Like everyone else’s grandmother, mine gave me all kinds of advice while I was growing up. Some tips I still remember.
One came when I was home for Thanksgiving during my first year of medical school. She was frustrated over her recent visit to an internist. He kept ordering more tests but wouldn’t answer questions about what might be causing her symptoms.
Dr. Allan M. Block
She told me that, if I didn’t know what was going on, to just say so. As a patient, she felt that an honest answer was better than silence.
Today, as a doctor, I agree with her. So, while I may still be doing tests to crack the case, I have no problem, when asked what I think is going on, with saying “I don’t know.”
This approach isn’t perfect for everyone. Some docs (and patients) may see it as a sign of incompetence or weakness, thinking that admitting fallibility is a breach of the relationship or that with some tests the doctor becomes omniscient. Of course, that’s far from the truth.
In my experience, patients prefer the honesty of my saying “I don’t know.” I’m not saying I’ll never know, I’m just saying that, at present, I’m still looking for the answer.
Nobody likes being in the dark about their health, but at the same time they don’t want to feel their doctor is keeping a secret from them. By making it clear that I’m not, I’m hoping to keep a strong therapeutic relationship. I promise them that when I know, they’ll know, and that I’m honest when stumped. If I need to refer elsewhere for an answer, I have no problem doing that. Medicine, and neurology in particular, is a complex field. If every diagnosis were a slam-dunk, we wouldn’t need specialists and subspecialists (and even subsubspecialists).
Most people know and understand that, recognize the inherent uncertainty of this job, and know that I don’t know. I promise them that “I don’t know” doesn’t mean I’m done looking, it just means I’m going to keep trying. That’s the best anyone can do. Right, Granny?
Dr. Block has a solo neurology practice in Scottsdale, Ariz.