The following is a summary of “Is emergency doctors’ tolerance of clinical uncertainty on a novel measure associated with doctor well-being, healthcare resource use and patient outcomes?,” published in the November 2024 issue of Emergency Medicine by Budworth et al. 

Emergency doctors often face uncertainty due to limited patient information, time constraints, and minimal post-discharge feedback, with higher uncertainty tolerance (UT) among staff potentially linked to reduced resource use and improved well-being in other specialties, but its impact in emergency settings remains unclear.  

Researchers conducted a retrospective study to develop a UT measure and examine its links to the clinician experience, patient reattendance, and healthcare resource use.  

They collected data from May 2021 to February 2022, with 3 specialty trainees and emergency doctors from 5 Yorkshire (UK) departments completing an online survey. This included a new UT measure based on the Physicians’ Reaction to Uncertainty scale, adapted by the team using Hillen et al.’s (2017) model. The questionnaire also covered well-being metrics (e.g., Brief Resilience Scale) and gathered details like seniority. Patient encounters involving predetermined “uncertainty-inducing” cases (e.g., headaches) were analyzed. Multilevel regression examined links between clinician factors, resource use, and patient outcomes.  

The results showed 39 doctors were matched with 384 patients. The UT measure had high reliability (Cronbach’s α=0.92). Higher UT was significantly linked to improved psychological well-being, including greater resilience (Pearson’s r=0.56; 95% CI=0.30 to 0.74) and reduced burnout (e.g., Cohen’s d=−2.98; −4.62 to −1.33; mean UT difference for ‘no’ vs ‘moderate/high’ burnout). No significant associations were found between UT and resource use (e.g., episode costs: β=−0.07; −0.32 to 0.18) or patient outcomes, including 30-day readmission (e.g., OR=0.82; 0.28 to 2.35).  

Investigators concluded the UT measure was reliable for emergency medicine, showing links to clinician well-being, but its effects on resource use and patient outcomes were uncertain. 

Source: emj.bmj.com/content/early/2024/11/27/emermed-2023-213256