When asked, what is the biggest mistake a leader can make, here is how some influential leadership experts responded:

“Failing to embrace uncertainty. The biggest mistake a leader can make, I believe, is being certain. Things are constantly changing. Times are unpredictable. When we confuse the stability of our mindsets with the stability of the underlying phenomenon, we act as if we know. When you think you know, you don’t pay attention anymore. Why bother since you know?” — Dr. Ellen Langer, Professor, Harvard University.

“Becoming too enamored with their vision that they loose all capacity for self-doubt.”– Gianpiero Petriglieri, Affiliate Professor of Organizational Behavior, INSEAD.

“Acting too fast. Executing before thinking through the issue.” – Jonathan Doochin, Leadership Institute at Harvard College.

Related: What is the Biggest Mistake a Leader Can Make?

In the patient-physician relationship, the physician, as the leader, is supposed to guide the team to victory. Acting too fast, failing to exercise self-doubt, acting like we know a diagnosis are also the greatest mistakes we can make as we seek to guide the patient-physician team towards diagnosing and treating disease. Scientific research has shown that “our level of confidence in a diagnosis correlates poorly with its accuracy.”

One solution being proposed by Dr. John W. Ely, MD, MSPH and his colleagues is the use of diagnostic checklists. He says, “Checklists are no substitute for training and experience, but training and experience alone are not enough. Failing to consider the correct diagnosis, whether because of a simple oversight or a not-so-simple presentation, is the most common cause of diagnostic errors. In either case, a checklist has the potential to prevent this failure. As human beings, we are terrible at recognizing our own emotions and cognitive biases at the time these biases are doing their damage, and our level of confidence in a diagnosis correlates poorly with its accuracy. Gawande admitted that we do not like checklists because they can be painstaking and embarrassing, and are not often used by those we aspire to be. However, they may lead to a more reliable and safe diagnosis, just as they have led to more reliability and safety in the airline industry, operating room, and intensive care unit. Taking specific steps to make diagnosis more reliable is something we should all consider. We will never be perfect, but we owe it to our patients and our profession to improve.”

As clearly shown by the leaders above, this need for effective decision making through creating systems like the diagnostic checklist that will enable the leader to reduce the chances of making a mistake in their decision making is not only important to doctors but to all leaders in general regardless of their specific role. Even if you don’t see yourself as a leader, this also applies to you.

I leave you with the words of the amazing inventor and leader, Steve Jobs: “Stay hungry. Stay Foolish.”
And the words of the wise and saintly Paul of Tarsus: “Those who think they know something do not yet know as they ought to know.”

Don’t be too quick to believe the first thing that comes to your mind. Don’t think that what you are doing, even when it seems to be working is necessarily the best way or the only way. Questioning yourself and reevaluating yourself doesn’t mean you don’t believe in yourself. It only means you know yourself well.

What steps can you take today to reduce mistakes in your decision making?


John W. Ely, MD, MSPH – in the AAFP journal. Article titled: Preventing Diagnostic Errors in Primary Care