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How Decision Fatigue Impacts Physician Micro-business Owners' Success

May 04, 2024


What is Decision Fatigue? Decision fatigue refers to the deteriorating quality of decisions made by an individual after a long session of decision-making. For you as physician micro-business owner, this manifests in the form of mental exhaustion, leading to suboptimal choices in both professional and personal realms.

Why is it Relevant for Physician Micro-business Owners? In the fast-paced world of healthcare entrepreneurship, every decision holds significant weight. From patient care protocols to business strategies, the constant barrage of choices can overwhelm even the most seasoned physicians-turned-entrepreneurs.

Understanding Decision Fatigue

Definition of Decision Fatigue Decision fatigue encompasses the mental strain and reduced decision-making abilities that occur as a result of making numerous choices throughout the day. It's akin to a muscle that tires with repeated use, leading to lapses in judgment and increased impulsivity.

Causes of Decision Fatigue The sheer volume of decisions faced by you as a micro-business owners contributes to decision fatigue. Whether it's selecting treatment options for patients or managing financial aspects of your micro-business, the cumulative effect can be draining.

Effects of Decision Fatigue on Physicians Decision fatigue not only impairs cognitive function but also leads to decision avoidance or procrastination. This can result in delayed or hasty choices, negatively impacting both business outcomes and patient care quality.

Even more troubling can be the impact at home on decision fatigue, where your partner and family members find you "non-present" and "unengaged" in the ever-present micro-decisions of home-life management.

I have always been grateful that my stay-at-home wife (and micro-corp bookkeeper) did a magnificent job of managing our home and five kids, helping me jointly lead the household while she efficiently managed the multiple daily decisions.

Impact on Physician Micro-business Owners

Financial Implications Poor decision-making due to fatigue can have dire financial consequences for micro-business owners. From investment decisions to contracting strategies, each choice influences revenue generation and long-term sustainability.

Effect on Patient Care In healthcare, decisions directly impact patient outcomes. Decision fatigue for you can compromise the quality of care delivered, potentially leading to medical errors or substandard treatment plans. As an example in my field of primary care, studies show that we are more prone to dispense antibiotics for medical conditions in the latter half of the day, than the beginning of a day. Why the discrepancy? Decision Fatigue

Coping Strategies To Reduce Decision Fatigue

Prioritization Techniques Learning to prioritize tasks based on urgency and importance helps alleviate decision fatigue. By focusing on critical matters first, you can conserve mental energy for essential decision-making.

Automation and Delegation Delegating routine tasks and leveraging automation tools can streamline processes and reduce decision-making burden. This allows you to allocate their cognitive resources more efficiently. I have long used this methodology in my primary care clinic empowering my staff with scripted “standing orders” for things like immunizations, medication refills, lab orders for chronic conditions, etc.

Mindfulness Practices Incorporating mindfulness techniques such as meditation and deep breathing exercises can enhance mental clarity and resilience against decision fatigue.

Importance of Routine

Establishing Daily Routines Structured routines minimize the need for constant decision-making, preserving cognitive resources for more complex issues. Consistency breeds efficiency and reduces the cognitive load on physician entrepreneurs.

Creating Decision-making Frameworks Developing decision-making frameworks and guidelines aids in quicker and more informed choices. By establishing clear criteria and protocols, you can streamline your decision-making process. For example my triage nurse in my clinic is empowered to scripted protocols for phone management of patient needs, that don’t have to be sent to me.

Outsourcing Decisions

Utilizing Consultation Services Seeking expert advice from consultants or industry professionals can provide valuable insights and relieve the burden of decision-making in specialized areas, including operating your micro-business.

Collaborating with Business Advisors Engaging with business advisors or mentors can offer strategic guidance and support in navigating complex decisions related to professional services management and growth. This is what we offer to you at SimpliMD!

Utilizing Technology

Decision-making Apps Specialized apps and software platforms can assist in data analysis, trend identification, and decision optimization, empowering you as an entrepreneur to make informed choices.

AI Solutions Artificial intelligence tools can automate routine tasks, analyze vast datasets, and provide predictive analytics, enabling more data-driven decision-making processes.

Electronic Health Record Systems Efficient EHR systems streamline patient management and documentation, reducing administrative burden and freeing up time for critical decision-making.

Time Management

Time Blocking Strategies Allocating specific time blocks for different tasks helps structure the day and prevents decision fatigue from creeping in due to continuous multitasking.

Effective Scheduling Techniques Optimizing schedules to minimize decision overload and allow for adequate breaks fosters better decision-making and overall productivity.

Self-care Strategies

Importance of Rest and Relaxation Prioritizing restorative activities and downtime is essential for replenishing mental energy and combating decision fatigue.

Exercise and Nutrition Regular physical activity and a balanced diet contribute to overall well-being, enhancing cognitive function and resilience to stressors like decision fatigue. I know for me, my 5 mile runs every other day help me de-stress and all for prayer and self-reflective time.

Seeking Support

Peer Support Networks Connecting with peers facing similar challenges provides a sense of camaraderie and allows for shared experiences and strategies for overcoming decision fatigue.

Professional Coaching Engaging the services of a professional coach or mentor offers personalized support and guidance in developing effective coping mechanisms and decision-making skills.

