One of my challenges this week has been getting past the basics in a business decision so that effective discussion can occur, eventually leading to decision making. Highly educated professionals, such as physicians, are experts in their field. The basic information and understanding in other areas can be foreign. For example, when discussing the various options for expanding real estate, the concepts of leasehold improvements, operating expenses, revenue per square foot, intensification of production, etc are part of the conversation. Keeping the conversation moving forward requires assuring that everyone in the room understands the concepts. Some of the decision makers will pick it up quickly, while others will not. In addition, some will tune out of the conversation, appearing to agree, when in fact he or she really doesn't have an opinion - yet. How do we keep the decision making moving forward? How far do we go to make sure the physician understand? What do we know about physician decision making in business matters that will help us support our organizations?