Some Pragmatic Tips for Dealing with Clinical Uncertainty

Purpose: This article proposes some recommendations to enable clinicians to balance certainty and uncertainty when evaluating the currency and effectiveness of their treatment approaches. Method: I offer the following advice: (a) Question the authority of the information previously learned in one's career; (b) be cognizant of what we do not yet know about best clinical practice; (c) understand that knowledge of "best practices" is both temporary and relative; (d) enable access to new information by the use of electronic alerts; (e) be flexible in reading new clinical reports, keeping an open mind as to their value; (f) get the clinically relevant details of new approaches by reading the full reports; and (g) employ, and then evaluate the outcomes of, new approaches used in treating individuals on our caseload. Results: Examples are provided to show that proactive 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.