10 MRS – Management 1: Coping with uncertainty

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


The doctor:

Rarely Occas
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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