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Insight: Sharing Uncertainty


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Physician Speaking with Patient

Insight: Sharing Uncertainty

By William Berry, MD, CRICO

Related to: Communication, Emergency Medicine, Primary Care, Nursing, Obstetrics, Surgery

In caring for patients every day, it can be easy to assume that they understand what we understand. Most often, however, they do not. The information imbalance between the physician and the patient can be extreme. Even well-informed patients expect to know or understand more after their exams and conversations with us. Patients come to us for our expertise and for our recommendations. They also generally come expecting to find out how we came to our recommendations and what alternatives are available to them—including the alternative to have no treatment at all.

Although it may be troubling for patients when physicians are uncertain of an outcome, it is imperative that we share our uncertainty with them. This is part of the communication process and is our responsibility.

Preparing patients and families for the uncertainties that can arise in medical treatment is part of our job as physicians, but it doesn’t mean that we overwhelm the patient or the family with a “laundry list” of complications—many of which are extremely rare. It does mean that we discuss with them the most serious and common complications of treatment, not leaving out that we’re unsure of an outcome.

When we give patients all the information we can, we increase the likelihood that they will feel part of the decision making process and will take more ownership of their care. They will also have more confidence and trust in us and in what we provide them. The more uncertain we are about an eventual outcome, the more important it becomes to let the patient know that. Being forthright about our own uncertainty will lead patients to trust us more, not less.

There are few things in life that are one hundred percent certain, and most patients easily understand and can cope with this. Most of the time, we can predict for our patients what the future holds. Sometimes, though, we know that we can’t. When that happens, sharing that uncertainty with our patients can prepare them to face an uncertain future, but with us as their partners in care. 

December 1, 2006
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