Human beings don’t like to fail.   Doctors are terrible at it.  It’s hard, especially when that failure is linked to your self-esteem, professional image, and livelihood.   It’s especially hard at the moment with the additional demands placed on our profession and healthcare system during a Pandemic.   

But sometimes, the strong emotions that accompany failure, stop us from taking the time to consider why we may have had that outcome in the first place. Consequently, we habitually reattempt assessment without reconsidering our approach – which can often lead to an unchanged outcome.  

What do we do when a patient keeps coming back with the same unresolved symptoms?  We usually try a few alternative treatments, perhaps increase a medication dose, whilst at the same time re-enquiring as to their initial symptoms, checking for red flags, and safety-netting.   If they are still not getting better, we usually go right back to basics – retake the history again, re-examine, review the results of any investigations, perhaps read around the topic – and then reconsider what might be going wrong.   If we are still stuck, we ask for a colleague’s insight.  This approach works for reattempting assessment as well.