Medical Challenges: Jumping to Conclusions and Medical Uncertainty
"A DOG'S STORY
The man dressed all in white quickly raised the dogs over the flames. Fortunately they were neither burned nor damaged. Covered with the yellow emoliment, he bedded them to rest for now but not for long. Every dog lover must know that
Nathan's on the Coney Island boardwalk is famous for their dogs."
When you read A Dog's Story, you are presented the perfect example of what all physicians face when confronted with a patient's medical story without sufficient time because of scheduling or where an action must be taken quickly and that is--jumping to conclusions and, in fact, the wrong conclusion.
And if the challenge of "conclusion jumping" is not enough for the physician there is also the "fog of medicine", the certainty that there is uncertainty in medicine.
Patients may unrealistically expect their doctors to uniformly overcome these challenges. But it really is difficult. Robert Lowes writes about this issue in the October 24 2003 Medical Economics: "In fact, The doctor-on-a-pedestal model of medicine also makes it hard for doctors to voice their doubts. Patients naturally prefer comfort and reassurance to any talk about percentages. Many physicians assume that anything less than supreme certitude on their part will discourage them and set back their progress. In the end, doctors have no choice but to live with unease."
How do you expect your doctor to respond to these challenges? How would you feel if your physician expresses personal doubt about his or her diagnosis or prediction of the outcome of any treatment? Would you be willing to face the uncertainty together or would you expect to be transferred to another physician who would be able to provide you with all the answers to the questions you are asking? But is there such an "other physician"? ..Maurice.