Empower Your Team to Make Decisions (Without Losing Sleep Over It)

An unsettling truth: decisions are being made in your practice every day without you.

Your admin fielding a call. Your practice extender communicating with a patient. A booking manager deciding when and how to schedule a case.

Each of these involves judgment – small, maybe, but still a decision made under the umbrella of your practice. Your name. You.

Does that also cause you a slight, uncontrollable twitch?

The real problem with trying to control everything

Here’s the thing: we only have so much good decision-making capacity in a day. (There’s actual science on this – it’s called decision fatigue, and it’s real. If you want more, check out the book Willpower.)

Trying to be in the loop on every phone call and every judgment call in your practice isn’t protecting you or your patients. It’s most likely just burning you out.

And yes, there’s always the risk you might not be part of a decision but still end up dealing with the fallout. That’s the reality of having employees.

Our instinct to micromanage is understandable – but it’s also a fast track to less joy at work and more time tethered to your phone.

There’s a better way: empower your team to make decisions like you would, even when you aren’t there.

Borrow this idea from an Infectious Disease specialist

The most important lesson I learned from an ID specialist in residency wasn’t anything to do with antibiotics. 🫣

She wanted more control over her patients’ care – even overnight when she wasn’t physically there. Her solution? She built contingency plans (“decision frameworks”) directly into her orders. If this happens, do this. If that happens, order these tests. Only if X, Y, or Z, broaden the antibiotic coverage.

Her patients got the same quality of antimicrobial care they would have received if she’d been standing there at 2am. Instead, she got to sleep. Soundly. Only getting paged for anything that actually needed her.

Same idea, different context: McDonald’s wouldn’t be what it is today without the systems Ray Kroc built so that any employee, anywhere in the world, could make the same burger. (If you’re not sold on the power of systems yet, E-Myth Revisited is worth your time.)

The principle is the same whether you’re running a fast food empire or a medical practice: clear priorities and guidelines create confident, autonomous teams that can make decisions like you would.

Make your priorities explicit

The first question to ask yourself: What are my foundational priorities for patient care?

Mine are simple. Three things that guide every decision my admin, my nurse and I make:

1. What is safest for the patient?
2. Does the patient feel heard?
3. When in doubt, book them to be seen.

That’s it. When everyone on my team knows these are the non-negotiables, they can make good decisions without me – because they’re making decisions guided by my priorities.

What this looks like in practice

When I brought a nurse on to handle straightforward results calls, the task was clear: call the patient, share the results, field questions. My job was supposed to get lighter.

Instead, every time a patient question came up, she’d loop me in. Which, to be perfectly clear, is what she was supposed to do. What I told her to do.

What I realized was that the task of calling patients with results hadn’t moved off my plate – it had just changed shape.

I was the problem here, because I hadn’t given her guidelines on how to handle questions or concerns without me.

After some soul searching I got clear on my top three priorities. After communicating them directly with my team, everything shifted. She felt confident. I stopped getting pulled in unnecessarily.

I also put together a simple FAQ from with answers to common patient questions. This included some specifics to my procedures (the skin peeling is normal and expected on the palm), the common concerns (yes, the scar will be thick and lumpy for several weeks). This alone cut a significant amount of back-and-forth.

Getting clear on your priorities means your team can do their jobs, you all feel confident about it and you’re not thinking about it at 3am.

This is clinical effectiveness, not just efficiency: building a practice that runs as if you were there, even when you’re not watching every move. It means things are done the way you want, without needing to micromanage.

It reduces your decision load, protects your schedule, and yes – genuinely helps you sleep better.

What are your top priorities for patient care? Have you ever said them out loud to your team? That conversation might be worth having sooner than you think.

Drop your thoughts in the comments – what have you done to help your team make better decisions without you?