--- title: "Expressing uncertainty in clinical interactions | Sutter Health" description: "Patients expressed more uncertainties than physicians during visits. Patients and physicians both expressed more uncertainties on mental health topics." url: "https://www.sutterhealth.org/research/publications/expressing-uncertainty-in-clinical-interactions-1055312608" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Expressing uncertainty in clinical interactions # Expressing uncertainty in clinical interactions between physicians and older patients: what matters? Tai-Seale M, Stults C, Zhang W, & Shumway M. _Patient Educ Couns. 86(3):322-8. doi: 10.1016/j.pec.2011.06.005. Epub 2011 Jul 20._ 2012-03-01 ## Abstract ****OBJECTIVE:**** Uncertainty is one key factor influencing physician and patient behavior. We examined the propensity to express uncertainty on mental health versus biomedical issues by elderly patients (>65 years) and physicians during primary care visits. ****METHODS:**** 385 videotaped visits were coded according to "topics," which are issues raised by any participant during the visit. This approach allowed us to examine if uncertainty was expressed in biomedical, mental health or other topics, and the factors associated with expressions of uncertainty. ****RESULTS:**** We found that patients expressed uncertainty in 20.21% of topics compared to physicians expressing uncertainty in 11.73% of topics discussed in all visits. Patients expressed uncertainty in 22% of biomedical and 46.5% (p<0.01) of mental health topics. Similar statistics were found in physicians' expression of uncertainty with more uncertainty being expressed with mental health topics (23.9%) than biomedical topics (12.56%, p<0.05). ****CONCLUSION:**** Patients expressed more uncertainties than physicians during visits. Patients and physicians both expressed more uncertainties on mental health topics suggesting that patients and primary care physicians felt less knowledgeable or less confident about dealing with mental health issues. ****PRACTICE IMPLICATIONS:**** Understanding the inherent uncertainties in medicine can help physicians and patients engage in more productive discussion about both biomedical and mental health topics. [PubMed abstract](http://www.ncbi.nlm.nih.gov/pubmed/21764238) ![Cheryl Stults, Ph.D.](https://dyn.mktgcdn.com/p/3IhveEwq-t5WoqAzSNGeAr-4g4yrj4v7x1QcPGdCX_s/fit=crop,gravity=auto,dpr=2,width=188,height=250,quality=100) Cheryl Stults, Ph.D. Principal investigator [View profile](https://www.sutterhealth.org/research/investigators/cheryl-stults-phd-1049681000) ## Research topics - [Aging and Longevity](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Aging+and+Longevity%5C%22%22) - [Health Services](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Services%5C%22%22) - [Mental Health](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Mental+Health%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [How do primary care physicians respond when patients cry during routine ambulatory visits?](https://www.sutterhealth.org/research/publications/how-pcps-respond-when-pts-cry-in-outpt-visits-1055312766) Stults CD, Elston Lafata J, Diamond L, MacLean L, Stone AL, Wunderlich T, Frankel RM, Tai-Seale M. J Comm Healthcare. 7(1):17-24. DOI: http://dx.doi.org/10.1179/1753807614Y.0000000044 2014 Mar 01 - Publication ### [New Era Of Patient Engagement](https://www.sutterhealth.org/research/publications/new-era-of-patient-engagement-1055312777) Tai-Seale M. Health Affairs website. 2013 Feb 06 - Publication ### [Two-minute mental health care for elderly patients: inside primary care visits.](https://www.sutterhealth.org/research/publications/two-minute-mental-health-care-for-elderly-patients-1055312643) Tai-Seale M, McGuire T, Colenda C, Rosen D, Cook MA. J Am Geriatr Soc. 55(12):1903-11. 2007 Dec 01 - Publication ### [Three types of ambiguity in coding empathic interactions in primary care visits: implications for research and practice.](https://www.sutterhealth.org/research/publications/ambiguity-in-coding-empathic-interactions-in-pc-1055312573) Stone A, Tai-Seale M, Stults C, Luiz J, Frankel R. Patient Educ Couns. 89(1):63-8. doi: 10.1016/j.pec.2012.06.013. Epub 2012 Jul 17. 2012 Oct 01 - Publication ### [Understanding primary care physicians' propensity to assess elderly patients for depression using interaction and survey data.](https://www.sutterhealth.org/research/publications/pcp-propensity-assess-sr-pts-depression-1055312561) Tai-Seale M, Bramson R, Drukker D, Hurwicz ML, Ory M, Tai-Seale T, Street R Jr, Cook MA. Med Care. 43(12):1217-24. 2005 Dec 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/expressing-uncertainty-in-clinical-interactions-1055312608#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Expressing uncertainty in clinical interactions"}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/expressing-uncertainty-in-clinical-interactions-1055312608#medicalscholarlyarticle","name":"Expressing uncertainty in clinical interactions between physicians and older patients: what matters?","headline":"Expressing uncertainty in clinical interactions","abstract":"OBJECTIVE: Uncertainty is one key factor influencing physician and patient behavior. We examined the propensity to express uncertainty on mental health versus biomedical issues by elderly patients (>65 years) and physicians during primary care visits. METHODS: 385 videotaped visits were coded according to \"topics,\" which are issues raised by any participant during the visit. This approach allowed us to examine if uncertainty was expressed in biomedical, mental health or other topics, and the factors associated with expressions of uncertainty. RESULTS: We found that patients expressed uncertainty in 20.21% of topics compared to physicians expressing uncertainty in 11.73% of topics discussed in all visits. Patients expressed uncertainty in 22% of biomedical and 46.5% (p\u003c0.01) of mental health topics. Similar statistics were found in physicians' expression of uncertainty with more uncertainty being expressed with mental health topics (23.9%) than biomedical topics (12.56%, p\u003c0.05). CONCLUSION: Patients expressed more uncertainties than physicians during visits. Patients and physicians both expressed more uncertainties on mental health topics suggesting that patients and primary care physicians felt less knowledgeable or less confident about dealing with mental health issues. PRACTICE IMPLICATIONS: Understanding the inherent uncertainties in medicine can help physicians and patients engage in more productive discussion about both biomedical and mental health topics.","description":"Patients expressed more uncertainties than physicians during visits. 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