Dr. Ralph – Medical Diagnostics Plugin Using Claude Code's Ralph Wiggum
Built this over the weekend for a friend dealing with chronic health issues who wanted help analyzing their medical records. Dr. Ralph is a Claude Code plugin that runs a 5-phase diagnostic workflow: records intake, literature research, differential diagnosis, treatment planning, and SOAP documentation. It uses the Ralph Wiggum plugin’s Stop hook pattern - the loop keeps iterating until diagnosis confidence reaches 80% or max iterations. The interesting bit was adapting Ralph for multi-phase work instead of single-task refactoring. I used Thariq’s AskUserQuestion interview approach to spec…
What it does
In the maker’s words, at launch
Built this over the weekend for a friend dealing with chronic health issues who wanted help analyzing their medical records. Dr. Ralph is a Claude Code plugin that runs a 5-phase diagnostic workflow: records intake, literature research, differential diagnosis, treatment planning, and SOAP documentation. It uses the Ralph Wiggum plugin’s Stop hook pattern - the loop keeps iterating until diagnosis confidence reaches 80% or max iterations. The interesting bit was adapting Ralph for multi-phase work instead of single-task refactoring. I used Thariq’s AskUserQuestion interview approach to spec it out first, which made the actual build surprisingly fast. ~1,600 lines. Uses the Stop hook to check for completion promise in Claude’s transcript, re-feeds the prompt if not done. State lives in a markdown file with YAML frontmatter. Not a replacement for doctors - just an experiment. Our team builds clinical decision support at the VA, so this was adjacent territory. Code: https://github.com/blencorp/dr-ralph
Does the same job
all alternatives →- YAYet another tool to wrap agents in a loopDec 2025 · github.com · ▲6
I was randomly browsing claude codes ralph wiggum plugin[1] and was surprised to see my toy project referenced. Since it appears people are getting some value out of it, thought I'd share it here... Full disclosure, this repo itself was built with a primitive ralph wiggum loop so expect AI slop. It works though. ¯\_(ツ)_/¯ https://mikeyobrien.github.io/ralph-orchestrator/ [1] https://github.com/anthropics/claude-code/tree/main/plugins/...
- RRRalphex – Ralph-inspired loop extended with plan creation and reviewsJan 2026 · ralphex.umputun.dev · ▲9
Built this to manage the full Claude Code workflow autonomously, from initial plan creation to reviewed PR. Tested it on a 25-task plan (5-7 items each) - ran overnight, woke up to a surprisingly solid PR-ready branch. Just run `ralphex` (single binary) in your project directory. Without a plan file, it starts interactive mode. Asks what to build, explores the codebase, writes the plan, then executes. The loop: plan creation (asks questions, writes markdown) → task execution (fresh session each, no context bloat) → multi-phase reviews (Claude + optional Codex) → branch ready for PR. Prompts…
- OSOpen-source autonomous dev teams for Claude CodeJan 2026 · github.com · ▲5
We're releasing the next-gen Ralph Wiggum architecture - agent clusters with independent validator agents with clear rejection mandates. As long as the code is not feature-complete and production-grade, it will not be approved. The result is AI without any need for babysittng.
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