A case of "I don't know!": Tips for patient communication

Not all disease symptoms are clear and unambiguous. There are often differential diagnoses. What is the best way to communicate diagnostic uncertainty?

4 examples of diagnostic uncertainty

Diagnostic uncertainty is not uncommon

Some diagnoses in medicine are at-a-glance diagnoses or easy to make. Especially when all criteria are met, there is usually no doubt about them. But this is not always the case. Often, different causes for a person's complaints come into consideration. Then the diagnosis is not so easy - especially if there are more complex diseases. So it is not uncommon for a working diagnosis to be made without the attending physician being sure that they are on the right track. Of course, this has nothing to do with the ability of any given physician, but is simply due to the nature of some diseases and the advances in modern medicine. The more examinations one does, the more alternative diagnoses that may come into question.

Not an easy situation for patients

When physicians are not 100% sure of the diagnosis, this can often be stressful for patients. The diagnostic ambiguity can be unsettling for them and shake their trust in their treating physician. Therefore, it is all the more important to find effective communication methods for such situations so that both sides can talk to each other as equals.

Cooperation between GPs and patients

This is exactly what a team from Boston, USA set out to do. Teams of GPs and patients developed a communication tool for four case vignettes in which diagnostic uncertainty is common: enlarged lymph node in post-lymphoma condition, new onset headache, fever and upper respiratory infection, and back pain.

Six important pieces of information are relevant

In the course, it became clear that the following six pieces of information are particularly important:

Good acceptance of the tool

The brochures developed by the team were finally tested on 15 patients. The patients reacted positively to the information provided to them. The tool was also easy to integrate into the doctors' daily work.

Conclusion for medical practice

If a diagnosis is not clear, it is important to discuss this with the person concerned. Here, the "how" is just as important. The study authors identified six essential pieces of information to communicate. Creating and using brochures can be helpful in some cases.