Parents of pediatric patients less likely to follow instructions when physicians express uncertainty, study suggests

Parents of pediatric patients may react more positively when physicians use broad differential diagnoses or most likely diagnosis in cases of diagnostic uncertainty, according to a study in the International Journal for Quality in Health Care.

Physicians communicated diagnostic uncertainty in three different ways: explicitly expressing uncertainty, implicitly expressing uncertainty with broad differential diagnoses and implicitly expressing uncertainty with "most likely" diagnosis.

Parent participants were randomly assigned one of the vignettes and answered a questionnaire. Explicit expression of uncertainty, such as saying "I don't know," was associated with lower patient satisfaction and less trust in the physician's competence. Parents were also less likely to adhere to the physician's instructions when physicians expressed uncertainty.

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