Causal decision making (CDM) based on machine learning has become a routine part of business. Businesses algorithmically target offers, incentives, and recommendations to affect consumer behavior. Recently, we have seen an acceleration of research related to CDM and causal effect estimation (CEE) using machine-learned models. This article highlights an important perspective: CDM is not the same as CEE, and counterintuitively, accurate CEE is not necessary for accurate CDM. Our experience is that this is not well understood by practitioners or most researchers. Technically, the estimand of interest is different, and this has important implications both for modeling and for the use of statistical models for CDM. We draw on prior research to highlight three implications. (1) We should consider carefully the objective function of the causal machine learning, and if possible, optimize for accurate treatment assignment rather than for accurate effect-size estimation. (2) Confounding does not have the same effect on CDM as it does on CEE. The upshot is that for supporting CDM it may be just as good or even better to learn with confounded data as with unconfounded data. Finally, (3) causal statistical modeling may not be necessary to support CDM because a proxy target for statistical modeling might do as well or better. This third observation helps to explain at least one broad common CDM practice that seems wrong at first blush: the widespread use of non-causal models for targeting interventions. The last two implications are particularly important in practice, as acquiring (unconfounded) data on all counterfactuals can be costly and often impracticable. These observations open substantial research ground. We hope to facilitate research in this area by pointing to related articles from multiple contributing fields, including two dozen articles published the last three to four years.