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Telling Me You Don’t Know Is OK – A Patient’s Perspective

February 11, 2020

Written by Clay Smith

Spoon Feed
Acknowledging uncertainty with patients openly, while showing them you are listening, you care, and are determined to help them is a way to reassure fearful patients in the midst of a challenging diagnostic workup.

Why does this matter?
How do you communicate with a patient when you aren’t sure their symptoms are real or when you have no idea what is wrong? We sometimes think that expressing, “I don’t know” is anathema. But is that true, from a patient’s perspective?

This was an editorial written by a patient. He had an illness that was difficult to diagnose. He had odd neurological symptoms and was diagnosed with a functional disorder with great certainty by the initial healthcare team. But he got worse, became more debilitated, and received a second opinion. The next team that cared for him expressed that they were uncertain of his diagnosis at first but made it clear that they were listening and determined to help. Sharing their uncertainty while investigating thoroughly reassured this patient. Simply acknowledging the patient’s symptoms made him feel hope and feel that his symptoms were being taken seriously. They included him by openly discussing how the diagnostic workup was progressing and about ongoing areas of uncertainty in plain language. They eventually diagnosed that his symptoms were due to a viral infection. The patient’s take-home was, “The doctors helped me to understand that they might not always have the answers but were doing their best to help me.” In other words, sometimes I don’t know is OK.

Telling me you don’t know is ok. BMJ. 2020 Jan 8;368:l6803. doi: 10.1136/bmj.l6803.

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What are your thoughts?