Presented with few facts we are expected to provide differential diagnoses and ‘put our money where our mouth’ is and present a solution to the problem at hand despite the powerful effect of cognitive biases. Too often we are expected, particularly as students, to transform a client’s grey-scale narrative into a black-and-white diagnosis that can be neatly categorized and labelled; clients also expect that from us. The unintended consequence – an obsession with finding the right answer, at the risk of oversimplifying the richly iterative and evolutionary nature of clinical reasoning – is the very antithesis of humanistic, individualized patient-centred care.
We must continually make decisions on the basis of imperfect data and limited knowledge, which leads to diagnostic uncertainty, coupled with the uncertainty that arises from unpredictable patient responses to treatment and from health care outcomes that are far from binary.
Certainty is an illusion. Not knowing is ok.
Thanks to Paul Kirwan for the share!