Beyond Protocol: A Call for Critical Thinking in Medicine By Dr. EV Rapiti | July 15, 2025; Cape Town www.drrapiti.com
We need critical thinkers and not robotic doctors that abide rigidly to protocols
Beyond Protocol: A Call for Critical Thinking in Medicine
By Dr. EV Rapiti | July 15, 2025; Cape Town
www.drrapiti.com
"In an era where knowledge is abundant but discernment is scarce, the true mark of intelligence lies not in the memorization of facts, but in the courage to think critically".
On Sunday evening, a patient of mine—whom I’ve served for over three decades—reached out in distress. He had visited a hospital emergency room feeling acutely unwell. Based solely on a raised C-reactive protein (CRP) result, the attending ER doctor advised urgent admission to consult with specialists, declaring him “very ill.” Alarmed, my patient declined, choosing instead to place his trust in his GP.
When he entered my practice the following morning, he looked much improved. He’d received a paracetamol drip the night before and, feeling significantly better, chose to leave the hospital. Yet fear lingered. His nurse-wife was shaken by the ER doctor’s prognosis and the high-stakes script for Augmentin—a broad-spectrum antibiotic often prescribed in panic, not prudence.
In our extended consultation, I took a detailed history, conducted a thorough examination, and made a diagnosis drawn not from reflexive protocols, but from reflective clinical insight: influenza. A viral illness, not a bacterial infection. His symptoms mirrored those of countless patients I’d seen recently—and even my own experience a fortnight prior. No antibiotics. No cascade of tests. Just bed rest, fluids, and analgesics. He left reassured, relieved, and more importantly—protected from unnecessary intervention.
This incident is emblematic of a growing crisis: the erosion of independent thinking in medicine. The young ER doctor, though well-intentioned, followed the rule book without question. History-taking was skimmed, fear was implanted, and treatment escalated beyond reason. It was not a failure of knowledge, but a failure to think.
If we train doctors to become mere technicians of protocol, then the art of healing is lost. Medicine must never be reduced to algorithms and fear-driven conveyor belts. The patient’s wellbeing must be upheld by thoughtful judgment, not mechanical obedience.
We need more than memory in medicine—we need meaning. And meaning arises only when intelligence meets compassion, and experience informs action.
--- Reflection Quote:
_"Medicine should be a dialogue, not a diktat;
True intelligence begins where protocol ends;
in the mind of the doctor who dares to think;
We owe it to our patients, to practice with integrity and discernment."_
— Dr. EV Rapiti | July 15, 2025;
www.drrapiti.com