Clinical Uncertainty in Primary Care: The Challenge of Collaborative Engagement

The Power of Colleagues
What happens when primary care clinicians meet together on set aside time in their practice settings to talk about their own patients?
.....Complimenting quality metrics or performance measures through discussing the actual stories of individual patients and their clinician-patient relationships
In these settings, how can clinicians pool their collective experience and apply that to ‘the evidence’ for an individual patient?
.....Especially for patients who do not fit the standard protocols and have vague and worrisome symptoms, poor response to treatment, unpredictable disease courses, and/or compromised abilities for shared decision making
What follows when discussion about individual patients reveals system-wide service gaps and coordination limitations?
.....Particularly for patients with complex clinical problems that fall outside performance monitors and quality screens
How can collaborative engagement of case-based uncertainties with one’s colleagues help combat the loneliness and helplessness that PCPs can experience, no matter what model or setting in which they practice?
.....And where they are expected to practice coordinated, evidence-based, EMR-directed care
These questions inspired Lucia Sommers and John Launer and their international contributors to explore the power of colleagues in “Clinical Uncertainty in Primary Care: The Challenge of Collaborative Engagement” and offer antidotes to sub-optimal care that can result when clinicians go it alone.

From the Foreword: “Lucia Sommers and John Launer, with the accompanying input of their contributing authors, have done a deeply insightful and close-to-exhaustive job of defining clinical uncertainty. They identify its origins, components and subtypes; demonstrate the ways in which and the extent to which it is intrinsic to medicine…and they present a cogent case for its special relationship to primary care practice…‘Clinical Uncertainty in Primary Care’ not only presents a model of collegial collaboration and support, it also implicitly legitimates it.’’ Renee Fox, Annenberg Professor Emerita of the Social Sciences, University of Pennsylvania.