The three steps to making tough decisions

One of the most significant career decisions I’ve ever made was not mine alone. It involved my wife and children, as well as close colleagues and industry experts whose deep knowledge I trust. I knew what my gut instinct was telling me – that this was a unique opportunity to make a difference and build a legacy beyond personal academic ambitions. But their individual perspectives and external validation were essential in making what also turned out to be one of my best decisions – joining GSK.

In effect, it was a unique collaboration. The decision was mine but their advice made my choice more complete. It’s the same in pharmaceutical research and development. We have to make decisions that influence the direction of an entire organisation, that can both inspire and deflate colleagues, that improve countless patients’ lives whilst bolstering the health of the company.

Whether the impact is on one’s family or business, effective decision-making requires three essential ingredients – listening, judgement and explaining.

Firstly, how we make decisions means listening to a diverse range of thinking and expertise from external advisers as well as internal insightful colleagues, regardless of title or rank. Nobody knows everything, so that input should challenge our beliefs and bias. It means we need to listen, with an open mind.

It’s an approach we’re pioneering within GSK’s Immunology Network, where we mobilise collective knowledge and intelligence. We foster a culture of diverse thinking in which some of our brightest minds collaborate with the best experts in academia. These interactions allow us to identify the opportunities of the future, to test hypotheses and make more far-sighted decisions.

And we also listen to the data. Intuitive judgement is often an important starting point in decision-making. When deciding how best to progress our pipeline of potential new medicines, the next step needs to be to consider the scientific data, competitor analysis, business scrutiny – all to enrich our decision-making capabilities and provide essential checks and balances. And my role as a leader is to facilitate this listening process, to ensure people are heard and the data are acted upon.

Next, leaders need to explain why decisions are made to inspire a more empowered, engaged and energetic team ethic; to help people understand the decision and get behind it. If we make sure we explain the rationale behind a tough decision, the team or individuals may not necessarily agree with it, but they respect and understand that we have been thoughtful and thorough and will commit to making it work.

  My children, for instance, were suddenly moved from the Netherlands to live in a new country, far away from friends – difficult at any age, but particularly so for teenagers. I have tried to mitigate their disappointment by explaining the reason for my decision to join GSK - that this was a rare opportunity to play a small but significant part in potentially changing the lives of millions of patients. It’s impossible as a parent not to question the impact of such a decision, but by explaining the ‘why’, they were able to understand and I’m thankful for their support of a purpose that they are now able to share in.  

What does this mean for R&D? We need to place resources, time and energy behind those projects we believe will enable us to achieve the best successes and optimum outcomes for patients. We can’t spread ourselves too thinly, which inevitably disappoints those whose projects are de-prioritised. Yet truly collaborative groups rally behind these tough decisions, as long as they first are listened to, and then understand the reasoning behind them.

Very rarely are significant decisions immediately obvious. Our subconscious and gut instincts may suggest they are but it is careful judgement – incorporating rational understanding, emotional intellect, business experience and transparent values – that combine to make good decisions better ones.

Throughout this entire three-step process, leaders need to be decisive and persistent. Decisive because there is nothing more painful in the long run than not making a decision; and persistent because outcomes are always best achieved by a laser-focused commitment to pursuing goals without changing tack - until new data or circumstances appear.

It’s why I’m such a fan of experimental medicine, a systematic approach in which small human studies allow us to gather a lot of data per patient to facilitate go/no go decisions in early development.  Some projects can be halted before large numbers of patients are exposed to a medicine that is unlikely to have a transformational effect. Others are accelerated based on promising emerging data and subsequently tested in larger clinical trials to determine whether the effects are indeed clinically meaningful. Such a way of working supports those three strands of decision-making, making clear where, how and why we invest resources.

Building a sustainable business in a highly competitive environment - whilst always achieving the best for our patients - means decisions are not always easy to make or take. Which is why individuals and organisations need to show courage by concentrating on what they’re really good at. And to recognise, as I did, that being part of a team which truly changes things for the better is far more significant than mere individual achievement.

Successful decisions take perseverance. Arriving in Britain a few years ago was just the beginning – I have needed to constantly listen to my family, address their concerns and show continued empathy to help them feel a positive part of a decision that changed our lives.

It must have worked because, for all the difficulties, we’re as close and supportive of each other as ever.