ABSTRACT
The process of diagnosing typically involves a series of steps requiring a variety of specific skill sets and expertise. From patient to patient, the process can differ, depending on circumstances, how simple the problem is, how direct a cause is assumed, and whether or not an intervention or treatment is identifiable and without controversy or contraindications. Although diagnostic pathways are sometimes reduced to algorithms, in reality, medical decision making is often less ordered, and frankly, even a bit messy. This chapter explores the largely unseen, even unspoken, mental process of clinical reasoning and the making of a diagnosis. The fact that medical practice is grounded in scientific knowledge and uses analytical testing with mathematics and statistics gives a semblance of certainty, but these methods do not guarantee accuracy. In actual practice, clinicians rely on analytical methods, intuition, formal logic, and informal rules, all of which help describe and explain how diagnoses are made.
