The art of being uncertain

In his latest post, Dr. John Ford, aka the California Medicine Man discusses many of the factors that go into our profligate test ordering. It boils down to the fact that we want NO uncertainly in our life, and we're willing to spend a lot of (other people's) money to rule even the most obscure possibilities.

The post is a good read and I recommend it. I've been reading a very thoughtful essay that just happened to dovetail into this discussion: Medicine, Love, and the Art of Being Uncertain by Dr. Daniel Sulmasy of Georgetown University, taken from his book The Healer's Calling, published by Paulist Press. I've enjoyed the essay and will share an extended excerpt from it:

The quest for certainty undermines trust. The quest for certainty fills the vacuum that remains as trust evaporates from the doctor-patient relationship. Intolerance for uncertainty results from the absence of a certain basic trust, informed by a strong belief that the future could not possibly turn out OK for me unless I manipulate things and people in order to make it come out OK.

Tolerance for uncertainty, by contrast, demands a level of basic trust. In the present era, however, this trust is hard to come by. It now seems as if doctors no longer trust their patients and patients no longer trust their doctors.

It is not easy to say what accounts for this situation, but I think health care professionals themselves, taken as a whole, are largely to blame. One source of this distrust and intolerance for uncertainty is that medicine has been so successful in convincing the public of its invincible powers and the certainty of a cure for everything, that death and other human limitations on medicine are now interpreted as someone's fault. This in one for the causes of the malpractice explosion and the growth of defensive medicine.

Another source of mistrust is the cynical attitude toward doctors that doctors themselves have cultivated among the public...Patients fail to see how organized medicine can claim to put patients first when organized medicine has, by and large, fought against every type of true health care reform.

Exactly.