S1, E47 - Vimla Patel: Cognitive Science of Clinical Reasoning

Dr. Vimla Patel has spent four decades studying how physicians actually reason, and what happens when technology ignores it. In this episode, she explains the difference between forward reasoning (the fast, pattern-driven hallmark of expertise) and backward reasoning (the slower, hypothesis-testing mode of novices), and why most clinical AI is built for the wrong one. Through two vivid cases, a textbook expert diagnosis and a near-fatal potassium overdose driven by a flawed order-entry system, she shows how good design preserves clinical judgment and bad design erodes it. She closes with a warning about confident AI and the quiet loss of independent thinking.