Does you doctor say “I don’t know” when you ask a complicated question? If he does, you are lucky.
Yes, that is correct. You are lucky if your doctors says, “I don’t know” when you ask a complicated question. Many medical mishaps, misdiagnosis and wrong treatments happen because doctors are reluctant to say “I don’t know” when they really don’t know the right answer.
Many doctors believe that they need to protect their authoritative image to gain trust of the patients. They feel the need to show that they have all the answers because they assume patients expect them to have all the answers. They want to help the patients by projecting confidence. Here are some familiar ways doctors like to project confidence:
“I know what you are having.”
“I am sure you will be fine.”
“I know exactly what you need.”
“I am sure about your diagnosis.”
“I know what caused this.”
“I know this is the best treatment you can get.”
“I am sure there is nothing you need to worry about.”
It feels nice to hear such words from your doctor and your doctor feels better when you have full confidence in his advice. You may truly have a doctor who is very knowledgable and always gets the right diagnosis the first time and proudly projects his confidence with very reassuring words. However, you need to know the odds.
According to most studies, wrong diagnosis or missed diagnosis happen at least about 10% of all medical encounters. Could your doctor be an exception to this statistics?
For a profession where things go wrong at least 10% of the times, are doctors projecting more confidence than they should?
I believe they are and I think that is a big problem.
There is so much uncertainty, individual variation and subjective analysis involved in medical diagnosis that it can sometimes be outright dangerous to have 100% confidence in the initial diagnostic impression. When doctors have 100% confidence in their diagnosis but only get it right 90% of the times, there is a big problem.
As a doctor, I believe the first step to improve my diagnostic accuracy is to acknowledge the fact that I will make mistakes. The second step is to reconsider my diagnosis when I have a new piece of information. The third step is to listen to the patient properly when he/she has a doubt about the diagnosis. Patients are correct more often than doctors believe them to be. Doctors are correct less often than patients believe them to be.
I believe it all starts by learning to say, “I don’t know” when I really don’t know. When your doctor is brave enough to say “I don’t know”, you know that he will seek help from a specialist when help is warranted. When your doctor is brave enough to say “I am not sure”, you know that he will reconsider your diagnosis when appropriate; you know that he will listen to you properly when you believe the diagnosis may be incorrect.
In this age of rapidly expanding medical knowledge and highly specialized medical practice, it is wrong to assume that your doctor automatically knows the right answer to all your questions right away. The doctor who is willing to say “I don’t know” is usually also the doctor who is willing do some research to find out the right answer. You know you have the best doctor when your doctor says, “I don’t know but lets find out” and involves you in the research.
Has your doctor ever said,”I don’t know.” If yes, how did you feel about it?