Want proof that being busy makes decisions worse?
Researchers analysed 76,000 emergency department cases, tracking doctors’ actions second-by-second.
Here’s what they found.
Under high cognitive load, doctors:
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Order more tests (+4-9%)
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Order basic rather than targeted tests
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Admit 28% more patients (even when not necessary)
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Default to safer, more conservative decisions
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Spend less time on thinking-intensive work, and more on activity
In short, they switch to busy rather than thinking mode. They look productive but make lower-quality decisions.
If this feels familiar, it should.
In business, overload leads to:
• Over-analysis and over-reporting
• Extra layers of approval as people kick decisions down the road
• Risk-averse decision-making
But for me, this research is so important because it debunks two ideas that many of us hold:
1. That intelligence protects us from overload
It doesn’t. Even experts think worse when they’re stretched.
2. That if you want something done, give it to a busy person
Sure, you’ll get more done – but it won't necessarily be done well.
So, if you want better decisions, from yourself or your team, the most valuable thing you can protect isn’t time to do more.
It’s time to think.
Ref: Benjamin R. Handel, Louis-Jonas Heizlsperger, Jonas Knecht, Jonathan T. Kolstad, Ulrike Malmendier & Filip Matějka, Working Paper 35034 DOI 10.3386/w35034, Issue Date April 2026
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