by Ted Eytan, on 11 May 2007 02:29 pm
The Journey
Quote: How Doctors Think, Uncertainty
I’m still filling in for Lee, so I’ll try for the quote of the week. I’m doing this one from the lovely community of Burlington/Montpelier, Vermont, where I was invited to talk about patient activation and empowerment through Information Therapy. As part of the way I do things in the era of LEAN, I asked to visit medical practices where care is provided to patients, instead of just coming to show what I’ve done. I learned an incredible amount - 10 things every 10 minutes, easily. The graciousness of the patients and physicians who I observed is a reminder that everyone is interested in quality improvement - when we ask.
The quote is from a book recently published called “How Doctors Think?” by Jerome Groopman, MD.
The book does a nice job of pointing out the way physician thought processes are shaped and the impact that it has. Here’s the quote:
Does acknowledging uncertainty undermine a patient’s sense of hope and confidence in his physician and the proposed therapy? Paradoxically, taking uncertainty into account can enhance a physician’s therapeutic effectiveness, because it demonstrates his honesty, his willingness to be more engaged with his patients, his commitment to the reality of the situation rather than to resorting to evasion, half-truth, and even lies. And it makes it easier for the doctor to change course if the first strategy fails, to keep trying. Uncertainty is sometimes essential for success. - Jerome Groopman, MD
This quote talks about a patient’s diagnosis, but I’m applying it to the diagnosis of a system. Physicians are trained to resist uncertainty. When we learn to accept uncertainty it allows us to experiment with different ways of providing care. If a new way isn’t better, then we’ll try something else. If it is, then we keep doing it. I think it’s okay to tell our patients that we’re trying new things, just like Lee and I are doing on this blog.
I thought the book itself was excellent and is worth a read. It includes an action plan for patients. I would add an action plan for physicians - visibly diagnose and treat the system, too. It will increase a patient’s sense of hope and confidence in health care.