The Pharma Career Ladder · The country manager · Step 7: Leading the leadership team · Lesson 8

Decision making under pressure

Fast, slow, and knowing which one

By Ahmed El Menshawy · 20 years in pharma, from medical rep to country manager in the UAE. Founder of RepPharma. LinkedIn
Published

Pressure makes every decision feel urgent.

A stock issue, a lost tender, a number that will not close. Everyone in the room wants an answer now, and the leader feels it most.

Kahneman described two ways we think: fast and intuitive, slow and deliberate. Both are useful. The mistake is using the wrong one.

In my experience, most decisions a country manager makes should be fast. Small, reversible, familiar. A first-line manager needs a yes or a no on a trade question within agreed limits. Waiting a week helps nobody.

A few decisions need the opposite. Anything that touches people, patients or the licence. Anything new, or anything that looks strangely obvious. Anything hard to undo.

The question I ask myself first is simple: can this be undone?

If yes, decide and move. If no, take the extra day. Ask finance. Ask medical. Sleep on it. That day almost never costs what a wrong decision does.

The worst version I have seen is deciding a restructure on the same day the bad numbers arrive. The pressure is real. The decision still deserves time, and the people affected deserve a fair process.

“Decide small things fast, so you can decide big things slowly.”
Decision making under pressure: Fast, slow, and knowing which one

Lesson 8 of 15 in Step 7: Leading the leadership team, with the full guide and a checklist for this week.

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