consideration of our own personal situation.
Status quo decisions are defensive, often made due to paralyzing concern that anything other than the current state-of-affairs will result in undesirable consequences.
Lastly, I would advise against “confirming innate prejudices” decisions. Such decisions occur when we avoid reviewing and considering objective data and instead merely seek out information which confirms our own viewpoint.
Alluded to above, fear is the absolute nemesis of sound decision making. Fear makes us focus on all the wrong things. Obstacles, impediments, and the rare and exceptional instances of adverse events are examples of things fear elicits. Fear makes all the problems attendant to one decision or another appear insurmountable. Any past failures start to haunt us, and the risk of future failure becomes paramount. The thought of a horrendous “what if…?” overtakes rational thought processes and potential calamities dominate the decision-making process. As a result, we may develop profound inertia. Try to consciously avoid operating while being mentally threatened by fear.
Having reviewed some tips on how NOT to make a decision, let’s turn to sound decision-making.
First, assess how important the decision really is and apportion a commensurate amount of time to come to a conclusion.
Set a time limit, and don’t exceed it.
Carefully examine the opportunities (strengths, pros) and challenges (weaknesses, cons) of each choice. I actually like to write these out in two columns and consider them side by side. If applicable, do a cost-benefit analysis of each choice, always keeping in mind the human and financial resources that might be needed to accomplish any chosen goal.
Always take into account how major professional decisions might ultimately affect others, such as co-workers, patients, and even your family members. You might find it helpful to consult one or two trusted friends or colleagues.
When making the ultimate decision, do so in a quiet place, preferably alone, without a lot of auditory or visual distractions. You’ve all heard the phrase “trust your gut.” Listen to your intuition. Which choice strikes you as the best one? Does either choice excite you? Make you feel unduly stressed?
Finally, remember that we all have to live with our decisions. Deliberately consider how any decision overlaps and intersects with your own personal beliefs and values and/or the mission and goals of an organization for which you are making the decision. Do the options detract from organizational mission and goals? Does any option directly clash with your personal morals and core values? If either of the latter two statements applies, re-think the entire proposition.
Once the choice is made, take ownership of the decision. Disclose the decision to those who need to know. If need be, contemplate writing a detailed rationale of the decision to stakeholders. Should an organization be involved, you may need to amend existing published policies or create a new one. Keep in mind what Warren Buffett once said, “We all make mistakes. If you can’t make mistakes, you can’t make decisions.” If you’ve made a mistake, if your decision doesn’t turn out well, then admit it and take corrective action as soon as feasible.
