BMJ  2005;330:515 (5 March), doi:10.1136/bmj.330.7490.515

Commentary

Uncertainty, consultation, and the context of medical care

¹ School of Public Health, Ohio State University, 246 Atwell Hall, 1583 Perry Street, Columbus, OH 43210, USA tanenbaum.1@osu.edu

The first 150 words of the full text of this article appear below.

Although the ascendancy of evidence based medicine obscures the uncertainty inherent in patient care, this uncertainty remains a defining fact of medical life. Griffiths et al listened to health professionals and identified three distinct approaches that were used in consultations—two of which they judged to understate the risk level of patients.¹ They recommend that health professionals should be trained to communicate with their patients without recourse to the myth of medical certainty.

The authors produced a distribution of approaches to consultation across several health professionals, settings, and health issues, and draw some intriguing inferences. Their findings also generate further research questions, especially about the relation between the context of medical care and the strategies used by health professionals in consultations. The potential to improve the communication of risk through training may be mitigated by factors external to the doctor-patient relationship—specifically, by extra clinical functions of the healthcare system. For example, . . . [Full text of this article]

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