The doctor's answer should list what other options were considered (i.e. those that were discarded in favour of the recommended action). For example, if a patient had been newly dicovered to have diabetes, a decision would have to be made to start the patient on a diet alone or to to combine it with medication.  The decision would depend on the severity of the diabetes and the rate of progression.  The options might thus be:

 

Diet alone

 

Diet with metformin

 

Diet with a sulphonylurea

 

Diet with insulin

 

Ideally the choice should depend on direct experience of a randomised control trial conducted on patients with a similar age, gender, symptoms, examination findings and test results to the patient on whom the decision is to be made.

 

© Huw Llewelyn 2016