Uncertainty in medicineBMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j2180 (Published 11 May 2017) Cite this as: BMJ 2017;357:j2180
- Steven Hatch, associate professor of medicine
- UMass Medical School, Worcester, MA, USA
Uncertainty is ubiquitous in medicine. It can be seen in something as basic as a differential diagnosis or as complex as a new set of guidelines by a professional society. And yet uncertainty is often ignored as a subject in medicine, its importance underappreciated and its consequences suppressed. The public could be forgiven for regarding physicians as trafficking in certitude, producing diagnoses or summarising research with triumphant finality. To a large extent, we participate in that self delusion, and indeed encourage it.
Despite early work,1 the systematic study of uncertainty did not begin in earnest until the 1990s. Since then, uncertainty has usually been studied in relation to professional development. A 2014 study, for example, reported that certain personality traits of general practitioners influenced their levels of anxiety about uncertainty; the authors note this may lead to resource overuse and medical …