Uncertainty in Medicine: A Shared Experience – Part 2

In a 2024 journal article titled “Three Types of Uncertainty: A Qualitative Study of Family Medicine Residents”, Dr. Purkl identifies and describes three key categories of uncertainty encountered in clinical practice:

• Biomedical Uncertainty –referring to the challenges involved in making diagnostic or therapeutic decisions.
• Interpersonal Uncertainty –involving the complexities of communication and relationship dynamics between physician and patient.
• Psychosocial Uncertainty – arising from trying to understand a patient’s social, emotional, and environmental context.

The known unknowns of patient care are a daily reality for Family Doctors. Kathryn Montgomery, in her book How Doctors Think, reminds us that “the whole of medicine is to some degree uncertain.”
Every day, patients walk into the clinic looking for clear, simple answers. And yet, more often than not, I find myself facing uncertainty. Take, for example, the chief complaint of “dizziness”—just hearing those words makes my heart rate go up. Why? Because behind that one word could lie a hundred different causes. It’s a diagnostic minefield.

One of the best pieces of advice I’ve come across in the medical literature is from Dr. Galina Gheilman et and colleagues, in their  journal article 12 Tips for Thriving in the Face of Clinical Uncertainty.   Stay tuned for part 3 of my Dr. Dan series on Uncertainty in Medicine.