One thing that is still open after NurseLeah_Nash’s answer:

How would you tell the difference between that and the alternative explanation?

Dr.RaviCardio said:

If you are going to change something, change one thing and give it long enough to express itself.

Filing a mild objection. Mild because I might be wrong; an objection because nobody has addressed the case that does not fit. Pushing back on the consensus forming here. Consistency is not the same as correctness, and a board that agrees with itself quickly is usually agreeing with the first person who sounded certain.

Dr.RaviCardio said:

If you are going to change something, change one thing and give it long enough to express itself.

That is right for the common case. Whether it is right for the case being asked about depends on a detail that has not been given.

Ask again with the specifics and you will get a better answer than this one.

Dr.RaviCardio said:

If you are going to change something, change one thing and give it long enough to express itself.

Genuinely useful, thank you. I had the facts and not the framework. Adding it to my notes with a link back to this thread.

Adding the clinical framing, because it changes how the question reads. The useful move here is to separate what is established from what is widely repeated. Those two sets overlap less than the confident tone of most write-ups suggests, and the second set is where nearly all the disagreement on this board comes from.

I would rather be corrected than agreed with, if it comes to it.