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Editor's Choice

Navigating medicine’s grey areas

BMJ 2019; 367 doi: https://doi.org/10.1136/bmj.l6153 (Published 24 October 2019) Cite this as: BMJ 2019;367:l6153

Rapid Response:

Medicine’s grey areas - the role of education

The role of uncertainty, risk, choices, chance and how these complex issues are handled by professionals and how this understanding is shared with patients is, obviously, of vital importance in all areas of healthcare.

You might think that such complex issues would require maturity and training to understand especially as may of us seem to be unable to communicate effectively notwithstanding - maybe because of - all the training and knowledge we have. In fact the Gloucestershire CCG backed Facts4Life programme for all schools in Gloucestershire has shown that kids 'understand grey' (https://facts4life.org/about-f4l/evaluation/ & https://doi.org/10.1093/pubmed/fdx003). They know we live with illness, they get that life's complex and some die early. Despite this positive approach we know there's lots to do: many children already have unrealistic attitudes to health learnt from their parents, the media, government and us - even as they join the education system. A more rounded education that encompasses a realisation that bad things happen but mostly we fix ourselves can improve outcomes and could lead to better shared decision making (ref to Patient Centred Care: How shared decision making helped cut a Dutch hospital's costs, BMJ 2019; 367:l5900).

Isn't it time we shared our thinking and insights as well as our decisions? Just as health and social care are forging links at - predominantly - the end of life, education would do well to link better with the health world. Yet the government has consistently disinvested from prevention over the last 5 years or more.

Competing interests: No competing interests

28 October 2019
Hugh van't Hoff
Director Facts4Life and GP (Stonehouse, Glos)
Regent Street Surgery, 73 Regent Street, Stonehouse, GL10 2AA