Biehn J
Can Med Assoc J. 1982 Apr 15;126(8):915-7.
Because patients present in the early stages of undifferentiated problems, the family physician often faces uncertainty, especially in diagnosis and management. The physician's uncertainty may be unacceptable to the patient and may lead to inappropriate use of diagnostic procedures. The problem is intensified by the physician's hospital training, which emphasizes mastery of available knowledge and decision-making based on certainty. Strategies by which a physician may manage uncertainty include (a) a more open doctor-patient relationship, (b) understanding the patient's reason for attending the office, (c) a thorough assessment of the problem, (d) a commitment to reassessment and (e) appropriate consultation.
由于患者在未分化问题的早期阶段就诊，家庭医生常常面临不确定性，尤其是在诊断和治疗方面。医生的不确定性可能不为患者所接受，并可能导致诊断程序的不恰当使用。医生在医院接受的培训强化了这个问题，这种培训强调掌握现有知识并基于确定性进行决策。医生应对不确定性的策略包括：（a）建立更开放的医患关系；（b）了解患者就诊的原因；（c）对问题进行全面评估；（d）承诺进行重新评估；（e）进行适当的会诊。
