Is “Getting it Right” Slowing you Down?

A decision that should have taken 20 minutes has been following you around for two weeks. Do we keep using a specific manufacturer’s product line as payment rules and margins change? Do we move a portion of our fabrication to a C-Fab or try to hire a new technician? Do we keep working around incomplete records and notes, or put a firm stop in the workflow before a case reaches the clinical schedule? 

You think it through, sleep on it, ask a few people, and think it through again. Somehow you are no closer to a decision than when you started. 

A recent article by leadership researcher Amanda Nimon-Peters makes a helpful distinction: thinking hard about a decision can improve it; overthinking is the loop that adds time and stress without adding clarity.1 That matters in a small practice, where you may be the clinician, manager, troubleshooter, and decision-maker. 

The goal is to recognize when more thought is useful and when it has stopped helping. 

Getting Stuck 

Overthinking tends to follow three patterns. 

Trying to find the perfect option. This is the owner who cannot approve a modest purchase without several vendor calls, a comparison spreadsheet, and another week of reflection. The problem starts when the search for the “best” option holds up a reasonable one that would solve the real problem. 

Too many choices with no clear goal. You may be looking at multiple potential manufacturers whether you should commit to a single C-Fab or multiple, or keeping everything in house, the challenges and the solutions are practically endless. The sticking point is often not the number of choices. It is that nobody has said what matters most: shorter fabrication turnaround, fewer missed appointments, better documentation, or a cleaner patient handoff. 

Replaying the decision after the useful work is done. This is rumination. “Why do I always second-guess myself?” can feel like problem-solving, but it is not. Once the question becomes proving you are not making a mistake, rather than deciding what to do next, you are no longer moving forward.  

The most useful idea here is simple: you can control the quality of your decision process, but you cannot control every outcome. 

In O&P, there are too many variables outside your control for the outcome to be a fair test. A payer can change a policy. A physician office can send incomplete documentation. A supplier can have a backorder. A patient can miss the fitting appointment after your staff has done everything right. 

You can have a sound process and still get an unfavorable result. You can also get a favorable result after a weak process. Neither outcome, by itself, tells you whether the decision was good. 

For bigger operational decisions, write down the problem, the goal, the information you used, the choice, and when you will review it. That gives your team clarity and a basis for review. 

This is not a substitute for formal compliance review when one is needed. Regulatory requirements, payer rules, and contractual obligations should be checked against the applicable source. But for ordinary practice-management decisions, a simple written decision record can stop you from reopening the same question every month. 

A practical way to get unstuck 

Try this framework this week. 

Start with the one thing that matters most 

Before comparing options review your mission statement and then finish this sentence: “For this decision, success furthers our mission by  ________.” (Note: if you cannot figure out how it furthers your mission, you need to ask why you are doing it.) 

Set a reasonable decision window 

Decide how much information the choice deserves before you gather it. A workflow change may merit a week of staff input. A reversible $400 purchase may deserve a lunch break. Match the effort to the risk. 

Move from “what” to “how” 

When you catch yourself stuck in the emotional loop, change the question. Instead of, “What should I dol?” ask, “How does this challenge impact my mission?” And then, “What is the first next step?” 

Maybe the next step is a 15-minute conversation with your biller, a call to a referral source about partnering in patient care, or a two-week trial of a new intake step. A next step creates information you do not yet have. 

Make the worst case concrete 

For the decisions that keep you awake, name the worst realistic outcome. Be specific. What happens, to whom, and when? Then estimate the likelihood and write down how you would respond. 

Suppose you are considering ending a frustrating payer relationship. The worst case may be a short-term drop in referrals or revenue. The coping plan may be to monitor affected volume, communicate with referral partners, protect capacity for stronger service lines, and revisit the decision after 90 days. Naming the concern and a response makes it more manageable.