Decision Making Made Easier with Madelaine Weiss LICSW, MBA, BCC

by Coach Jill Farmer | Physician Wellness, Podcast, Work Life Balance, Work Life Integration

In this episode, Licensed Psychotherapist and Board-Certified Executive Coach Madelaine Weiss gives us tools for decision making made easier that will save your time and save your energy. 

“These are all ways of sort of clarifying and tailoring things so that the mind doesn’t run rampant all over the place and waste your energy and your time.” –Madelaine Claire Weiss LICSW, MBA, BCC

In episode 162, Master Certified Coach Jill Farmer welcomes Licensed Psychotherapist and Board-Certified Executive Coach Madelaine Claire Weiss LICSW, MBA, BCC to the podcast to discuss how to make decision-making easier. Madelaine gives us four tips to try when making decisions. Go Fast, Go Bold, Go Emotional and Go High. She goes into each of these tactics in detail and explains how and why they work as well as the science behind them. According to Madelaine, “It’s not the decisions we make, but what we make of the decision once we have made it that makes the difference in our lives.” Additionally, Jill and Madelaine discuss decision fatigue and Madelaine gives us a question we can ask ourselves when faced with decision fatigue in order to move through it. This episode is all about tools you can use to help save your precious time and energy! 

Visit to find more resources from Madelaine and get in touch with her. 

Madelaine Claire Weiss LICSW, MBA, BCC is a Harvard Medical School trained Licensed Psychotherapist, and Board-Certified Executive Coach, with an MBA, who helps busy professionals master their minds for satisfaction and success in work, play, love, and life—for themselves and all the (big and little) people counting on them.

She is a co-author in the Handbook of Stressful Transitions Across the Lifespan, the bestselling author of Getting to G.R.E.A.T. 5-Step Strategy for Work and Life…Based on Science and Stories, a former group mental health practice administrative director, corporate chief organizational development officer, and associate director of the Anatomical Gift Program at Harvard Medical School.

Her widely well received trainings include the American Bar Association, Harvard Law School Association, International Association of Business Communicators, Harvard Medical School, The National Association of Realtors, DC Academy of General Dentistry, AARP, and the Bureau of National Affairs.

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Podcast produced by: Amanda Taran

Please enjoy the full transcript below

Madelaine: These are all ways of sort of clarifying and tailoring things, so that the mind doesn’t run rampant all over the place and waste your energy and your time.


[DocWorking theme]


Jill: Hi, everyone. We’re so glad you’re here at DocWorking: The Whole Physician Podcast. I’m Jill Farmer, a cohost and one of the lead coaches at DocWorking. Today, we’re going to be talking about decision making and how you might be able to make better decisions for yourself. But first, remember, we’re sponsored by DocWorking THRIVE, a subscription coaching service that provides coaching as well as peer support for physicians. Our physicians in THRIVE tell us that they feel better, less burned out, and it helps them stay happier in their work and life. So, go over to today to check out DocWorking THRIVE


To join us in the conversation today, we have a fantastic expert, Madelaine Weiss. She is a Harvard trained psychotherapist and she’s a board-certified executive coach. Madelaine, I love what you have to say about why sometimes as humans, and specifically physicians in this conversation, have a hard time making decisions and have a hard time making good decisions. So, thanks for joining us today. 


Madelaine: Thank you for having me here. I am really excited to be here. I spent a lot of my own life in healthcare, so, this really means a lot to me. I did a lot of work with the first-year medical students at Harvard Medical School and it was such a privilege, so, this is too. This brings me back to the memory of what that meant, to be able to lay hands on just a little bit and to be able to help to tweak in just the right place, I hope. I know that you, Jill, have a special interest in time and I can’t think of any better way to free up time than to refine and upgrade our decision-making processes. So, thank you for having me here to dig in a little bit on that with you. 


Two months after I wrote this. I saw this little piece of data that said that humans make 35,000 decisions a day. I thought, “Yeah, right. This five-step strategy for work and life and getting to ‘great’, what is that if it’s not one decision after another along the way?” And they say that about 200 of them are about food and I always say, I think that’s low. But the other thing that’s low is the part of the brain that a lot of these, not all 35,000 of them, but a lot of them are really life shaping and they’re not necessarily coming from the highest, smartest executive functioning part of the brain. By the time we’re finished today, I have a 30 second mindset reset to kick it upstairs, so that more and more of them can be.


Jill: I think that’s such a good way to think about it. Because we do tend to think about decisions as something that we wrestle with, we have different styles in the way that we make decisions, we have different capacities based on the amount of sleep we’ve had, and all kinds of other things that really can weigh into this. What do you think in your experience as a coach, and a psychotherapist, and somebody who has worked with physicians in the early part of their training and other times as well, what do you think are some of the mistakes that we make around decision making?


