[Clinical inertia, or the defeat of evidence-based medicine].

Clinical inertia, or the defeat of evidence - based medicine. Often doctors do not follow good practice guidelines that have been widely disseminated, that they know and even approve. Sometimes they do it wisely, considering that the guideline does not apply to the patient they have in front of them: in that case their behaviour would represent an appropriate inaction, of which they can give a reason that is often validated by their peers. But sometimes this is not the case, and this is referred to as clinical inertia. This phenomenon, recently described, seems to defeat evidence-based medicine (EBM). The aim of this article is to propose that it is at least in part caused by a difference in logic: the purely rational logic of EBM, and the complex thought of patients and doctors, which combines rationality and irrationality, linked to the presence in the mental functioning of human beings of rapid circuits of reasoning called heuristics and of emotions.