For Growth-minded, independent, specialist physician-owners.
Why Smart Practice Owners Make Bad Decisions (And How to Stop)
Decision-Making Series for Practice Owners, Part 1 of 7. Most practice owners don’t struggle because they lack intelligence or effort. They struggle because they’re making million-dollar decisions with $5 decision tools. This series fixes that.
DECISION-MAKING
Pam Thompson
2 min read
Medical practice owners are not bad decision-makers.
They’re intelligent, highly trained, disciplined, and used to working under pressure. Yet many practices stall, struggle, or plateau, not because of a lack of clinical skill, but because of decisions that seemed reasonable at the time and under-performed later.
Unfortunately, most damaging practice decisions don’t look reckless. They look “logical”.
The Myth of the “Obvious” Decision
When owners look back on a disappointing hire, expansion, or investment, they often say things like, “It made sense at the time.” “Everyone else was doing it.” “I didn’t see a better option.”
That’s because the decision wasn’t careless. It was too narrowly framed.
Growth decisions are rarely about intelligence or effort. They’re about how the problem was defined before a solution was chosen.
Why Clinical Excellence Doesn’t Translate to Strategic Clarity
Medicine rewards decisive action under uncertainty. Strategy punishes it.
In clinical work, doctors tend to choose the best option quickly because delay has consequences. In business, rushing to a “good enough” answer can create downstream consequences that last years.
Practice owners tend to:
* Default to familiar solutions
* Overestimate capacity improvements
* Underestimate execution complexity
* Assume systems will “catch up later”
They don’t fail because they chose badly. They fail because they didn’t widen the decision frame first.
The First Fix: Stop Asking the Wrong Question
Most struggling practices didn’t make one catastrophic decision. They made a series of reasonable ones based on incomplete thinking.
Better outcomes start with a shift from asking “what should I do” to “what am I actually trying to solve?”
For example, revenue problems are often capacity problems. Capacity problems are often workflow problems. Workflow problems are often leadership or system problems. So, instead of solving the symptom of “revenue problems” and getting it wrong, in order to get it right, you need to follow the path down to its root cause, and solve for that.
If you solve the wrong problem well, you still lose. Solving the right problem is easier, and actually produces the result you want.
So, what are you actually trying to solve?
The next post in this series, "Why Pro and Con Lists Are Holding Your Practice Back" (Post 2 of this Decision-Making Series ) will show you how to kill the most common bad habit in decision-making.
I wrote an in-depth, step-by-step “how-to” guide to help practice owners find and solve the right problem to achieve their goals. You can download it for free HERE.