This story was first published on the 29th June 2017 for Pomegranate Health  , a podcast of the Royal Australasian College of Physicians. Subscribe to the series on iTunesAndroid or search for it in any app using the RSS feed if needed.

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Uncertainty can be frightening for patients and doctors alike, but it’s an unavoidable fact of medicine in every specialty. In this two part story, we hear from a GP, a paediatrician, a surgeon and a rheumatologist about how they navigate the grey areas of diagnosis and treatment, and maintain a patient’s faith throughout.

In the first part, we examine the culture among doctors and the general public that expects nothing less that perfection in medicine; the shiny new technology that appears to make everything soluble; the pressure on doctors to back their hunches or to be heroic in intervention.

We also ask whether hospital training might inadvertently shelter younger doctors from the experience of complex, chronic conditions, and whether the simplicity of protocols might be misleading.

In the second part, the stigma and disorienting experience of patients with medically unexplained syndromes is discussed. While the definition of functional disorders still causes some debate, behavioural strategies for intervention can often have a great impact on the lives of these patients.

Treatment outcomes are never guaranteed, however, and clinical outcome cannot be the only measure of success. Our guest speakers each give examples from their speciality about how a patient’s expectations can be managed from the beginning of the consultation. Ultimately, some conditions will never be cured completely, and in those cases the psychology of long-term coping must also be considered.


Guests: Dr Louise Stone FRACGP (Australian National University), Professor Phil Fischer (Mayo Clinic, Rochester, Minnesota), Professor Ian Harris RACS (Liverpool Hospital, UNSW), Dr Rebecca Grainger FRACP (Wellington Regional Rheumatology Unit, University of Otago)

This episode was produced by Mic Cavazzini. Music from Transient (“The Earl of Shaffer,” “Vodka,” “Damascus”), Ben Carey (“Calico,” “Ghost Limb”); photo courtesy Shutterstock. Recording assistance from Ryan Smith and Mark Flaherty. Pomegranate Health’s executive producer is Anne Fredrickson.