Both approaches have value and a long tradition in the history of science. They differ in the source of hypotheses: intuitive experience versus rational deduction from a pre-existing theory. The rigor of scientific method is equally important in both approaches. Over time, this approach may lead to the development of a higher-order theory as a byproduct. We have preferred instead to move between the context of discovery and the context of justification - deriving intuitive hypotheses from clinical experience, submitting them to the verification of scientific method, and then going back to the drawing board to try again. This has simply never been a forte or primary scientific interest for either of us, to the dismay of some of our mentors and colleagues. The world of academia, in contrast, tends to place a high premium on starting from coherent theory and rationally deriving hypotheses that will be tested to either confirm or revise the theory. Much of what we have done in our careers has sprung from efforts to deal with practical problems that clinicians encounter in their daily work. In part this reflects our own temperaments, preferring intuitive to rational-deductive ways of knowing, with a focus on the "real" world of clinical practice.
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