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  • Chuck Hulse

Decision Making – Get Better with these TIPS


I suspect the reason that there are so many good books on the topic is that organizations are not so good at decision making. Hierarchical structures and a myriad of legal structures are overlaid with all kinds of unique physician interrelationships that just make decision making messy. Managers are trained in a model of “we decide” and doctors are trained in a medical model of “I decide”. With such training it is difficult to seed decision making to others – their trusted manager or administrator, or even a physician colleague. Lack of effective delegation is but one source of ineffective decision making.

When struggling to understand why your practice is experiencing difficulty with decision making consider the 5 C’s …. Concepts borrowed and paraphrased from a host of authors sprinkled with years of observation of my own successes and failures on the subject:

C1: Are your choices well informed? Did you actively consider alternatives? TIP: Beware of making either /or decisions – remember the genius of AND - can you option 1 AND option 2? Or, what if the choice was no longer an option – what is the next best alternative?

C2: Is the decision you are about to make consistent with the values of the practice?

TIP: Similar to a hospital requiring managers to designate a Studer Pillar to capital budget requests, try attaching an organizational value that is advanced by this decision, e.g. teamwork, productivity, quality of care, financial growth.

C3: Is the decision you are about to make compatible with your 3-year plan?

TIP: The 3-year plan provides FOCUS – how strongly does this decision correlate with your plan?

C4: Are the decision makers prepared to commit to the decision?

TIP: An Amazon executive refers to this as Disagree and Commit – leaders cannot undermine decisions.

C5: How will the decision be communicated to ensure successful implementation?

TIP: Human nature compels us to ask “why” – communicate the why along with the implications and changes that will result from the decision.