Uncertainty is the norm in medical practice, yet often gives rise to distress in clinicians, who fear they will make shameful or guilt inducing errors. This book offers a succinct method to clinicians for classifying uncertainty and finding the right skills to manage different types of uncertainty successfully. Every clinician experiences moments when 'they don't know what to do'. Modern medicine is increasingly complex and training has also become more complicated. The days of 'see one, do one, teach one' are over. Yet, both younger clinicians and senior practitioners describe uncertainty as one of the most challenging and stressful aspects of clinical work. If uncertainty is uncomfortable or threatening to individual practitioners, it also provides complex educational challenges. How can we learn to cope with uncertainty effectively ourselves? How can we teach others to understand and manage uncertainty? In this ground breaking book, the authors propose ways to cut through uncertainty, which is explored as an inevitable (and even desirable) component of clinical practice. A Map of Uncertainty in Medicine (MUM) is used to classify uncertainty and to define the skills that will help find a way though practical difficulties. It is always good to have your MUM with you in a tricky situation!

Uncertainty is the norm in medical practice, yet often gives rise to distress in clinicians, who fear they will make shameful or guilt inducing errors. This book offers a succinct method to clinicians for classifying uncertainty and finding the right skills to manage different types of uncertainty successfully. Every clinician experiences moments when 'they don't know what to do'. Modern medicine is increasingly complex and training has also become more complicated. The days of 'see one, do one, teach one' are over. Yet, both younger clinicians and senior practitioners describe uncertainty as one of the most challenging and stressful aspects of clinical work. If uncertainty is uncomfortable or threatening to individual practitioners, it also provides complex educational challenges. How can we learn to cope with uncertainty effectively ourselves? How can we teach others to understand and manage uncertainty? In this ground breaking book, the authors propose ways to cut through uncertainty, which is explored as an inevitable (and even desirable) component of clinical practice. A Map of Uncertainty in Medicine (MUM) is used to classify uncertainty and to define the skills that will help find a way though practical difficulties. It is always good to have your MUM with you in a tricky situation! Selling points If you experience uncertainty in clinical practice this book: - will help you understand it, help you manage it effectively and improve your stress levels and resilience as a result - help you share and manage uncertainty with patients and colleagues - provides effective teaching approaches. Audience Clinicians in training in all specialties and experienced clinicians looking to expand their skills or teach and train others to deal with uncertainty. Training Programme Directors. Secondary audiences: Nurse Practitioners/Clinical Nurse Specialists working in Primary Care or Accident and Emergency GPs and family doctors overseas. Needs met: personal and professional development.

What makes a good doctor? It's not what you think. A doctor willing to face their own uncertainty in the face of illness and treatment might just be the best medicine. Too often we choose the wrong doctor for the wrong reasons. It doesn't have to be that way. In The Good Doctor, Ken Brigham, MD, and Michael M.E. Johns, MD, argue that we need to change the way we think about health care if we want to be the healthiest we can be. Counterintuitive as it may seem, uncertainty is integral to medicine, and you want a doctor who knows that: someone who sees you as the unique case you are, someone who knows that data isn't everything, someone who is able to change her mind as the information changes. For too long we've clung to the myth of the infallible doctor--one who assuredly tells us this is what's wrong and here is how I will cure you--and our health has suffered for it. Brigham and Johns propose a new model of medicine, one that is comfortable with ambiguity and that centers on an equal partnership between patient and doctor. Uncertainty, properly embraced, opens a new universe of possibilities.

Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.

The Power of Colleagues What happens when primary care clinicians meet together on set aside time in their practice settings to talk about their own patients? .....Complimenting quality metrics or performance measures through discussing the actual stories of individual patients and their clinician-patient relationships In these settings, how can clinicians pool their collective experience and apply that to ‘the evidence’ for an individual patient? .....Especially for patients who do not fit the standard protocols and have vague and worrisome symptoms, poor response to treatment, unpredictable disease courses, and/or compromised abilities for shared decision making What follows when discussion about individual patients reveals system-wide service gaps and coordination limitations? .....Particularly for patients with complex clinical problems that fall outside performance monitors and quality screens How can collaborative engagement of case-based uncertainties with one’s colleagues help combat the loneliness and helplessness that PCPs can experience, no matter what model or setting in which they practice? .....And where they are expected to practice coordinated, evidence-based, EMR-directed care These questions inspired Lucia Sommers and John Launer and their international contributors to explore the power of colleagues in “Clinical Uncertainty in Primary Care: The Challenge of Collaborative Engagement” and offer antidotes to sub-optimal care that can result when clinicians go it alone. From the Foreword: “Lucia Sommers and John Launer, with the accompanying input of their contributing authors, have done a deeply insightful and close-to-exhaustive job of defining clinical uncertainty. They identify its origins, components and subtypes; demonstrate the ways in which and the extent to which it is intrinsic to medicine...and they present a cogent case for its special relationship to primary care practice...‘Clinical Uncertainty in Primary Care’ not only presents a model of collegial collaboration and support, it also implicitly legitimates it.’’ Renee Fox, Annenberg Professor Emerita of the Social Sciences, University of Pennsylvania.

It has been recognised by governments and healthcare organisations worldwide that for Universal Healthcare in pursuit of Health for All under the Sustainable Development Goals to be achieved, effective primary care that is integrated, accessible, and affordable for everyone is essential. This practical guide is the first designed specifically to support those planning and conducting family medicine/primary care education within medical schools around the world. It offers medical educators a collection of concise easy to follow chapters, guiding the reader through the curriculum requirements with key references for further detail. Plain English and practical, deliverable advice, adaptable to different contexts, ensures the content is accessible to those educating medical students in any country, while the structure within sections ensures that family medicine doctors and educators can dip into chapters relevant to their roles, for example curriculum design for academic educators or teaching methods for those educating in clinical practice. Key Features ■ The first “how-to” guide dedicated to effective integration of family medicine teaching into medical school curricula ■ Offers a strong evidence-based framework for integrating family medicine into medical schools ■ Wide in scope, for academics and educationalists at all levels and in all geographies, reflecting and embracing the experience and variation in family medicine across the globe to produce pragmatic and effective information on which medical schools can base change ■ Step-by-step introduction to the processes of literature review (establishing the existing knowledge base), choosing a topic, research questions, and methodology, conducting research, and disseminating results ■ Supported by the WONCA Working Party on Education The book is edited and authored by members of the World Organization of Family Doctors (WONCA) Working Party on Education, which is ideally placed to offer a strong platform for medical schools to integrate family medicine whatever the local context, enabling all future doctors, whatever their career aspiration, to understand the importance of family medicine to health systems and holistic medicine and encourage family medicine doctors to inspire students to consider a career in the field.

Through one theoretical paper and empirical studies of contemporary examples of healthcare related uncertainties and their management, this collection articulates the different ways in which uncertainty may be articulated, enacted and experienced. Considers the role of ‘implicit normativity’ in masking and containing potential ethical uncertainty Presents core analytical strands: (1) conceptualising uncertainty; (2) intersections of uncertainty with aspects of care; (3) managing uncertainty; and (4) structural constraints, economic austerity and uncertainty work Reflects on the methodological and theoretical stances used to think sociologically about uncertainty in healthcare Considers the implications of the insights gained for ‘synthesising certainty’ in practice and for future research in this area