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How Can Clinicians Navigate Uncertainty?

It’s uncomfortable but we must embrace uncertainty to excel as healthcare providers. Each patient that enters our clinics is a unique individual. They bring their own combination of beliefs, symptoms, support, medical history, and behaviors. The research we use to determine and understand our treatments evolve every day. Furthermore, we are adapting as clinicians, developing new mental models, and building intuition.

Despite the advancements in our clinical reasoning and research foundations, we are left with more questions than answers. We can never account for all of the variables in a given case or gather all of the facts needed to make a fully informed decision. Errors in our judgments are a primary reason why simple algorithms are often superior to expert decision-making across healthcare, economics, and business. This paper provides strategies for clinicians to better navigate uncertainty.

The difference between the logic of choice and the logic of care is a foundational clinical concept. The logic of choice is the linear process of using instruments and presenting facts, from which patients can assess and make decisions. The more facts that are gathered, the greater the certainty in the assessment and treatment plan. Conversely, the logic of care contends clinicians do not treat facts as neutral information. Values and contextual factors are adopted into care. The logic of choice focuses on the facts, separating goals and context. The logic of care melds them all together, inviting more uncertainty but also more personalized treatment.


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