Introduction

The introduction frames healthcare's supply and demand crisis as decades old, then argues that improving how individual clinicians decide is a route to change that does not wait on yet another reorganisation. Metacognition is defined simply as awareness of your own thinking. The authors point to a paradox: enormous sums fund drug trials, yet almost nothing studies the clinician's final choice to prescribe at three in the morning. That neglected step, they suggest, is where the gap between evidence and practice widens. They trace the project back to their first NHS jobs in 2013, when both felt trained to pass exams rather than to decide, and to popular science by Kahneman and Syed.