The theme for GLMS this month is “ The Power of the Decision ” with the guidance that small decisions can have a big impact , either immediately or with implications for the future . Many decisions involve both , but we ’ re not always able to weigh every implication prior to our decision-making process . What we can do is acknowledge the immediate impact by visualizing and appreciating what outcomes have occurred . Only time will provide the long-term consequences of our decisions .

I have shared many aspects of my life in these articles , and you can appreciate that behind much of what I have shared , a multitude of decisions were made . Some of these decisions at times seemed almost paralyzing . I have made decisions based on a thoughtful , introspective personal conversation with myself and I have reached out to mentors , friends and family for their invaluable perspective . And , in full transparency , I have also made decisions that were rather quick , and , I would like to think , efficient : not careless , not haphazard , but thoughtful and deliberate .

What process do you use to determine the best decision ? Most of us recognize that there are major decisions which can be life-changing but I would ask you to consider that a seemingly minor decision could lead to a life-changing event . Having too many decisions at once can create a sort of paralysis . We can feel sort of frozen in place , fruitlessly running over various options . This uses up the time necessary to fully explore the risk and rewards . Should we consider delaying the process , telling ourselves that “ we need more time ” since we fear the decision and its consequences ? Decisions require us to explore not just our options , but our feelings . We should determine the impact and establish if we think it more likely we ’ ll succeed or fail .

This brings me to one of the most important aspects of the decision-making process that many of us come to accept : how does one measure regret ? Does one fear or embrace regret ?

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Daniel Pink ’ s book The Power of Regret : How Looking Backward Moves Us Forward offers his perspective on embracing regret and using it as a tool to move one forward . Regret can offer an opportunity to improve our decision-making process . We can look at regret as a more positive experience that propels us forward armed with the knowledge gleaned from less than ideal outcomes .

As I have previously shared , the decision to attend medical school occurred at a time in my life that was totally unexpected . It was a decision made by 1 . Exploring my options ( what if I was not accepted ? – back-up plan in place ), 2 . What would be the impact on my family ? ( discussed at length how to make it less onerous for them ), and 3 . What would I do if I failed ? ( hard to accept , but back-up plan ready ). As I look to the past , there are some minor decisions that I regret and now use in my personal dialogue to motivate me moving forward . Regret is a tool I accept !

As physicians , we make many decisions by having a clear and precise conversation with ourselves ( and our patients , in that setting ). We reach a decision based on facts and experiences present at the time of the decision – making process . Based on the outcome , we then strengthen our experience in future decisions . And yes , we utilize regret to acquire knowledge that was not previously available . Hence , we look backward to move us forward . We make decisions based on the understanding that there is not a perfect choice , but a choice made that has been reflective , evaluated for pros / cons and ultimately based on the information available at that time .

Then , we live with it .

Dr . Purcell currently serves as the District IV Vice Chair for the American Academy of Pediatrics .