Madelaine: What happened was I got so excited about this that I actually started digging into whatever science I could find on decision making. No sooner did I do that, then I noticed that there was a Forbes article that said that, “Decision making should top the growth agenda for every company going forward.” I realized I’m not the only one who thinks this is really a sweet spot. There are lots of myths around decision making. All these studies that I was finding really were kind of myth busting, which is fun in a way. I’m giving a few presentations on this. I have a PowerPoint presentation and it’s go fast, go bold, go emo, go high.


Jill: Okay. So, let’s start with go fast. What do you mean by that as it relates to decision making?


Madelaine: I want to preface this by saying, there’s no black and white and not everything I’m going to say is going to apply to every decision we make. But there are tendencies that we think are true and good. I know you like to pause. We’re both big fans of the pause. If people can pause and use some of this data, “Okay, so, go fast.” The natural tendency, I believe, correct me if I say anything that you want to modify or add to, is the more important the harder a decision feels, the more time we think we should spend on it. And by the way, all of these citations are on my website and if anybody wants to write to me, I’d be happy to provide them for you. 


But the science that I found was that in fact, they did a study with CEOs, the harder it was, the less time they found that they should spend on it. The reason for that is because what’s making it hard is that there’s threat and opportunity roughly equal on both sides. If that was not the case, it wouldn’t be hard at all. The reason it’s hard is because on the one hand “this” and on the other hand “that.” I don’t know if you’ve ever heard of Buridan’s Ass, but there’s this donkey and the idea is that he’s looking at two bales of hay and also seeing one bale of hay and another pail of water, and the donkey dies trying to decide whether to pick this one or this one, because they were equally important. I made this thing up that I always say, it’s not the decisions we make, but what we make of the decision once we have made it, that makes the difference in our lives. When it’s that hard, when there’s equal threat and opportunity on both sides, pick one and give it everything you’ve got to make it work. 


The other reason for not going as deliberately slow as we may want to is that, if you’re in leadership, there’s a study that 66% of people would not support a leader who appeared hesitant. People are watching and if you’re a role model or a leader, you want to look like you are conscientious to a point, but not paralytic in it. So, that’s “go fast.”


Jill: I love that. I think one of the pieces of research that you refer to I have come across previously, I thought it was interesting, too, is that, I think this was at a Stanford study, “The slower somebody takes, the longer it takes them to make a decision, the less information they’re actually taking in.” 


Madelaine: I saw that, absolutely.


Jill: I think that you’re deliberating more and more. “Oh, I’m just going to know so much more and I’ll finally know enough.” Sometimes, there’s a lot of that fact finder paralysis, analysis, all the things we talked about with physicians that, “If I just get enough more information.” It’s there, but this study showed us that actually, sometimes, we’re just getting to the point where we’re staying in that tension point, as you said, between those two poles and then we end up just stuck.


Madelaine: Yes. When we’re making 35,000 decisions today, you could see why someone’s like, “That’s enough.”  


Jill: Absolutely. 


Madelaine: So, go faster than we might otherwise on more occasions than we might otherwise not always. 


Jill: Let’s talk about what you mean by “go bold.” 


Madelaine: Okay, so, bold. There was another study that found that they had people who played it safe and stayed in their safety zone, and then they had participants who actually made a bolder decision. Then months into it, later, they checked who had more satisfaction down the line. The ones who went bolder did, which makes perfect sense. There’s the Yale study that I love, which suggested that optimal learning and decision making is 70% outside of your comfort zone. On one of the podcasts that I listened to, I think I heard that “just because it’s uncomfortable, it doesn’t mean it’s bad.” This Yale study actually turns the whole thing on its head and says that, “If you’re not uncomfortable, you’re not learning anything, you’re not doing anything.” So, it made perfect sense that the people who were stimulating their brain were more satisfied. 


So there’s this thing called the Goldilocks principle, not too hot, not too cold, just right. You don’t want the novelty and the change to be so much that it shuts the brain down, because we’re talking about how overwhelmed people feel with the 11 million bits per second of information that the senses send to the brain (and the brain can only handle 50 of them). So, you don’t want so much that we defend, but also, the brain likes to be stimulated. It wants to know something new is happening here, and it’s motivating, and then good things do happen. That’s the idea for going bold. 


