Navigating Healthcare Pt IV: Make Decisions (MD)

Daniel Fosselman
Apr 24
4 min read

Is This Series Too Much—or Just What We Need?

I sometimes wonder whether this series has been helpful or simply overwhelming. But if we agree that conflicts of interest exist in healthcare—and they do—then the next question is: How do you, as an individual, make better decisions and advocate for yourself?

Unfortunately, the health space is flooded with content, but not much of it teaches effective decision-making. The good news is that there are thought leaders—across psychology, behavior change, and economics—who have made major contributions in helping people think better.

Learning to Think: Mental Models and Cognitive Tools

Foundational thinkers like Daniel Kahneman and Amos Tversky laid the groundwork with their research on decision-making, particularly the book Thinking, Fast and Slow. This work is a great introduction to understanding how we process information and why we often get it wrong.

The field of behavior change psychology has also grown, thanks in part to researchers like BJ Fogg, whose work informed James Clear's popular book Atomic Habits. Another go-to resource for me is Shane Parrish, whose podcast The Knowledge Project focuses on mental models—a way of understanding how the smartest people in the world approach thinking. These ideas are heavily inspired by Charlie Munger, Warren Buffett’s longtime partner.

Another excellent voice is Annie Duke, a former professional poker player who studies decision-making under uncertainty. Life, like poker, is a game of probabilities—but most of us are never taught how to think probabilistically.

MD = Make Decisions

One of the best dad jokes in medicine is that “MD” stands for Make Decisions. In clinical practice, we’re constantly forced to decide quickly and confidently. Many people get stuck in paralysis by analysis—but as physicians, we don’t have that luxury. We're trained to move forward, even when the path isn’t completely clear.

Two Simple Tools:

The Eisenhower Matrix: Categorize tasks based on urgency and importance.
The Shark Bite Rule (Dan John): If it takes less than 2 minutes, do it immediately. James Clear calls this the Two-Minute Rule.

When it comes to small decisions—what to eat, what to wear, where to go—make the choice quickly and move on. These things ultimately don’t matter much. For bigger decisions, especially those involving health or relationships, take the time they deserve.

As a physician, I often feel like I’m on an island. I can’t defer. I must decide. That pressure, while difficult, is a powerful teacher. Yet outside of medicine, too many people have become overly dependent on specialists, especially in urban environments where hyper-specialization is the norm. This dependence creates blind spots—especially when financial incentives are involved.

Systems Are the Antidote to Chaos

We live in a time of overwhelming complexity. There’s more data, more choices, more noise than ever before. As a result, people freeze. Many look for a cookbook to life—a step-by-step manual that tells them exactly what to do. But that only works for some.

Roughly 10% of the population is naturally anti-authoritarian, and that’s a good thing. These people resist being told what to do—and often help society progress by challenging norms. They still need systems, but they need to build those systems for themselves.

Books like Michael Pollan’s Food Rules offer simple guidelines without dogma. And as Americans, we value freedom—perhaps because many of us descend from immigrants who had the audacity to cross an ocean with nothing but a dream and a bit of madness. This frontier mindset is powerful, but it also means the U.S. has higher rates of mental illness, including bipolar disorder, than most of the world. (Australia may give us competition there—after all, it started as a penal colony.)

Life as a Game of Learning

This is why games and sports matter in childhood. They teach risk, uncertainty, and decision-making—without major consequences. Games mimic life: there are rules, risks, and opportunities. You can cheat and get away with it—at first. But if you’re caught, no one wants to play with you again.

So don’t cheat. Play hard. Have fun. Be competitive. But help others too. When you lift people up, everyone wins. Life works better when we leverage each other's strengths, and the more you invest, the more you get in return.

Redefining Success in My Practice

As I’ve said before, the Latin root of “doctor” is “teacher”. My job isn’t just to fix problems—it's to teach people how to live with fewer of them.

Success in my practice is simple: I’ll know I’m doing a good job when my patients only need to see me once or twice a year. My goal is to align their current lifestyle with their ideal life trajectory, while improving health, energy, and clarity so they can focus on what really matters to them.

But values shift. Goals evolve. Who you are at 25 is not who you are at 55. That’s normal. In fact, the second half of life should be about unlearning—stripping away the noise and nonsense we’ve picked up from society.

Reclaiming Our Original Self

We are born curious, joyful, musical, loving, and playful. These qualities get stripped away as we conform to expectations. Over time, we forget who we really are.

The task of adulthood is to remember.