"General practice is the art of managing uncertainty"
The only precaution that we can make when drafting a hypothesis regarding a patient is to ask our selves:
· If I am right, what do I expect to happen
· How will I know if I am wrong
If I am right, what do I expect to happen?
· How sure am I of the diagnosis
· How reliable is my assessment
· What is the natural history of the disorder
· What effect if any will intervention have and what are the possible ill effects of this intervention
How will I know if I am wrong?
· What will happen if I am wrong and what is the worst possible outcome
· Should I give specific instructions to the patient
· When should I follow the patient up
· What if the patient doesn't come back
· If I am wrong can I sort it out then
What to say to the patient
Best to be honest but at times this can cause problems e.g. warning patients about all of the side effects of a tablet.