What Should Doctors Do When They Don't Know What to Do Allen Frances

[Cheshire]

Short but valuable article about uncertainty in medicine.

One negative side effect of scientific drum beating is the unrealistic expectation (held by doctors and patients alike) that every medical presentation can be accurately diagnosed and effectively treated. When, as so often is the case, this expectation is defeated by the hard reality of our limited knowledge, doctor and patient are both likely to feel grave disappointment and the relationship between them may become uncomfortable and unproductive.

The only certainty in medicine is uncertainty and the appropriate response to uncertainty is Hippocratic humility.

The difficulty accepting uncertainty is just as strong today as it ever has been. It leads now to excessive testing, quack treatments, and blaming the patient. We need to expand our frontiers of knowledge, but also to recognize our limitations and do the best we can within them. Confronting the reality of uncertainty almost always beats the creation of a false certainty.

http://www.huffingtonpost.com/allen-frances/helping-doctors-and-patie_b_3457682.html

The best thing I was told since being ill was "I don't know what you have".

 

[SilverbladeTE]

Hurray!
as I've said repeatedly: I love Science, but the reality is, we know almost *nothing*
we have had a "technological scientific world" for only two and a half centuries.
Humans are the result of 4 billion years of evolution, and we and the living world around us, is STILL changing!
We have scraped only the very surface layer of the Universe we live in,
no Human has even set foot on another world (technically the moon is a satellite of Earth not a true planet)
The Moon is as far as Human Beings have reached
our robotic probes are just now, reaching the edge of our solar system
the vast majority of our planet us unexplored (oceans, underground)

So we really don't know very much
alas many people DO treat Science as a "religion", they DO!
And that is a very dangerous thing.
There are *no certainties* in Science, only probabilities based on best current data.
But listen and watch how folk like our "psych" enemies behave (and yes they are enemies)
Medical Science is their "god", their religion, THEY know THEY are absolutely right...
they put on a song and dance, they please their masters who have the reigns of power by saying things that divert dissent

And many doctors fall in this crap too.
some of it of course is honest concern of a doctor who is still a decent genuine PHYSICIAN, and not wanting to cause distress to a patient
But far more commonly, it's really about a "priest" who cannot say that his religion doesn't know something!

 

[Woolie]

This is a really interesting article, @Cheshire. Thanks for posting!

 

[Sean]

The best thing I was told since being ill was "I don't know what you have".

All I have ever asked is that doctors understand, admit, and stay within the limits of their knowledge. But even that is too much to ask, apparently.

I am a huge fan of modern science based medicine. It is one of the greatest achievements of the human race.

I just wish there was more of it.

 

[daisybell]

Good article! If only more doctors had the attitude of that neurologist...
I followed a link at the bottom of the article to an article on CFS that had appeared in the Oprah magazine. I missed this first time around I think!
http://www.huffingtonpost.com/entry/chronic-fatigue-syndrome_us_5654ddd9e4b0a07b8c70982e