Jill: Yeah, I remember once talking to somebody, who worked exclusively for a large healthcare organization, and worked in the onboarding and bringing people in, and they shared a piece of research which I can’t put my finger on now, but they said that people have better job satisfaction, the steeper the learning curve within the first six months of a job. A lot of times it’s really uncomfortable when we start something new. But over time, even though our brain immediately might say, “I wish it was familiar, I wish I had mastery, I wish I wasn’t being challenged,” and I think that’s true with decisions, too. We wish it was just simple and there was no possibility of being wrong, that’s a big thing physicians like to tend to avoid for a variety of reasons. 


Madelaine: Of course.


Jill: And of course, when it comes to healthcare decisions that they’re making on behalf of patients, that is a very powerful motivator. But the other side of it is when you’re trying to be absolutely 100% certain in every other situation or decision you make in your life, that’s just not possible. Being willing to take some stretches and be a little bit bolder in those areas where it isn’t life or death, brings more satisfaction is what I’m hearing you say. 


Madelaine: Well, I actually noticed something really interesting and important with my clients. They would present as if there was something wrong with their job or there was something wrong with their spouse. What we found is, the tree wants to grow and the bird wants to fly, and so do we. My gifted and talented clients were bored and didn’t know that that was what it was. They were doing wonderful things, but it was the same thing. They were bored and so once they knew that, the externals like the job, or the spouse, or how much money they make, or whatever it is, they can take it inside and say, “Where do I want to go from here?”


Jill: Yeah, really powerful. That’s the second idea that you’ve shared beautifully. Tell me a little bit about what you mean by go emo.


Madelaine: That’s the word my children use for emotional. Another myth is that decision making should be logical. I’m sure you all know about the Psych 101 Phineas Gage, where he had a brain injury in the frontal lobe and it injured the emotional centers of the brain. While he seemed kind of normal, his judgment was impaired. And then there was this wonderful story– and I can’t find the citation anymore so if anybody knows it, please send it to me– of a male physician who  could not get dressed in the morning because he had the same kind of injury. He didn’t know what his preference was, so he would look at all these pairs of pants and didn’t know what pants to put on because he didn’t know how he felt about what to wear. They did this whole study on that. 


And then, there are also more current citations that when there are those kinds of injuries, there is cognitive impairment in judgment, planning and decision making, and so on. There’s the hand model of the brain. I think it’s Dan Siegel’s hand model of the brain. The idea is that when this part of the brain, say the amygdala, is freaking out, it doesn’t like what’s going on here. When this thing is not under very good control, it knocks the higher brain centers offline and your decision making is coming from here. What we do with my 30 second mindset reset is to stimulate the polyvagal nerve, which stimulates the parasympathetic nervous system. It takes us out of the fight-flight freeze and the executive functioning brain. We’re now an integrated brain and this can say to this, “I’m not sure I like what’s going on here. Can you help me?” This can say to this, “I got it from here. Thanks for sharing.” Decision making then comes from the smartest part of the brain, because they’re talking to each other.


Jill: That amygdala hijack, which I think is pretty powerful to reacting without thinking. What I’m understanding when you say go emo is that, a lot of times, especially if somebody is very traditionally that scientific or what some people would call left brain, they think, “I just need to be logical and just be weighing things as if I just do the pros and cons list” and then, it gets clearer. It turns out, we have to bring some of our emotional intelligence on board with the logic in order to make decisions that are ultimately going to be better in the long run. Am I understanding you correctly?


Madelaine: Yes. As I say, emotions are data, not directives, but the data is really important, so you could pick your pants out in the morning without wasting time thinking about it. 


Jill: Yeah, that’s really powerful. Okay, so, we’ve talked about the idea when it comes to making decisions of being willing to maybe go a little faster.


Madelaine: Go faster. Yeah.


Jill: Be bold, go emo, or be willing to bring some of our emotional intelligence onboard when it comes to making decisions. What else do we need to know about making decisions?


Madelaine: There was another study, which I thought was going to undo everything I just said to you, because it seemed to be suggesting that people feel better about their decisions if they put a lot of themselves into it. I thought, “Oh, no, I just got done saying, we should move fast.” But as I read more, I realized that they realized that they weren’t really talking about time. What they were really talking about was attention. The quality of the attention that we put on a matter. You could spend a lot of time, the mind wanders 70% of the time into past regrets, future worries, and not really be attending to a major decision in your life. They really got to a place in this article that I read. I was so relieved when they were talking about mindfulness and they were saying, “It’s really putting a quality attention on these matters of importance in our lives.” “That’s what I mean by going high, doing that hand model of the brain and integrated brain, so that the executive functioning brain is driving the bus.”


Jill: Yep. You’re speaking my language there.


Madelaine: Thank you.


