Now that debates are well underway involving candidates who seek to be the Presidential nominee in the 2020 election, the word existential has been associated with a claim that climate change poses such a threat. One view of existentialism is that it represents an effort by individuals to construct meaning out of a world characterized by chaos and uncertainty. The realm of health care may be viewed as offering a suitable template for a cursory exploration of how it happens to be influenced by the term uncertainty.
Attention was drawn to this matter in a paper appearing in the October 2019 issue of the Journal of Patient Education and Counseling. The authors’ contention is that uncertainty in health care is an extremely important, but incompletely understood phenomenon. They argue that improving an understanding of the many important aspects of uncertainty in health care will require a more systematic program of research based upon shared, integrative conceptual models and active, collaborative engagement of the broader research community.
Uncertainty not only may be considered an essential facet of human life and an integral problem of health care. It is the single, common challenge faced by every patient who receives health care and every clinician who provides it, along with administrators, payers, policymakers, and researchers who deliver, finance, regulate, and study it. In every one of these diverse activities undertaken by different actors, uncertainty of one form or another—arising from various sources, pertaining to any number of relevant issues, and formed and reformed through communication—provides the call to action, and provokes a variety of different responses.
At the level of patient-provider interactions, diagnostic misclassifications and errors can result in treatment that is inappropriate and harmful. Moreover, patients may be plagued by doubts and uncertainties about their ability to remain employed, have satisfactory health insurance coverage, and be able to meet out-of-pocket costs for health care. Medicare for All proposals by political candidates raise concerns regarding whether reimbursement policies will suffice to meet the costs experienced by clinicians and facilities, such as rural hospitals. Policymakers also are faced with the quandary of coping with the task of figuring out how to provide free health care without simultaneously necessitating a huge spike in taxation.
Studies that focus explicitly on uncertainty have grown in number and diversity, but the growth is not systematic because the research has developed organically, in an uncoordinated, piecemeal fashion. Developing a more systematic approach to uncertainty in health care has the potential to improve the clinical communication of uncertainty by providing health professionals with a coherent, comprehensive understanding of the uncertainties that arise in different circumstances, the diversity of responses to these uncertainties, the various approaches to communicating uncertainty, and the many competing goals of doing so. A positive end product of enhancing this field of research could be a more comprehensive, rational, deliberate approach to communicating and managing uncertainties.
PRESIDENT’S CORNER—ASAHP MEMBER FOCUS
Susan Hanrahan offers her thoughts on the upcoming ASAHP Annual Conference from the standpoint of speakers, a leadership panel, and the Business Meeting, along with updated information about the Association’s Institutional Profile Survey. Read More
AVOIDING A GOVERNMENT SHUTDOWN
Describes legislation involving appropriations for fiscal year 2020 that begins on October 1, 2019 and action underway to reduce pharmaceutical costs. Read More
HEALTH REFORM DEVELOPMENTS
Discusses questions pertaining to enactment of proposed Medicare For All Legislation. Read More
DEVELOPMENTS IN HIGHER EDUCATION
Summarizes finalization of stricter rules for student loan claims and trends in the ratio of the Pell Grant to total price of attendance and federal loan receipt. Read More
QUICK STAT (SHORT, TIMELY, AND TOPICAL)
Mortality Patterns Between States With Highest Death Rates And States With Lowest Death Rates
Comparing Retail Clinics With Other Sites Of Care
The Use Of Small-Scale, Soft Continuum Robots To Navigate In Cerebrovascular Areas
The Use Of “Phyjamas” In Health Care Read More
AVAILABLE RESOURCES ACCESSIBLE ELECTRONICALLY
Hospital Concentration Index
Reducing Inequities In Healthy Life Expectancy
Investing In Interventions That Address Non-Medical, Health-Related Social Needs Read More
BALEFUL IMPACT OF WORKPLACE INCIVILITY ON HEALTH
Mentions how dissimilarity in political identity can relate to reducing the quality of interpersonal interactions and subsequent well-being of workers. Read More
“BURNOUT” AND EARLIER SOMATIC PHENOMENA
Refers to a possible relationship between burnout in the 21st century and neurasthenia in an earlier century. Read More
THE ROLE OF ACCIDENTS ON THE PATHWAY TO INJURY AND DEATH
Examines factors pertaining to death and injury of adolescents from motor vehicle accidents and adult mishaps stemming from attempts to remove an avocado pit with a knife. Read More