Decision Making

Making a decision can be really hard and stressful. Making decisions that will affect your whole life can be especially hard to do. These decisions need a lot of thought. Decision-making is the steps we go through when choosing what to do by considering what will happen with each choice (1). Our decision-making skills are influenced by our thoughts, the way we think, our society and our culture (1). Also, the way we make decisions changes as we age and with more experience (1).

Luckily, there are steps you can use to make a decision that will allow you to make the best choice (2) (3) (4). Follow the example as you go through each step.

1. Identify the Problem.
a. This is the most important step!
b. Say your problem in a simple, one-sentence description.
 I am experiencing a lot of pain.
c. Look at how, where, when, and with whom the problem is happening.
 My pain is all over my body. This happens several times per week.
d. Look at causes of the problem.
 My pain is caused by my fibromyalgia condition.
e. Approach the problem with confidence, knowledge, and effort.

2. List Possible Solutions.
a. Think about past solutions. Have these worked or not? Why?
 I have taken Tylenol when I was in pain. However, the Tylenol did not help the pain because Fibromyalgia is a different kind of pain.
b. Don’t limit your solutions. List everything.
 My possible solutions: Take pain medication, try an alternative medicine technique, go back to the doctor, or try to stay in bed when I have pain.

3. Determine which solution is the Best Choice.
a. List all of the good things and bad things that come with each possible solution. Write them down, so you can see it.
 Taking pain medication may eliminate my pain, however it could be expensive and it will require me to remember to take the medication daily.
 Trying an alternative medical technique, such as acupuncture, could decrease my pain and would be relaxing. However, it may be expensive and require time.
 Going back to the doctor may help because he could suggest a new treatment. However, it may be expensive, require time, and he may not have any new suggestions.
 Staying in bed on the days I have pain would be relaxing. However, if I don’t get of bed, I won’t get anything done that day and I will feel bad about myself.
b. Determine risks of each solution.
 The risk of pain medication is that I may need to increase my dosage over time.
 The risk of an alternative medical technique is that it could increase my pain if I don’t choose the right technique.
c. Take as much time as you need. Even “sleep on it” if needed.
d. Choose the solution that is best for you!
 I chose to try an alternative medicine technique, such as acupuncture.

4. Act on your Decision.
a. Make a detailed plan of action for your decision. Include how, when, and where you will act on your decision.
 I will try an acupuncture session with Dr. John next Monday at 2 p.m.
b. Think of the resources you will for your decision, such as money, time, people, etc.
 I will talk with my insurance company to see how much I will be charged. I will need to make time for the appointment, and I will need transportation.
c. How will you know when your decision is acted on?
 Once I have completed my acupuncture session, I will know that I acted on my decision.
d. Give the decision your best effort!

5. Review your Decision.
a. Did your decision help or solve the problem?
 The acupuncture session decreased my pain.
b. If the decision was too difficult to do, you may want to review, redo, and/or rethink your other solutions.
c. Ask yourself, what did I learn from this?
 I learned how to really think about a problem before making a decision.

Another way to think about decision-making is by remembering the art, science and practice of problem solving. The art would be asking good questions (6). The science would be answering these questions, reviewing the answers and evaluating their results (6). Finally, the practice would be acting on the solutions (6).

There are online tools you can use to help you make a decision. One online resource titled the Ottawa Personal Decision Guide can help you identify the decision, weigh the benefits and risks, and help you review items such as knowledge, support and values. This guide is designed for people facing tough health or social decisions. It can be found at http://decisionaid.ohri.ca/decguide.html.

Think about your problems as opportunities. Try not to focus on the problem, but rather the answers to the problem (6). Remember that how you understand or see the problem can make a difference in your ability to solve it (6). See every problem as an opportunity (6)!

Healthcare decisions can be very hard to make. However, there are steps you can use to make a healthcare decision. These steps can be remembered by the letters BRAND. The steps are (5):
1. B- benefits of the action (the good things)
2. R- risks in the action (the bad things)
3. A- alternatives to the prospective action (the other possible choices)
4. N- nothing, that is, doing nothing at all
5. D- decision

Here are a few examples of how to use the BRAND model for making a healthcare decision.
Example 1. I have been diagnosed with cancer. My doctor recommends chemotherapy for treatment, however the doctor says there are other options, too.
B- The chemotherapy would reduce my cell count and help the cancer. It could also bring me to a state of remission.
R- Chemotherapy is very time consuming. I would also lose my hair and have to increase the time I spend sleeping.
A- I could try another medication or form of treatment. I could also try an alternative medical technique, such as guided imagery.
N- I will think about it for one week.
D- I decided to do the chemotherapy.

Example 2. I am considering changing doctors because my condition is not improving.
B- I want to get a “fresh eye” with new ideas and treatment options. This could improve my condition and decrease my pain.
R- It will take time for the doctor to get to know me and my history. My condition may not improve. The cost and travel time may be different than my current doctor.
A- I could also talk to my current doctor about seeking new treatments, medications, or other ideas.
N- I will think about it for two weeks.
D- I will talk to my current doctor about trying a new treatment or medication because he is experienced in my medical condition.