Mrs B goes to the GP, having just visited the cardiology clinic. The discharge letter from the specialist registrar states: “Could you please start [Mrs B] on spironolactone 25mg daily and monitor her electrolytes in two weeks” …

Will Mrs B be prescribed spironolactone? No spoiler here!

Read this insightful delightful case study of how GPs make decisions about prescribing medicines. It involves, among other things: time, 11 biases (obedience bias, expectation bias, risk aversion bias, time pressure bias …), being “blinded by statistics and misled by optimism”, knowing (or not) number needed to treat or number needed to harm, asking questions and listening to the patient.

Richard Lehman on prescribing Spironolactone, published on The BMJ Blog, on 23 October 2015.