How to Make Smarter Decisions Under Pressure, From an ER Doctor Who's Done It for 20 Years We asked an emergency physician who studies decision-making under pressure about leadership. His insights reveal why the best leaders think like scientists of themselves.

What happens when you ask someone who makes life-or-death decisions daily to break down leadership? You get insights into the ultimate high-pressure environment.

Dr. Dan Dworkis is an MD-PhD, emergency room physician, adjunct professor at the USC Keck School of Medicine, author, podcast host, and medical director for the Mission Critical Teams Institute. Dworkis has spent the last 20 years studying the way human beings make decisions under pressure and how we work in small teams. His work focuses on how pressure affects our decision-making, our ability to harvest information and how small teams work together in stressful situations.

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In this interview, we asked him to distill decades of emergency medicine and research into seven fundamental questions about leadership. His answers reveal why he believes leaders are temporary stewards, the power of systematic curiosity, and how his perspective has shifted from individual performance to team systems.

Q1: What is the role of a leader from your perspective?

Dworkis: I think leaders have two roles. First, you're trying to do the mission that your team is here for right now, and second, you're trying to build better for the future. You always have to see both of those roles. How do I succeed right now, and how do I train my team to be better tomorrow?

Q2: What's the one thing that every leader needs to know?

Dworkis: There's this great banjo player, Earl Scruggs, who says it's a wild world we live in, but we're just passing through, right? So every leader needs to understand that they're just renting that seat. Their main job is to get folks ready to do better than they can do.

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Q3: What's your most important habit?

Dworkis: Curiosity. Being curious about myself and being essentially a scientist of myself. You're always pushing, always experimenting and always trying to get better.

Q4: What's the most important thing for building an effective team?

Dworkis: Purpose. Making sure everybody understands what your mission is, which is usually some version of saying that answer to that first question. Here's our job today, and here's our job tomorrow.

Q5: What's the biggest mistake you see other leaders make?

Dworkis: I'm gonna talk about myself, not other leaders, right? The biggest mistake that I make is not pushing as hard as I could on that curiosity, leaving things to chance as opposed to really doing more experiments.

Q6: What's the best way to deliver bad news?

Dworkis: That's something I do a lot as an ER doctor, right? We have a big protocol for that. The idea is essentially, hey, I've got some bad news today, you're not going to like this. And then I'm going to tell you what the bad news is, and then I'm going to sit. And I'm not going to say anything. And I'm going to let the space happen and let the person process.

Q7: What's something you've changed your mind about recently?

Dworkis: I think when I started a lot of this journey, I was really hyper-focused on how I could perform better under pressure, because I thought a lot of it was about me and what I needed to change. The more time I've spent in this universe thinking about applying knowledge, the more I realized it's a lot about the team and the system, and it's a lot about what you do before and after the moment of the bang.

The full interview with Dworkis can be found here: