Heuristic Thinking Isn't Heretical: How Should Doctors Think?

Abstract

ABSTRACT Doctors are intelligent people, but are we good thinkers, and how should we think? The evidence-based medicine movement harnessed the power of computers and the electronic medical record to champion a highly analytical approach to individual patient care. As an unintended consequence, the movement came to depict heuristic thinking—intuitive “rule of thumb” thinking—as a folksy and imprecise way of dealing with our patients. Yes, analytical thinking is deliberate, deductive, and rule-following, but it is not always as “logical” as we suppose it to be, and it is not intellectually superior to intuitive thinking. Rather, it is intellectually complementary to heuristic thinking, which allows experienced clinicians to collapse unmanageable complexity and uncertainty into categories that allow for pragmatic decisions. To provide our patients with the best possible care, we'll have to overcome our blind faith in anything with a probability value of less than 0.05, and our disdain for the idea of “acting...