Have you ever had to make a decision with a multitude of options on the table and you stand there, mouth open, feeling a little like an idiot? Then you decide that getting a bagel is the most critical next step. Then you buy a Diet Coke. Then you decide to decide later. The fact is that we approach change two different ways – analytically and emotionally. Generally, our emotions are the bigger part of our decision making process. They kick in first and let go last. Beyond our emotions lies the analytical element, where we think about options and determine our best course. In their book Switch – How to Change Things When Change is Hard, Chip Heath & Dan Heath share the following story about how change can literally force our thinker to a point of indecision:
“A doctor was asked to consider the medical records of a 67-year-old patient who had chronic hip pain from arthritis. In the past, the patient had been given drugs to treat his pain, but they’d been ineffective, so the doctor was forced to consider a more drastic option: hip-replacement surgery, which involves slicing open the thigh, wrenching the bone out of the socket, sawing off the arthritic end, and replacing it with an implant. Recovery from hip-replacement surgery is long and painful.
Then came an unexpected break in the case: A final check with the patient’s pharmacy uncovered one medication that hadn’t been tried. Now the doctor faced a dilemma: Should he prescribe the untried medication, even though other medications had failed, or should he go ahead and refer the patient for surgery?
This dilemma, based on real medical cases, was created by physician Donald Redelmeier and psychologist Eldar Shafir, who used it to study the way doctors make decisions. When doctors were presented with this case history, 47 percent of them chose to try the medication, in hopes of saving the patient from going under the knife.
In a variation on the dilemma, another group of doctors were presented with almost exactly the same set of case facts–except this time, the patient’s pharmacy discovered two untried medications. If you were the patient with the arthritic hip, you’d be thrilled–certainly two nonsurgical options are better than one. But when the doctors were presented with two medications, only 28 percent chose to try either one. . .
What happened here is decision paralysis. More options, even good ones, can freeze us and make us retreat to the default plan . . . ”
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