What does the search for certainty do to us as clinicians?
In searching for answers we are picking up patterns that let us go past that initial uncertainty.
And so Evidenced Based Practice serves this role… to solve the uncertainty.
We look to research to let us know unbiased truths. Hey, this patient is not responding today, but if I stay the course science supports that I will see some improvement.
We can look to clinical training or algorithms to help us along. For example a McKenzie assessment may help us get past the “maybe”s and the “yellow lights” and help us get to true positives or negatives without wavering.
We also rely on our clinical experience. The patient is complex, but I’ve seen some like her before, so I’ll continue with what I know and some change should be seen.
These things are just mechanisms that cloak our uncertainty and allow us to look to our colleague and say “Hey, I’m doing what’s right” thereby reinforcing our own thoughts about our effectiveness.
It’s what we’ve got, I’m not saying it’s perfect, and many flaws are found among these strategies… to avoid that uncomfortable uncertainty… but that’ seems to be what we do. We use vetted research or we make cognitive mistakes to protect our vulnerability. We do human things and make human mistakes in the name of not making human mistakes.
We trade our uncomfortability for biases.
A systematic approach and using research can minimize mistakes. But does not minimize bias in treating.
I suppose I’m keeping the position that there is value in uncertainty… even though I strive to be certain. Perhaps unknowing is the most honest position there is, and all the rest are just versions of pseudo-truth on a continuum.
Dang… I still don’t know…