Evidence-Based Medicine

Anna Stecher, MD Anna Stecher, MD (1 Posts)

Resident Physician Contributing Writer

Oregon Health and Science University


Anna is a PGY-2 in Internal Medicine at OHSU in Portland, OR. She has degrees in anthropology and medicine which she hopes to put to good use as she pursues a career in palliative medicine. Besides gardening, drawing, reading, and watching Game of Thrones on repeat, Anna spends a significant amount of time cuddling her three geriatric rat terriers.




Figure 1. “Relationship between System 1 and System 2 thinking.” Daily encounters lead to the activation of System 1 or System 2 thinking. Problems demanding higher levels of thought either directly or indirectly activate System 2. Repetitive exposure decreases the demand for System 2 thinking and increases both productivity and the risk for error.

Systems-Based Thinking: How Subconscious Thought Affects Medical Decision Making

System-based thinking describes a set of subconscious thought processes aptly named System 1 and System 2. The profession of medicine relies heavily on SBT — the ability to rapidly diagnose, treat, and improvise during stressful situations is dependent on these systems, which develop and mature throughout one’s training.

Brian Secemsky, MD Brian Secemsky, MD (2 Posts)

Resident Editor Emeritus (2015-2016)

UCSF One Medical Group


Brian Secemsky, MD is an internal medicine physician currently practicing and teaching outpatient medicine in San Francisco, CA. His interests include preventive health, patient education and medical journalism. The goal of his writing is to expose those who are interested in medicine to various health care topics and to break down the jargon of medical literature into something that everyone can understand and learn from. You can find him on Twitter @BrianSecemskyMD or the website http://www.briansecemskymd.com