I often see patients who struggle at times making decisions about which surgery to have for their breast cancer, whether to have breast-conserving surgery (lumpectomy, wide local excision, partial mastectomy) or mastectomy. I am wondering whether the 10-10-10 rule would be useful in their decision-making. Many medical decisions depend on the degree of risk and uncertainty under which they are made. Decisions are hard because we fear making a mistake and living with the regret afterwards.

The 10-10-10 rule, introduced by Suzy Welch in her book "10-10-10: A Life-Transforming Idea," offers a powerful decision-making strategy that encourages individuals to consider the consequences of their choices in three different time frames: the immediate future (the next 10 minutes), the short term (the next 10 months), and the long term (the next 10 years).

The core concept of the 10-10-10 rule revolves around the idea that our present emotions and short-term considerations often dominate our decision-making, overshadowing the potential long-term implications of our choices. By consciously shifting our focus to the future and considering the impact of our decisions across these three-time frames, we can effectively balance short-term desires with long-term consequences.

This approach helps us identify and prioritise our values, anticipate potential outcomes, and mitigate the influence of short-term emotions that may cloud judgment. It encourages us to think beyond the immediate pressures and anxieties of decision-making and adopt a more deliberate and purposeful approach to problem-solving and life planning.

But does this system help patients make medical decisions?

Here's how the 10-10-10 rule can assist patients in making decisions:

1. Clarifying Values and Priorities: By considering the impacts of their healthcare decisions in the short and long term, patients can align their choices with their values and priorities.

2. Managing Emotional Stress: Healthcare decisions can be emotionally overwhelming. The 10-10-10 rule encourages patients to step back and consider their options from a broader perspective, which can reduce the immediacy of fear or anxiety.

3. Evaluating Consequences: Patients can use the 10-10-10 framework to think through the potential consequences of their healthcare choices systematically. This might include considering how a decision will affect their quality of life in the next 10 minutes, 10 months, and 10 years, thereby helping to highlight the possible benefits and drawbacks of different options.

4. Facilitating Communication with Healthcare Providers: Armed with a clearer understanding of their long-term goals and immediate needs, patients can more effectively communicate their preferences and concerns to healthcare professionals. This can lead to more personalised care and better-aligned treatment plans.

Decision-making largely takes place in the patient's head, but it helps to listen to your gut, too. Weigh up the options and crunch the numbers by all means, but take a moment to tune in to the subtle shifts that occur in the body when you consider each option. Bad decisions can make the body tighten up, while good decisions can trigger a relaxation response.

In the end there are not wrong decisions made, it was the best decision made with limited information that was known at the time. And if the time shows that maybe it was not the best decision, it often can be changed as well.