Jill: I talk a lot about mindfulness and being in the present moment and that it’s not just a nice thing we tell you to do in order to be a peaceful Zen-like person, it really does take the brain from its natural tendency at times of ruminating backwards about things you can’t change, projecting forward with scary movies about things that haven’t happened yet, and bring you into a place, where you’re likely to make at least the next best decision in a given moment. 


Madelaine: People worry though that they’ll go soft and especially, for physicians, who hold people’s lives in their hands, they want to be clear, and sharp, and focused. That’s what these mind exercises do. I don’t know whether you saw this, too, but I saw something within the past week or so, where they were suggesting that meditation, which I have been doing every day and have been studying Advaita Vedanta, pre-Hindu tradition regularly for over 20 years, but people are saying now that breathwork, which is much quicker, might yield enough benefit. There’s somebody Sara Lazar at Mass General does studies on, for example, how long do you need to do this? But this 30 second mindset-reset, I’m such a fan and I teach it to all of my clients. It’s on my website for free in this box that’s complimentary mind management exercises. So, if anybody wants to pull the quick one-page instruction, you can go there and do that.


Jill: And we’ll circle back around the end and tell people how they can reach you as well. Let’s talk about something that is in a lot of conversations as it relates to physicians and making decisions. And that’s the idea of decision fatigue, which I think as it’s used generally, it just means that when you make lots and lots of decisions in a given day, there’s some research that says that we lose our capacity to make as accurate or as quick of decisions as the day goes on. What’s your feeling about this concept of decision fatigue?


Madelaine: I have a favorite question that I think will help with decision fatigue. The question is, is there something to be done here? Because as you were saying, just because you feel uncomfortable, it doesn’t mean anything bad is happening. Just because you feel uncomfortable, it doesn’t mean you have to do anything either. We need to pause with the 30 second mindset reset, kick it upstairs, and ask, “Is there something to be done here?” Sometimes, yes, right now, there’s a car coming and you need to get out of the way or whatever might pertain to patient care. Sometimes, yes, but I already did it. Sometimes, yes, but not by me in which case something needs to be delegated, and sometimes, the answer is no. And then, just breathe. These are all ways of clarifying and tailoring things, so that the mind doesn’t run rampant all over the place, and waste your energy and your time. I’m just a really big fan of getting refined enough up here that we save time and energy for better things than running around in our heads.

Jill: Wow, that is fabulously said and a perfect way for us to end this really fascinating conversation. Thank you for your insights, for giving us some new information in ways that really allows us to think about the way we make decisions. I know our physician clients will really appreciate your wisdom and our physician listeners, especially, as well. Madelaine Weiss, thank you so much for being with us today. 


Madelaine: Thank you.


Jill: If you guys would like more information on how to get your brain where you would like it to be when you’re making decisions, her website at I’m going to spell it real quickly for you, because it’s M-A-D-E-L-A-I-N-E-W-E-I-S-S dotcom. There is a really simple way that you can go through that 30 second mind reset. Very good information there. We also have that information in our show notes for you as well. It could be a good tool for you to try to integrate some of these ideas that we’ve talked about here today. Thanks, again, for joining us, Madelaine. Thanks to all of you for being with us. Until next time, make sure you go over to, check out our incredible program, DocWorking THRIVE to help get you the coaching support and the peer support you need in order to thrive in these very challenging times. Until next time, I’m Jill Farmer.



Amanda: I’m Amanda Taran, producer of DocWorking: The Whole Physician Podcast. Thank you so much for listening. Please don’t forget to like and subscribe and head over to to see all we have to offer.

Top Coach for Doctors and Healthcare Professionals, top life coach. 

Jill Farmer is an experienced physician coach who has been helping doctors live their best lives, increase their success, and move through burnout for well over a decade.

She has delivered keynotes, programs, and training everywhere from Harvard Medical School to the American College of Cardiology.

She has personally coached hundreds of physicians, surgeons, and other busy professionals to help them be at their best—without burning themselves out. Her coaching has supported professionals at places like Mass General Brigham in Boston, Washington University in St. Louis, Northwestern University in Chicago and too many others to list.

Jill wrote the book on time management for busy people. Literally. It’s called “There’s Not Enough Time…and Other Lies We Tell Ourselves” which debuted as a bestseller on Amazon. Her work has been featured everywhere from Inc. to Fitness Magazine to The Washington Post.

Nationally recognized as a “brilliant time optimizer and life maximizer,” Jill will cut straight to the heart of your stress to liberate you from its shackles. She has two young adult daughters. She lives with her husband and their poorly behaved dachshund in St. Louis, MO.

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