Physician expressions of uncertainty during patient encounters

Uncertainty is inherent in clinical medicine and may contribute to variabil ity in physician practice patterns, patient satisfaction, and exchange of i nformation. However, research on physician disclosure of uncertainty to pat ients is sparse. We measured the frequency of physician expressions of unce rtainty to patients using audiotapes of visits to 43 physicians by 216 cont inuity patients in a university-affiliated general medicine clinic. We also analyzed the audiotapes using Roter Interaction Analysis. Physicians compl eted Gerrity's Physicians' Reaction to Uncertainty scale and patients compl eted the Kranz Health Opinion Survey and a standardized satisfaction questi onnaire. Physicians made verbal expressions of uncertainty in 71% of clinic visits. Physicians with greater self-rated reluctance to disclose uncertai nty to patients made fewer expressions. Physicians who made more uncertaint y expressions also used more positive talk and partnership building, and ga ve more information to patients. Physicians also expressed more uncertainty to patients with more education, greater desire for information, and more questions. Physician uncertainty expressions were associated with greater p atient satisfaction, but not independently of other physician verbal behavi ors that were also associated with satisfaction. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.