Decision making is something all of us do, and we do it all of the time. In some instances, the process can be almost automatic, while in others, it can be lengthy and cumbersome. While significant research has been done into how people make decisions, many people are unaware as to how they personally make decisions.

I have taken on the task of learning all that I can about decision making. My research has led me to experts like Daniel Kahneman, Herbert Simon, Gary Klein and Richard Thaler. Here’s some insight from each of these individual’s findings along with my own on the different methods you can use in your own decision making.  In addition, I’ll add some insight into how better decisions can lead to better health outcomes.

Satisficing and Optimizing
Herbert Simon is known for coining the concept “satisficing.” I find myself satisficing often and never gave much thought to the fact until I read what Simon had to say about it. Satisficing is the practice of finding an option that will work to solve a given problem. This doesn’t mean that you spend time trying to find the single best option — it means that you choose an option that will suffice, or satisfice.

Food choices are an area where I often satisfice rather than optimize.  It is faster and usually cheaper to eat fast food than to make something healthy or to seek out healthy food alternatives.  These easier alternatives solve the hunger need, but they are far from optimal when it comes to optimizing my health.

Healthy choices are typically optimizing choices and the ease we have in choosing quick and cheap food alternatives leads to less than optimal health outcomes.

Thinking ‘Fast And Slow’
Daniel Kahneman received a Nobel Prize in the 2000s for his concepts involving how our brains often deceive us when making decisions. He gained great notoriety for his “prospect theory,” but he also discussed concepts called priming, recency and many others. Much of this is brought to light in his best-selling book Thinking Fast and Slow.

Fast-thinking (System 1) and slow-thinking (System 2) explain how our brains often flow through easy decisions then stagnate or slow when we need to compute results or exhibit critical thinking.

Fast-thinking can be spontaneous, but slow System 2-thinking requires a much deeper focus and effort. Fast-thinking often gets us into trouble when we let our brains use models that may not completely apply to a situation. Slow-thinking is essential, but our brains use up much of our capacity when called upon to shift to it.

Many health choices are distorted by priming, the process of planting thoughts in our mind that cause us to make choices that are pushed in certain directions.  Diet fads often cause people to greatly alter their lifestyle or their food choices based on what they read or see in the media.  Rather than take the time to “drill down”, a focus of System 2 thinking, we let our brains take us to the quick solution, the one we are “primed” to choose.

Choice Architecture
Richard Thaler received a Nobel Prize in 2017 for his work in behavioral economics. His book Nudge: Improving Decisions about Health, Wealth, and Happiness discusses the many methods organizations can use to encourage individuals to make what are considered to be appropriate choices.

One of the concepts he explains is choice architecture, in which “nudging” can influence people to make a choice. It’s a powerful tool for driving behavior. It’s similar to the concept of an “opt-out” versus “opt-in” approach when it comes to your driver’s license listing you as an organ donor. The more organ donors there are, the higher the availability of organs.  This “nudge” making the organ process an “opt-out” versus an “opt-in” is a positive approach to decision making that provides benefits for many in the general population.  Prior to this type of decision architecture, the incidence of organ donation was much lower in areas that relied upon “opt-in” for organ donation.

Experience and Intuition
In his book Streetlights and Shadows: Searching for the Keys to Adaptive Decision Making, Gary Klein supports the value of experience and intuition in the decision making process. He uses firefighters as an example. When a situation is predictable or more structured, it will provide an opportunity for experience or intuition to be more useful in the decision making process. Firefighters amass tremendous amounts of knowledge that they can intuitively draw upon from fighting fires. They see what occurs in situations, then apply this experience when they see similar circumstances appear in a new situation.

When decisions are made where ample amounts of discussion or feedback are available, this too provides a good opportunity for using intuition or experience in the decision making process. These opportunities for individuals to discuss and review occurrences and outcomes allow for intuitive outcomes to be reviewed and considered.

Experience can be a great resource for health-related decisions, but experience can also be a barrier.  Much of the diagnoses process in determining a patient’s condition relies upon the experience described by Klein, but this experience also prevents providers from seeing “outside the box” when it comes to unique and rare issues.

Decision making is a conscious and unconscious process we all deal with every day.  Understanding how we make decisions and also how our decisions can be influenced will aid our ability to make better, sometimes optimal, decisions that affect and improve the health of each of us.


Photo by NeONBRAND on Unsplash



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