Thriving in Uncertainty as Physicians

As a medical oncologist, I am often asked by patients these two questions: 1. Is this treatment going to work? 2. How long do I have to live? I can never offer an exact answer for those two questions. The best I can do is to reply with a time range.

There are many things in medicine you cannot be certain about. It is easy to feel uncomfortable because of uncertainty. Why does uncertainty make you feel uneasy? When a situation is not clear, the outcome is not necessarily clear-cut. This means that there is a chance the result is not what you desire. In other words, you may get something you do not want. Oftentimes, people make it mean that they “fail” or did not do a good job.

It is important to give yourself the permission to operate in uncertainty, especially in medicine, because absolute certainty is rare to come by. What is essential is that you are certain of your purpose. Always remember why you are doing what you are doing. As a physician, your purpose is likely to take good care of your patients to the best of your ability. This means that everything you, every decision you make, is geared toward that purpose. When you allow a certain degree of uncertainty, it helps your patients accept it too.

Prepare for uncertainty. Sure, you cannot always predict what might come your way, and that is alright. One thing for sure is that you will always have some surprises, good or bad. A patient may have an unexpected adverse effect. There may be a power outage in your office. Whatever it is, for things you cannot control, let it be. Prepare the best that you can. Anticipate any possible outcomes. You may be right or you may be wrong. Give yourself the permission of not being perfect. Whatever decision you make, you do it based on the information and the circumstances at that time. Once you made a decision, stick with it. Do not go back and question if you should have gone the other direction instead. Focus on the next step to proceed.

Be honest and keep the communication open. Share with your patients what you are certain about and what you are uncertain about. Do not get stuck because you feel uncertain. I am not advocating for a hasty decision. I am not telling you to make any decision without doing your homework. Focus on what you are certain of and address the uncertainty accordingly. Utilize your past experiences or other people’s experiences as reference.  As you proceed with more steps, more will be revealed. You may want to adjust things accordingly – and that is another reason for effective and open communication.

As you move forward despite uncertainty, things become clearer. There is more and more certainty. In other words, do not let uncertainty stop you from moving forward. We get to learn from our past experiences and make decisions without absolute certainty. This is also what makes medicine more than just statistics and science. Medicine is also an ever evolving art, and you get to be one of the people with the privilege to paint this picture.