Dear Editor
Dr Matt Morgan make several very important points in his discussion about ‘what’ and ‘why’ and the proper use of protocols and guidelines. Put another way; ‘doctors know what to do when they don’t know what to do’. Expertise comes from experience and its acquisition cannot be hurried or short-circuited; it takes what it takes. Both depend on a deep knowledge of the underlying processes which the doctor can access immediately at the bedside.
There are important implications for assessment which may not always be recognised. There may be a tendency, particularly in constructing written assessments, to write ‘what’ questions; ‘what is this?’, ‘what do we do?’. We also need ‘why’ questions; ‘why has this patient presented at this time in this way, with this problem and needing this management?’. A focus on the ‘what’ will lead to learning the ‘what’ and an inability to do the slow thinking (1) needed for the ‘why’.
1. Kahneman D. 2012. Thinking Fast and Slow. Penguin.
Re: Matt Morgan: Don’t lose the “why”