Management 1: Coping with uncertainty
Main Scale
| The doctor, having failed to make a firm diagnosis shows intolerance of uncertainty by a hurried rush to treatment investigation or referral, without thought for the patient’s convenience, or proper concern for NHS economy. | The doctor, having excluded immediate risks is prepared to ‘use time as a tool’ to allow things to become clear, while giving the patient support and gaining his/her trust; when this is not possible he or she uses diagnostic and referral facilities appropriately, economically and with due regard to the patient’s feelings. | ||||||||
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
| Has little understanding of this. | Attempts to do this but is not yet skilful and sometimes runs into difficulty. | Attempts to do this and is usually successful but recognises his/her limitations. | Perfect | ||||||
Subscales
The doctor:
| Rarely | Occas ionally |
Fairly frequently |
Often | Usually |
| (a) | Once he or she is sure that the patient is not endangered, is prepared to wait and watch. |
| (b) | If he or she has decided on ‘masterly inactivity’ sets out to gain the patient’s trust for the course of action. |
| (c) | Where necessary chooses investigations which take into account both the feelings and convenience of the patient and also health service costs. |
| (d) | Where necessary gets consultant help in the most cost effective and considerate way.* |
Notes for raters
This area of behaviour is best assessed by case discussion, asking, “Whydid you do that?”, “Had you thought whether. ..?”, “Couldn’tit have waited?”
*See Appendix C for expanded scale to cover referral.
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