Fresh perspective for financial success

Being More Decisive: Widening Your Options

Over the last several posts I have discussed how my colleague asked me for advice about whether to close her practice and become an employed physician, and how I happily put in my two cents without applying any sort of formal or systematic decision making process.

As previously mentioned, one of the main take-home points of this series should be the identification of “whether or not,” or binary decisions, as indicative of being stuck in a narrow frame. Such narrow framing almost always suggests that there are solutions you are not considering, such as:

Ask a trusted colleague faced with a similar decision. We often assume that we are the only person in the world faced with a particular set of circumstances. While we are all unique, many other physicians have been faced with a dilemma similar to my colleague’s. Seeking out someone who left their practice for employment, as well as someone who chose to remain in their practice can help shift the spotlight to areas you might have failed to consider. Ask these individuals to look back. What other options do you have that they may not have considered at the time. These responses can become a playlist of other options for you to consider.

The Heath brothers describe a process that they refer to as laddering. At the lower rungs of the ladder, it is easy to see a solution—as you see someone like yourself—and the solutions that worked for them can easily be seen as working for you, too. But, as you move up the ladder the analogies become a little more difficult, or you may need to look outside your immediate group of colleagues.

A more difficult, or higher level, of laddering exercise is to look at your current situation and identify what you like about it. I recently suggested this to a colleague that had come to me for advice about having the “I’m quitting” discussion with our boss. Going through the “what do I like” exercise made him realize how many things he liked about his current job. The challenge then became how he might incorporate more of the experiences he liked and enjoyed, and do less of those things that sent him down the path of beginning to look for another job.

What are my other options? As for my colleague who was thinking about closing her practice, she only considered two options– her current practice and employment with a local hospital. However, there likely were at least several other options. Consider making a list of other possible jobs. For example, working for a not-for-profit clinic, locum tenems positions, the public health department, or a medical school are examples of employed physician arrangements that my colleague had not considered.

Additionally, ask friends and colleagues to identify people they know who have made career transitions and ask those contacts about all of the different options they considered. What did not work for them might be a great choice for you. Finally, you might want to potentially consider options outside of direct patient care. Insurance companies, law firms, media companies, a host of start-ups, and all sorts of other businesses need medical expertise. A simple Google search can identify all sorts of other things you might consider doing outside of the actual practice of medicine.

Try the Vanishing Options Test. This exercise will help identify other options that you may have failed to consider. Imagine that closing your practice is no longer on the table. You are stuck in your current practice for the next five years with your current colleagues and employees. What will you do to make the best of it and what steps could you take to improve your current situation? You could additionally ask this question of the contacts you identified above, in order to discover options that they considered as ways to improve the situation before they made a decision to transition into a new practice.

Multi-Track. From colleagues in my academic career and from residents that have entered private practice, I very rarely hear about multi-tracking as a way to help make decisions. On the other hand, I often hear lamenting about how a single decision did not work out. One way to tackle this problem is to consider multiple options simultaneously. Physicians may feel that embracing multiple options is too difficult, or will take too long, but there are some distinct advantages. Comparing solutions simultaneously opens up the landscape and lets you see, not only all the different variables impacting your decision, but also gives a more realistic view of what is, and is not, possible.

Think about it—if you were actively trying to improve your current position while simultaneously looking at other practice options, you will be less disappointed when one of the options does not work out. Such a built-in back up plan can be really freeing. For example, if my colleague tries to improve on what she doesn’t like about her current practice, while at the same time negotiating with the local hospital over an employed position, it will be much easier for her to remain in her practice if she ends up feeling undervalued by the local hospital. And she will not feel as though she has wasted several months only to be back at ground zero.

Previous articles in the Being More Decisive series:

You’ve Got to Make a Decision, But Do You Trust Your Gut?

The 4 Villains of Decision Making

WRAPing Your Way to Better Decisions

Dr. Pat Bass

Dr. Pat Bass is a physician, writer, educator and scientist that cares for both adults and children. Currently an Associate Professor of Medicine & Pediatrics at Louisiana State University Health Science Center in Shreveport, he participates in an active clinical practice, medical education activities and health literacy research. View full bio on authors page