We make thousands of decisions every day, yet most of us have not been taught how to make better decision. Doctors make critical decisions daily. The consequences of these decisions impact upon the lives of people. Sometimes, the quality of decision determines outcomes between life and death.
Making decision is a complex process that requires an ability to process relevant information, apply diverse mental frameworks and exercise sound judgement. We are going to discuss 3 frameworks every great thinker carries in his toolkit to make better decisions.
Are you a lateral thinker?
Doctors are trained to approach problem in a selective, analytical, and sequential way. They are conditioned to think vertically. We will get into logical and linear reasoning in a moment.
Can we use vertical thinking to tackle every single problem?
As the adage goes “If your only tool is a hammer, then every problem looks like a nail.” Applying vertical thinking to every problem is like pounding everything with a hammer.
Lateral thinking is a term coined by Edward de Bono. He described an approach that rejects the ‘status quo’ of ideas and conceives new creative ways to address challenges. In other words, lateral thinking is to move away from conventional line of reasoning and embrace creative solutions by thinking outside the box. An inquisitive mind is crucial to think laterally. Innovations in medicine often stem from lateral thinking.
Lateral thinking in medicine
Prior to the 1982 discovery of the bacterium Helicobacter pylori, the prevailing scientific knowledge considered stress and lifestyle problems as the main causes of peptic ulcer disease and gastritis. Dr Marshall and Dr Warren challenged the medical doctrine and rejected the status quo. Marshall’s approach in proving that H. pylori caused inflammation of the stomach gives us a glimpse of lateral thinking in action. He deliberately infected himself by swallowing a culture of the bacterium and developed gastritis. Marshall underwent endoscopy and stomach biopsy. The presence of H.pylori in the tissue samples proved the causative effect of the bacterium.
The discovery of the bacterium Helicobacter pylori and its role in gastritis and peptic ulcer disease radically changed our understanding and overturned previous view. Dr Marshall and Dr Warren jointly won the Nobel Prize in Physiology or Medicine 2005 for their discovery. The recognition of peptic ulcer disease as an infectious disorder has opened the way to a simple cure by eradicating the causative agent. A key component of the pair’s breakthrough is credited to their ability to think laterally.
Thinking outside the box
You probably know Leonardo da Vinci for his painting of The Mona Lisa. This masterpiece was undoubtedly a product of lateral thinking. Da vinci possessed an incredibly inquisitive mind and did not limit himself to one discipline. He combined interdisciplinary knowledge from anatomy, botany and mathematics in his paintings, experiments and inventions. In other words, he thrived being a generalized specialist.
Second-order thinking
“Failing to consider second- and third-order consequences is the cause of a lot of painfully bad decisions, and it is especially deadly when the first inferior option confirms your own biases. Never seize on the first available option, no matter how good it seems, before you’ve asked questions and explored.”—Ray Dalio
In Thinking Fast And Slow book, Daniel Kahneman described two systems of thinking: system 1 and system 2. First order thinking is simple and easy. It is driven by system 1 thinking which is intuitive, fast and emotional. Most people are first order thinkers. They solve for immediate problems without thinking of the 2nd, 3rd or Nth order consequences.
Second order thinkers look past the immediate consequences of a decision. They consider the long-term consequences of a decision, analyse the impacts of an intervention at a micro and a macro level. Second-order thinkers see things that others can’t see. They see upstream, downstream and avoid potentially negative consequences by anticipating and planning their next moves. Second order thinking involves system 2 thinking which is more deliberative and more logical. It takes a lot of effort to become a second-order thinker. Many people don’t engage system 2 and rely only on system 1. Kicking the can down the road hoping the problem will go away delays dealing with a serious problem.
Examples
First order thinking: “After a long shift at work, let’s eat a chocolate bar and watch Netflix. I’ve earned it.”
Consequence: You satisfy your craving at the expense of sabotaging your health by choosing a sedentary lifestyle.
Second order thinking: “I’ve had a long shift at work, let’s go for a run and get some fresh air.”
Consequence: You understand the benefits of movement to your body and develop a healthy post-work routine. This choice may seem difficult in the short term.
System 1 thinking is an effective model for most decisions we make every day. Many unimportant decisions can be processed with first order thinking. It is intuitive and effortless.
If we didn’t use system 1 thinking and only applied system 2 thinking for every decision, life would be impractical.
System 2 thinking is more effortful and slower. We benefit from applying it in our most important decisions.
Why do we need to consider the worst case scenario?
Scenario planning is an invaluable tool good decision maker can’t ignore. Being optimistic about the future doesn’t mean you should ignore the worst-case scenario. Considering the worst-case scenario helps in managing risks should a potential disaster emerge. The thought process of conceiving the worst possible outcome enables you to develop contingency plans to prepare for the worst. Nobody knows what the future holds. Planning for the worst-case scenario is taking measures to mitigate unnecessary risks.
Conclusion
Good outcome doesn’t always follow good decision. Sometimes, a good decision can lead to a negative outcome. While we can’t control every outcome we can control every decision we make. We make tons of decision every day that shape our life. What separate great decision makers from the pack is their ability to apply diverse frameworks to consistently make good decisions with sound judgement.