At SimpliMD we offer solutions for physician micro-business owners seeking support through peer networks, professional coaching, and consultations. Our products include:

  • Free Subscription to join our SimpliMD community

  • Paid Membership to our SimpliMD community providing you with over $2500 in savings on products. This is the place to start and it costs less than a dinner out! This is tax deductible if you are a micro-business owner.

  • SimpliMD coaching. Let me provide you with monthly to quarterly personal and professional development coaching with a micro-business focus. This is tax deductible if you are a micro-business owner, making all the more valuable

  • SimpliMD Business Consultation. Let’s explore together how micro-incorporation could benefit your unique personal and professional situation. You’ll get a free 1 year SimpliMD membership with this consultation!

If you know of other self-employed physicians, or even traditionally employed physicians who have 1099 side hustles, please invite them to join our community. I think they will love it.

Now lets reflect on decision fatigue for the self-employed vs the traditionally employed physicians. This has long been one of the hallmarks of why employment was better—because you were able to eliminate the stress and decision fatigue of “running a business”.

Before jumping into that, let clearly communicate that there are lots of self-employment models that include operating a private practice, a solo-practice, etc… but what I advocate for is the simplicity of a “practice without walls” meaning that your micro-business if virtual, you are the only employee to manage, and your income is based purely on your professional services. This simplicity, especially in the employment lite contract model makes it very appealing.

Decision Fatigue in Micro-business Owners vs. Traditionally Employed Physicians

Comparing Decision Fatigue

In comparing decision fatigue between physician micro-business owners and those traditionally employed by large healthcare corporations, it's essential to understand the dynamics of their respective roles and environments.

Physician Micro-business Owners: For physician micro-business owners, the responsibility extends beyond clinical practice to encompass the intricacies of running a business. This includes managing your micro-business finances (I recommend outsourcing this) and strategic planning, in addition to providing patient care. As an entrepreneur, you bear the burden of decision-making across various facets of your micro-business, from choosing professional contracts to setting pricing structures for services.

Traditionally Employed Physicians: In contrast, physicians employed by large healthcare corporations typically have a more narrowly defined scope of responsibilities. Their focus primarily revolves around patient care within the confines of established protocols and administrative frameworks. While they may still face decision fatigue regarding treatment plans and patient management, the breadth of their decision-making tends to be more limited compared to their entrepreneurial counterparts.

Let’s compare what their average day looks like:

Example of an Average Day

Physician Micro-business Owner: Dr. Smith

6:30 AM: Dr. Smith begins her day by reviewing patient charts and responding to urgent emails from her clinic's electronic health record system.

8:00 AM: She reviews her micro-business Quick books account and e-mails her accountant a question. She reads the SimpliMD blog post for the day and invests in building her micro-business competency.

8:30 AM: Dr. Smith starts seeing patients in her clinic, alternating between consultations, examinations, and follow-up appointments.

12:00 PM: During her lunch break, she takes calls from potential business partners regarding a new medical technology venture she's considering investing in.

1:30 PM: Afternoon sessions resume with patient visits, interspersed with phone calls to insurance providers and suppliers to address billing and inventory concerns.

5:00 PM: Dr. Smith wraps up her clinical duties for the day and transitions to home.

7:00 PM: Despite the long day, she spends additional time watching snippets from the SimpliMD “Doctor, You Are A Business” Course and attends a virtual networking event with other physician entrepreneurs.

Traditionally Employed Physician: Dr. Johnson

7:00 AM: Dr. Johnson arrives at the hospital and quickly reviews his patient list for the day, focusing on cases assigned to him by the department head.

8:00 AM: He begins rounds, visiting patients admitted under his care, discussing treatment plans with nursing staff, and documenting updates in the electronic medical record system.

12:00 PM: Dr. Johnson attends a departmental meeting to review protocols and discuss any operational changes or patient care updates.

1:00 PM: After a brief lunch break, he resumes rounds and consults with colleagues on complex cases requiring interdisciplinary collaboration.

4:00 PM: As the day winds down, Dr. Johnson completes his documentation, addresses any remaining patient inquiries, and hands over care responsibilities to the on-call physician.

6:00 PM: He leaves the hospital, knowing that his next shift will bring a new set of challenges but appreciating the structured environment that allows him to focus solely on patient care.

7:00 PM: He joins a virtual business meeting for all employed physicians in the hospital physician network, where they discussed the financial losses, the need to not leak any referrals out of the hospital system, and the compensation committee's decision to withhold 10% of their compensation as part of a quality metric that they would earn back if they met the metrics.


While both physician micro-business owners and traditionally employed physicians experience decision fatigue, the nature and extent of their responsibilities significantly influence the intensity of this phenomenon.

Micro-business owners navigate a multifaceted landscape of clinical, operational, and strategic decisions, whereas traditionally employed physicians operate within more structured frameworks, that still bleeds over to corporate citizenship time commitments.

Despite the challenges, each role offers unique opportunities for professional fulfillment and impact in the healthcare industry.

In my opinion, the self-employed doctor is empowered to make decisions that benefit their personal business interests, whereas the traditionally employed doctor is forced to make decisions that benefit their employer's corporate interests—regardless of how it affects you personally. It’s this latter tension that is more of a cause of burnout than the former.

I say empower yourself as a micro-corporation, it’s the best decision you’ll ever make!