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A good outcome doesn’t always mean it was a good decision. Winning the lottery is a great outcome—but buying the ticket is still a bad decision. If your patient gets better, it doesn’t mean the choices you made were sound. Decisions should be judged by the quality of the reasoning and evidence behind them, not just by how things turned out.

Don’t confuse reaction time with quality (the first hand in the air doesn’t always have the best answer). The speed at which you arrive at a decision is separate from whether that decision was smart. Quick decisions often rely on instinct, experience, and pattern recognition. That can be powerful—but it can leave important nuances unexplored. Smart decisions, on the other hand, blend evidence, clinical reasoning, and context.  The goal isn’t to choose between them. It is to b

When patients share their symptoms, one of the most frequent questions I hear is: “Is this normal?”  They’re not just asking about medical facts—they’re asking for reassurance, connection, and maybe even permission to feel what they’re feeling. Here’s the challenge: pain is rarely normal. By definition, “normal” suggests something typical, expected, and in some way okay.  And while it might feel comforting in the moment to say “yes, that’s normal,” what we end up doing is nor