The Human Side of Hard Calls
- May 6
- 5 min read
VP of Outpatient Operations, Mission Connection
Nobody tells you, when you are starting out in leadership, just how much of the job is simply sitting with decisions you are not sure about. I have a Master’s in Social Work, years of clinical experience, and a genuine love for the work I do leading outpatient operations. And still, some mornings I am standing in front of a big choice thinking, “I hope I get this right”.
What I have come to understand is that good decision-making is not about having all the answers. It is about asking better questions, listening more carefully, and being honest about what you know and what you do not. Those lessons did not come from a business book. They came from years of working with people in some of the hardest moments of their lives.
Whether you run a small business, manage a team, or are just trying to make a big life decision, I think these ideas apply to you too.
What Frameworks Help Leaders Evaluate Major Decisions?
The first thing I always ask before making a big call is this: does it line up with what we actually stand for? It sounds simple, but you would be surprised how easy it is to skip this step when you are under pressure. When things get stressful, it is tempting to just pick the fastest or cheapest option and move on. But decisions made in a hurry, without checking them against your values, have a way of creating bigger problems down the road.
The second thing I do is think through everyone who is going to be affected. In my clinical work, we are trained to look at the whole picture, not just the person sitting in front of you, but their family, their community, the systems around them. I take that same approach in operations. When we expanded our telehealth services, I did not just think about logistics. I thought about the clinicians who would need to learn new workflows, the clients who might find video sessions harder than in-person ones, and the parts of our infrastructure that would be stretched. Thinking it through in layers helped us avoid problems we might not have seen coming.
And honestly, one of the most powerful things I have learned is to just ask my team. Not because I lack confidence in my own judgment, but because they see things I miss. They are closer to the work. When people feel genuinely included in a decision, they do not just support the outcome better. They actually make the outcome better.
How Can Executives Analyze Risk Effectively?
Working in behavioral health gives you a very real relationship with risk. When you are making clinical decisions, the stakes are not abstract. That sharpens you. It teaches you to take risk seriously without letting the fear of it stop you from moving.
Something I try to do consistently is look past the obvious risks and ask what happens next. What are the ripple effects? If this works exactly as planned, what does that create that we have not thought about yet? A lot of the biggest surprises in business do not come from failure. They come from success that nobody fully prepared for.
I also think it is worth naming something that does not get talked about enough, which is the difference between managing risk and just avoiding it. Avoiding risk can feel responsible, but a lot of the time it is just fear dressed up in professional language. When we were launching in-person intensive outpatient services during a period of real uncertainty, there were genuine risks. But not serving people who needed care was also a risk. Learning to weigh those things honestly against each other, rather than defaulting to the safest-looking option, was one of the most important shifts I made as a leader.
A practical habit I have built is thinking through at least three possible futures before committing to a direction. Not just the best case and worst case, but the most realistic case. That middle version forces you to be honest about what you are actually working with, and it tends to produce much more grounded planning.
What Strategic Planning Methods Improve Results?
The best plans I have ever been part of share one thing in common. They started with honesty about where things actually stood, not where people wished they stood. It sounds obvious, but so many plans get built on a version of reality that is more hopeful than accurate. And then when execution starts and reality shows up, the whole thing unravels.
In clinical work, we talk about meeting people where they are. That principle has probably shaped my approach to planning more than anything else. You have to start from the real starting line, not the one you wish you were at.
Something that has genuinely improved how our team operates is building in shorter check-in cycles rather than waiting until the end of a quarter to see how things are going. We pause, look at what is working and what is not, and adjust. This keeps small problems from growing into expensive ones. It also means the people doing the work feel heard along the way, not just evaluated at the end.
And I want to say this plainly because I think it matters more than most leadership conversations acknowledge: your plan is only as strong as the trust on your team. If people are afraid to tell you when something is going wrong, you will always be reacting too late. I have seen it happen. I have also seen what changes when people know they can raise a concern without it being held against them. Problems surface sooner. Solutions come faster. The whole organization moves better.
Building that kind of environment is not a nice-to-have. It is a practical advantage that shows up in outcomes.
I did not come into leadership thinking of myself as a strategist. I came in as someone who wanted to help people. What surprised me is how much those two things turn out to require the same core abilities: listening well, being honest about hard truths, holding your plan loosely enough to change it when the situation changes, and never losing sight of the people you are ultimately serving.
Big decisions are hard. They are supposed to be. But I have found that when you slow down enough to ask the right questions, include the right people, and stay honest about both the risks and the possibilities, you end up making choices you can actually stand behind. And that matters a lot, especially on the days when things do not go exactly as planned.
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