The Art of Managing Uncertainty in Clinical Practice

This is a free preview of a paid episode. To hear more, visit mskmag.substack.com As I write this, many are bracing themselves for the start of a new school year. A new year, new teachers, new schools for some, exams on the horizon for many. I’m sure many of you have had those conversations with your kids where we try to reassure them that everything will be ok; the truth is, of course, we don’t actually know that. We are trusting that they will find their way through, and we hope to give them some reassurance that we will be there to, metaphorically, if not literally, hold their hand as they make their way. I was struck by the similarity between my roles as a parent and as a clinician. As a non-interventional pain clinician, this is primarily about helping people make sense of their pain. There is a great deal of ‘handholding’ involved in this (I try not to actually hold my patients’ hands; it gets awkward). This is all about navigating an uncertain world, both in terms of understanding what has happened but, perhaps as importantly, what the future may hold. Do I *know* what their future holds? No, of course not, no more than I know what the future holds for my kids, but I can hope to prepare them for whatever comes. My last article was about the challenges facing FCPs/APs in the UK. Among the various challenges, diagnostic uncertainty came up again and again in the literature. MSK health conditions are among the most complex, multifactorial issues we see in medicine. Uncertainty is rife, not just in identifying the most applicable diagnosis (or diagnoses) but also around prognosis, therapeutics, risk management, and, especially for FCPs/APs, the boundaries in terms of scope of practice.