How To Make The "Right Decision" More Often, From A Harvard Psychologist 

Too often, we divide the world into mindless dichotomies. You either have control or you don't. But the real question is: control over what? And from whose perspective? This is especially true when it comes to medical decisions.

For the vast majority, if not all, of such decisions, the outcomes are probabilistic and full of uncertainty. Which treatment should you choose? The doctor will typically frame the alternatives in terms of potential outcomes.

Take the question of knee surgery, a common dilemma among my friends.

We should begin by recognizing our limitations; the human brain is not an omnipotent supercomputer. Moreover, even if it were, there's the "problem" that every cost is also a benefit from a different perspective. As a result, when making decisions in uncertainty, more information, time, and calculations are not better. In fact, taking too much information into account can backfire, leading people to overthink the problem and choke.

Sian Beilock and Thomas Carr's work shows this at work in an educational setting.1 If we are anxious about a math problem, we consider too many possibilities, which can consume our scarce working memory and keep us from solving the problem at hand. We're so worried about getting it right that we get it wrong.

Imagine deciding whether to buy a house. What states, cities, or neighborhoods to consider? How much can you really afford to pay? To answer this question, we might need to know what the economy will look like in five years, whether the stock market will grow or shrink, whether our jobs will remain secure, whether unexpected expenses will occur, whether we'll remain married and continue to need a house, whether we'll continue to want the costs of homeownership, and so on. The list is almost endless, and each of the pieces of information above has its own inherent uncertainties and risks.

Rather than recommending endless analysis, my experience and research suggest taking a limited amount of information available at the time and going ahead and choosing an option. Then, rather than worry about whether the decision was right, we should try to make it work.

Look at any advantages that accrue from whatever happens, and then play it as the "right decision." That is, don't try to make the right decision; make the decision right.

The same applies to medical plans. That is, don't try to make the right decision, make the decision right by enrolling in a local gym or signing up for physical therapy after knee surgery.

We can never be sure our knee wouldn't heal on its own or with just a consistent practice of yoga or whether some new magical drug would soon be coming to market. We can never be sure the surgery will be successful. On the other hand, the surgery could be successful and we finally could be pain-free post-surgery.

Regardless of whether you do have the surgery, the next step is basically the same: Do all that you can to regain the pain-free life you're seeking. Satisficing suggests there is a correct answer but it's too hard to figure out. My view is that there is no correct decision independent of the decider making it right.