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Some pragmatic tips for dealing with clinical uncertainty

Purpose: This article proposes some recommendations to enable clinicians to balance doubt and certainty when evaluating the currency and effectiveness of their treatment approaches.

Method: I offer the following advice: (1) Question the authority of the information previously learned earlier in one's career; (2) be cognizant of what we do not yet know about best clinical practice; (3) understand that knowledge of "best practices" is both temporary and relative; (4) enable access to new information by the use of electronic alerts; (5) be flexible in reading new clinical reports, keeping an open mind as to their value; (6) get the clinically-relevant details of new approaches by reading the full reports; and (7) employ and then, evaluate the outcomes of new approaches used in treating individuals on our caseload.

Results: Examples are provided to show that pro-active participation in research-alert programs can enable clinicians to access emerging, clinically-relevant information, some of which is controversial. Staying abreast of such information is more efficient than performing guided searches for information as challenging cases arise.

Conclusions: Applications of these recommendations should enable practicing clinicians to entertain new, clinically-useful concepts, while not taxing the limited time that clinicians typically have to engage in continuing education.

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