Why veterinarians stick with disastrous decisions

“Wait—what? Two employees broke bones falling down, and your clinic still refused to fix the floor?” I stammered.

I admit that I had zoned out a bit when my friend, a veterinarian in Miami, started to talk about floor sealant. Now she had my attention. “Can you start over?” I asked.

In early 2004, Dr. Zimmler was working in a practice that had undergone a major renovation. The updated facility was beautiful, but there was a problem with the hallway leading to the grooming and boarding areas. Whenever the floor got wet, it became dangerously slippery. The problem appeared immediately after a new sealant was applied.

The staff believed the contractors had simply used the wrong sealant, but the practice management elected not to address this concern with the builders. Whether factors like cost or construction deadlines played into the decision was unknown to the staff. What was known is that everyone fell down—a lot.

In the first year, two staff members broke bones in accidents related to the floor. Rather than have the floors repaired, management instructed staff members to purchase special nonslip shoes to prevent further injury. Tours of the back half of the hospital were discontinued, and grumblings over the cost of slip-free footwear began.

A relative of one of the staff members worked in the flooring industry and offered to refinish the floor at no cost. To Dr. Zimmler, this seemed like a gift from the heavens. Management, however, perceived the offer as an insult and rejected it. As far as we know, slip-and-fall injuries are still occurring in the clinic today.

Committing to bad decisions

The most gruesome disaster stories all seem to have one thing in common: an unwillingness on the part of decision-makers to admit or correct problems. Why is it so difficult to own up to mistakes? How much heartache could we avoid if we simply decided to cut our losses and change course instead of charging ahead?

Making a bad decision is forgivable. One of my father’s favorite sayings has always been, “Good judgment comes from experience and experience from bad judgment.” Refusing to admit a bad decision is a mistake, and investing further time and resources into that decision only compounds the error. However, people exhibit this behavior on a regular basis.

Economists refer to this unwillingness to abandon bad decisions as the “sunk-cost fallacy.” They point out that when we assess a future course of action, we have difficulty ignoring everything we’ve already invested to get to our current position. If you’ve ever seen (or been) an orthopedic surgeon struggling to even consider amputation of a limb after one or two failed attempts at repair, then you’re familiar with this difficulty.

Why we can’t let go

Holding on to our mistakes is like telling knock-knock jokes at a funeral: We’re just making a bad situation much worse. So why do we do it? Well, according to researchers at Michigan State University, there are three main reasons.1

1. Ego threat. The most powerful motivator for sticking with bad decisions is the belief that changing course makes us (or makes us appear) foolish. As practitioners and managers, we feel pressure to appear infallible in front of our peers and our healthcare teams. So our desire to save face often motivates us to push harder and invest more in hopes of turning an error into a success, thereby proving to our team (and ourselves) that we were right from the beginning.

2. Project completion. As a profession of type A personalities, we’re accustomed to finishing what we start. For many of us, the idea of starting a project and then stopping it, even if only to reconsider our options, is extremely difficult.

3. Anticipated regret. Our thinking goes, “If I don’t see this through to the end, I’ll regret it.” As diagnosticians, we crave information. We want to know the prognosis and what the outcome will be. How many times have you thought, “If the pet’s owner had just let me run the next test, I might have been able to make the diagnosis”? We are regularly called on to look into our crystal balls and divine the future, so we think a lot about what might be. To people who make a living thinking about what could happen in the future, the fear of regret in changing course is powerful.

For many people (including us veterinarians), the stethoscopes doctors wear are as much symbols of faultlessness as they are functional pieces of equipment. There is a fantasy in our society that doctors (and those who manage them) do not make mistakes. If they do, they must be failures.

Every day we make hundreds of decisions that are highly visible to clients and coworkers alike. There is simply no way to function in this reality while maintaining the façade of perfection. We all make poor decisions sometimes, especially when we are forced to base them on unreliable or incomplete information (which happens frequently). The absolute best thing we can do when this happens is to critically evaluate our decisions, consider the possibility that we may be holding on to a poor choice, and then move forward in the best way possible— even if that means going backward first.

Reference

1. Grant A. Give and Take. New York, NY: Viking Press 2013.