Understanding, Managing, and Preventing Decision Fatigue

Sarah Wolff, DVM
September 24, 2024
4 min

Decision fatigue is sneaky. It’s a problem that creeps into our veterinary practices but often flies under the radar. Many of us aren’t even aware of what’s causing it or how much it impacts our work and well-being.

What Is Decision Fatigue?

Think of decision fatigue as your brain running low on gas during a long shift. Instead of sputtering to a stop on the side of the road, you find yourself procrastinating,1 taking the easy route,2-4 or making poor decisions. Over time, this leads to stress, frustration, and burnout.

Understanding Decision Fatigue

Self-control is a critical component of logical decision making. Unfortunately, self-control is a limited resource, and each decision we make uses up a little of our reserve. When we’re running on empty, our work suffers—we procrastinate, become impulsive, and are more prone to serious mistakes.

Even high performers in other fields know how important it is to sidestep decision fatigue. Steve Jobs wore the same outfit every day so he didn’t waste mental energy picking clothes. Jennifer Aniston ate the same salad for years while filming Friends. They understood that fewer decisions meant more brainpower for what really mattered to them.

Whether we’re tech moguls, actors, or veterinarians, we all need strategies to fend off decision fatigue and the mistakes that often accompany it. Personally, I’ve mixed up similar cases and delayed important callbacks when decision fatigue hit. In human medicine, decision fatigue can lead to doctors overprescribing antibiotics3 and has been linked to increased patient mortality.5 Scary, right?

Preventing Decision Fatigue

Tackling decision fatigue is like managing a complex case: it takes a comprehensive approach. Here’s what you can do on both a personal and practice level.

Personal Strategies

  1. Get enough sleep: Aim for 7 to 9 hours. Running on less can increase your error rate by 15 times!6
  2. Prioritize mental health: Anxiety, depression, and perfectionism can mess with how we process information, making simple cases feel overwhelming.7
  3. Plan your nutrition: Complex clinical decisions burn more glucose than everyday choices. Keep your brain fueled with healthy meals and snack breaks.8
  4. Use shortcuts: Experience builds mental shortcuts naturally, but if you’re a newer vet or you’re facing an unusual case, lean on practice protocols and algorithms to save brainpower.9

Practice-Level Strategies

  1. Protocols: Make sure everyone has access to protocols for common cases. No need to reinvent the wheel every time.
  2. Provide resources: Even seasoned team members benefit from diagnostic algorithms. Keep everything up-to-date and easy to access.6
  3. Mandatory breaks: Breaks are nonnegotiable. Leaders should set an example and explain why they’re essential for both individuals and the whole team.10
  4. Leverage your team: Don’t let the veterinarian carry all the decision-making weight. Spread it across the team to boost efficiency and ensure every capable team member gets to be part of the most interesting parts of our work.

Recovery Strategies

We’ve all had those shifts where everything feels like a chaotic blur. It’s crucial to recognize when decision fatigue is hitting hard and take action to recover.

  1. Prioritize tasks: Sort your to-dos into urgent and important, important but not urgent, urgent but less critical, and low-priority. Delegate or delay where you can.
  2. Recharge your brain: Grab a snack, step outside for a breath of fresh air, or take 5 minutes to clear your mind. Small resets go a long way.
  3. Reschedule when needed: Some tasks are better tackled later when you’re in a clearer headspace. Pushing through when you’re drained can lead to costly mistakes.

The Client Perspective

Clients feel decision fatigue too. Unlike us, they lack medical know-how, so each choice takes a bigger toll on their cognitive resources—especially during stressful visits.

Help them out by breaking decisions into bite-sized options. If you sense they are overwhelmed, give them some time (and maybe even a snack!). When a choice isn’t time-sensitive, offer to follow up the next day, when they are more likely to feel confident in their decisions. 

Addressing client decision fatigue will not only relieve pressure in the moment but will also reduce the amount of regret and resentment clients feel after the fact, making it more likely that they’ll return as loyal customers.

Related Article: Tough Conversations with Pet Owners: 5 Tips for Veterinarians

Takeaway Points

  • Decision fatigue is like a syndrome, with many contributing factors and many management options.
  • Ignoring decision fatigue isn’t an option. By being aware and taking proactive steps, we can reduce stress, improve patient outcomes, and improve client satisfaction.

Next time you’re feeling swamped by decisions, remember: You’re not alone, and there are plenty of ways to keep decision fatigue from running the show. Here’s to making choices that don’t leave you drained!

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About the Author

Sarah Wolff is a veterinarian and client experience consultant with 23 years of hands-on experience. Through consulting and public speaking, she helps veterinary practices attract and retain their dream clientele. She believes that client relationships are the cornerstone of veterinary care and that everyone wins when we care for both ends of the leash. She can be found online at drsarahwolff.com and on Instagram @drsarahwolff.

References

  1. Cleveland Clinic. 8 signs of decision fatigue and how to cope. Published June 1, 2023
  2. Persson E, Barragrem K, Meunier A, Tinghög G. The effect of decision fatigue on surgeons’ clinical decision making. Health Econ. 2019;28(10):1194-1203. doi: 10.1002/hec.3933
  3. Linder JA, Doctor JN, Friedberg MW, et al. Time of day and the decision to prescribe antibiotics. JAMA Intern Med. 2014;174(12):2029-2031. doi: 10.1001/jamainternmed.2014.5225
  4. Nasa P, Majeed NA. Decision fatigue among emergency physicians: reality or myth. Indian J Crit Care Med. 2023;27(9): 609–610. doi: 10.5005/jp-journals-10071-24526
  5. Ye H, Yi J, Zhong S. Decision fatigue in physicians. Department of Economics, National University of Singapore. Published 2019.
  6. Westbrook JI, Raban MZ, Walter SR, Douglas H. Task errors by emergency physicians are associated with interruptions, multitasking, fatigue and working memory capacity: a prospective, direct observation study. BMJ Qual Saf. 2018;27(8):655-663. doi: 10.1136/bmjqs-2017-007333
  7. Gruszka A, Matthews G, Szymura B. Handbook of Individual Differences in Cognition: Attention, Memory, and Executive Control. Springer New York; 2010.
  8. Gailliot MT, Baumeister RF. The physiology of willpower: linking blood glucose to self-control. Pers Soc Psychol Rev. 2007;11(4):303-327. doi: 10.1177/1088868307303030 
  9. Moorhouse A. Decision fatigue: less is more when making choices with patients. Br J Gen Pract. 2020;70(697):399. doi: 10.3399/bjgp20X711989
  10. Allan JL, Johnston DW, Powell DJH, Farquharson B, Jones MC, Leckie G, Johnston M. Clinical decisions and time since rest break: An analysis of decision fatigue in nurses. Health Psychol. 2019;38(4):318–324. doi: 10.1037/hea0000725