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Crammer’s Corner
GP, Chapelgreen practice, Sheffield, RCGP Examiner and Blueprint clinical lead, Associate Postgraduate Dean Yorkshire and the Humber Deanery
E-mail: amar.rughani@sheffield.ac.uk
| The first 10% of the full text of this article appears below. |
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Managing medical complexity: uncertainty and risk |
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| This competency is about aspects of care beyond managing straightforward problems, including the management of co-morbidity, uncertainty and risk, and the approach to health rather than just illness.
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In this article, we look at the second part of the performance area described above and will consider uncertainty and risk separately although in real life, they overlap.
The word pictures in Fig. 1 describe how we deal with uncertainty.
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Draws conclusions when it is appropriate to do so
In primary care, problem solving is challenging because patients present with unselected problems that have usually not had the benefit of a doctor's opinion or investigations and may still be in the process of
Is able to tolerate uncertainty, including that experienced by the patient, where this is unavoidable
Question: When trying to recognize a pattern, why cannot we always depend upon the evidence?
Question: How might you respond to uncertainty?
Anticipates and uses strategies for managing uncertainty
Appropriately prioritizes management approaches, based on an assessment of patient risk
Communicates risk effectively to patients and involves them in its management to the appropriate degree
Uses strategies such as monitoring, outcomes assessment and feedback to minimize the adverse effects of risk
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