Clinical Reasoning & Medical Principles

Worst-first or 'rule out the worst first'

Therapeutic nihilism

Zebra hunting

Occam's razor exclusively

Wait for definitive MRI before treatment

Time-sensitive action with parallel diagnostic confirmation

Refer to outpatient neurology for later workup

Treat empirically without imaging

Emphasizing clinician authority repeatedly

Eliciting patient values and explaining options clearly

Providing a long list of technical details

Using paternalistic directives

Use validated risk stratification and shared decision-making for testing

Prescribe anxiolytics and discharge without evaluation

Discharge with reassurance only

Order immediate invasive coronary angiography

Stick with the team's first impression unless proven wrong

Assign a 'devil's advocate' to propose alternative diagnoses

Limit discussion to the senior clinician's view

Avoid documenting any differential diagnoses

Duration of therapy is unrelated to outcomes

Use antibiotics for viral respiratory infections to prevent complications

Always start broad-spectrum antibiotics to be safe

Prefer narrow-spectrum agents and limit duration to effective shortest course

Monitor only when patients complain of symptoms

Rely solely on bedside nurse intuition without protocols

Use continuous invasive monitoring for all patients

Regular vital-sign checks with early escalation protocols

Physical activity can worsen chronic pain in all cases

Opioids are the best long-term solution for most chronic noncancer pain

Psychological therapies can improve pain outcomes

Multidisciplinary care often improves function