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Informed Mindfulness and the Art of Decision Making

By Adam Perlman, MD, MPH

Throughout our day, we face multiple decision points. On a personal level, it may be things like what to eat or where to invest our money. On an organizational level, it might be decisions about how to reduce spending while still increasing productivity or who to hire out of the three interviewed applicants.

Our ability to move in the direction of—and actually achieve—our larger goals and purposes are to a great degree dictated by these daily decisions. Every decision gives rise to a consequence; a result. These consequences can be large or small, but either way, the resulting outcomes then become causes for future decisions and actions—and on and on it goes.

Understanding the full impact of our decisions and their ripple effects is a key component to making better decisions and becoming a more effective leader.



If you are in a leadership position, you have an obligation to keep evolving as a person and a leader. Just as you expect the best from your team, you should also expect the best from yourself.

Maslow’s Hierarchy of Needs states that there are five interdependent levels of basic human needs (motivators) that must be satisfied in a strict sequence, starting with the lowest level. They are:

  • Survival — the physiological needs to stay alive and reproduce
  • Security — the need to feel and be safe
  • Love — the social needs for love, belonging and intimate relationships
  • Self-esteem — the need to feel worthy and respected and have status
  • Self-actualization — the need for self-fulfillment and achievement

If we agree with Maslow that the highest human need is for self-actualization—achieving aspirations and living up to our full potential—then that should be our goal. In his book, Motivation and Personality, Maslow said, “The growth of self-actualization refers to the need for personal growth and discovery that is present throughout a person’s life.” It is not about achieving some static state of perfection. Each of us continually moves toward or away from personal growth and self-actualization. But it is through a process of reflection and self-discovery and the pursuit of achievement that we discover a meaning in life that is both real and important to us.

This is why we practice mindfulness. Without the practice of paying attention to our thoughts, feelings, intentions and actions or a thorough examination of our own desires and goals, it would be hard to have a clear understanding of our higher purposes and how our behavior influences our self-actualization.

For example, if you have a purpose-driven intention to influence your culture in a way that promotes well-being, and you recognize that a core component of that is to emulate that which you hope to create, that then puts your decisions around your own well-being and need for self-care into a very different context. This makes it possible to lead by example.

Another instance might be when you are managing an employee who is performing well from a productivity perspective, but is not behaving in a way consistent with the values of the organization and the culture you are striving to achieve.  If they can’t be coached and ultimately adjust their behavior, you might need to sacrifice some short-term financial gain by terminating that person’s employment. Making the right decision requires understanding the priority of your goals and intentions. In recognizing that values and culture come before short-term financial success, you let the employee go—which likely leads to even better financials in the future, through a better culture that in turn results in happier, more engaged, and more productive employees.



How do we move from understanding to implementation?

First and foremost, we need to be mindful of our highest goals and intentions. We need to drop into mindfulness and use that awareness to move our decisions into action.

Uncomfortable feelings may come up. Process those uncomfortable feelings—lean into them so that you understand where they are coming from and if, in fact, they serve you. It’s a part of life for any leader; a part of the chosen role.

Sometimes when a decision is very emotionally charged, it is best to involve others.  Check your own thinking and actions with people you respect.

Let’s say you have an employee who you like a lot on a personal level but whose productivity is not meeting organizational expectations. Informed mindfulness about the situation will ultimately lead to a decision related to that employee that will deliver the best outcome attainable.

Examine your priorities, as we often have subtle competing priorities. Sometimes our thoughts are related to things we crave or wish to avoid. We need to be very clear about our own state of mind and emotions. If we deal with that employee from a place of needing to be liked, avoiding conflict, a place of demanding respect, or increasing our own financial success, we risk making decisions that ultimately don’t take the greater good of the employee and the organization—and potentially even our own ability to create a greater good on this earth—into account.

Continuous mindfulness, continuous self-reflection, and self-understanding is key. We all have a multitude of purposes. I classify them as little p’s and big P’s. A little p might be to get an advanced degree. A big P might be to change the way medicine is practiced. When we are dealing with that employee, we need to understand what his or her needs are, what his or her p’s and P’s are, and how they relate to the big P’s of the organization. Fully recognizing his or her strengths and weakness and how they align with larger purpose of the organization is critical. In the long run, we want to invest in people who can help us get the big P’s done. A key component of the value an employee brings to your organization relates to how well they make decisions, how effectively they perform, and how they can advise us about their area as it relates to the big picture.



Here is an example of mindful decision making in action. One of my managers and I disagreed on an issue about our budget. Both of us felt very strongly that we were right and the other person was wrong.

Before making a final decision, I went to great lengths to ensure that she felt heard and to bring in the opinions of others. I don’t like conflict, but I was aware of that and did not avoid it. Instead, I engaged in healthy conflict, in discussions that looked at both sides. I had to step back and not heed the need to make myself right and someone else wrong.

At the end of the day she still didn’t agree with my decision, but I felt I had done what I had to do to be consistent with my P’s.

I want to be someone who does listen but who can also make decisions even if that isn’t the consensus. At the end of the day, if it’s my decision to make; I reserve the right to make the it and be accountable for it. But I also hold the expectation that others on the team (after having been heard) will commit to that decision. It is only with that commitment that accountability and results can be achieved.

In this case, everyone did commit and the team was able to put the issue behind and move forward. That likely would not have been the case had I, instead of being mindful, simply mandated the direction I wanted to go.



Here are five things to do:

  1. Commit to achieving your highest potential
  2. Practice mindful awareness
  3. Understand your own goals and purposes.
  4. Lean into your fears and discomforts
  5. Always act in the best interest of your highest goals and purposes.

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