Expert patient and general practitioners' perspectives on the clinical attributes needed to deal with uncertainty: a qualitative study.

Abstract

Introduction Clinical uncertainty is not uncommon; however, the current conception of the professional clinician has meant that discussion on uncertainty has focused on elimination rather than recognition. Uncertainty comes from an imbalance in knowledge, data, clinical experience, evidence-based guidelines, judgement, and decision-making. There is a strong argument for improving tolerance of clinical uncertainty, particularly in primary care where general practitioners might be especially vulnerable to uncertainty due to their exposure to undifferentiated illness. Aim This research aims to establish expert patient and general practitioners' perspectives on the clinical attributes needed to deal with uncertainty. Methods Two focus groups, consisting of three general practitioners and five expert patients, discussed uncertainty regarding restless legs syndrome. This topic was used as a rhetorical proxy to examine expert patient and general practitioner perspectives on the clinical attributes needed to deal with uncertainty. The qualitative data were then analysed to form overarching thematic areas. Results Four overarching professional attributes were identified: collaboration, compassion, insight, and unconventional thinking. These are all attributes that lie within a clinician's skillset, but the evidence here suggests that they need to be foregrounded in practice. Discussion In attempting to assess professional clinical practice in relation to uncertainty, this research recommends that clinicians work to adopt a holistic, patient-centred approach, where they explicitly share uncertainties, focus on a patient's emotional state during the diagnostic phases of treatment, and see the merits of challenging themselves to look beyond routine algorithms.