Fallacious Reasoning and Complexity as Root Causes of Clinical Inertia

Fallacy and complexity contribute to clinical inertia and planning error on a regular basis in nursing homes. Gestalt for planning error, fallacy and complexity is not widely available to physicians, and they are remarkably unaware that their own cognitive limitations and biases have unintended adverse consequences for their patients. The author proposes that study of the cognitive psychology of longitudinal care is sorely lacking in current medical training. This type of reasoning differs from diagnostic reasoning, and may utilize a different part of the brain. Training in planning error should be introduced early, and refreshed periodically, as clinicians become more highly trained. Paradoxically, training and success seems to render the practitioner progressively more resistant to recognizing his entrenched fallacious belief systems.