The Processes of Decision-Making and Problem-Solving

Abstract

The good decision-maker must be able to define the elements inherent in a particular situation to include identifying the real problem as well as what aspects are not immediately apparent. Other factors include, but are not limited to, identifying major or critical variables and comparing the present situation with one’s experience with past similar problems. Addressing each of these elements in a systematic manner is a critical part of utilizing the decision-making cycle presented earlier to its maximum effectiveness. The practice of medicine is filled with risk and uncertainty—elements that physicians do not relish. Achieving the optimal outcome for the patient is not always possible, and assuming risk is unavoidable but is part of being a busy clinician subject to distractions and constraints on our time and concentration beyond the problem at hand. Considering only the scientific and technical aspects of any clinical problem is not adequate. The humanistic elements ethics, family dynamics, patient desires, and expectations must be balanced and tempered with our technical knowledge, skills, and judgment. The kaleidoscope model presented here integrates these elements visually and can be used as an aid when seeking the optimal decision or discussing the outcome of a decision in a forum or teaching situation.