When I see a patient, as a physician, I need to ask myself what the worst thing that could be going on is. Simply, asking myself, “what is the worst case scenario”, will ensure that I don’t forget anything.
I do this for every key symptom or symptom group.
The “rule out the worst-case scenario” strategy, in which certain diagnoses must be ruled out immediately, will help you avoid serious diagnostic errors.
Physicians should rule out several potential causes that can have serious consequences if the diagnosis is delayed.
The good news is that these “worst-case-scenario” diseases can often be ruled out on the basis of a non-worrisome history and physical examination rather than extensive testing.
Then you should document that you thought about them and why you don’t think they are at play.
Further Reading
https://www.medscape.com/viewarticle/782235_3