• Sara & Colin Taylor

Decision Fatigue

From deciding what to make for supper, to deciding how to manage a complex clinical scenario, we're faced with constant decisions in life each and every day. It can get exhausting. We're fortunate to have free will to make decisions, but still, decision fatigue truly exists.

What is decision fatigue?

Decision fatigue refers to the deteriorating quality of decisions made by an individual after a long session of decision making. It involves ego depletion, where there's a defined amount of mental energy that allows for self-control. Experiments have confirmed the 19th-century notion that willpower became fatigued with use, like a muscle. For instance, after you make a lot of decisions, your willpower goes down and you're more likely to lose self-control.

Decision fatigue in medicine

In a study published in JAMA Internal Medicine, scientists studied antibiotic prescribing practices for respiratory infections over an 18 month period. Unnecessary antibiotic prescribing increased over the course of hours, so that by the fourth hour of seeing patients, a physician was 26% more likely to prescribe an antibiotic than in the first hour.

An article that appeared in the December 16, 2014 issue of the Medical Post indicates that decision fatigue can happen even if someone is well rested but has been making many difficult decisions. The article includes interviews from various physicians, and fortunately, overall recognition of the problem of decision fatigue is growing.

Decisions aren't going anywhere, so what can you do?

Schedule and plan ahead as much as possible (maybe obvious, and still involves some decision-making). Take breaks - novel ideal for the medical culture but it really works to re-set our decision meter.Try to keep your mind fueled with nutrition as much as possible. Something like Kind bars are convenient for your pocket and will do in a pinch.Ask for help - sometimes even verbalizing the quandary can give you the clarity you need. Or straight up asking for someone's input may be just what you need to make a decision.

Well, it's 6 p.m. as we're finishing this up so it's time for a glass of wine for us...no decision involved.

“Alice came to a fork in the road. ‘Which road do I take?’ she asked. ‘Where do you want to go?’ responded the Cheshire Cat. ‘I don’t know,’ Alice answered. ‘Then,’ said the Cat, ‘it doesn’t matter.” ~ Lewis Carroll, Alice in Wonderland


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