Do you like to draw mind maps? Do you find conceptual tools built around acronyms (SWOT, SMART, and so on) help you find your way along life’s complex path? If so, this book may be a useful addition to your library.
Its purpose is to help doctors answer the question ‘What do you do when you don’t know what to do?’ — or WDYDWYDKWTD as it is usually referred to in the book. It seeks to do so by organising situations involving uncertainty that GPs can face into four quadrants; the MUM (Map of Uncertainty in Medicine). Situations are classified according to whether they concern diagnosis, involving just the doctor and the patient (ANALYSING), or the team (NETWORKING), or management, involving just the doctor and the patient (NEGOTIATING), or the team (TEAMWORK).
The book contains a lot of interesting theoretical material, useful ideas and techniques and is illustrated by stories of situations where clinicians find themselves facing uncertainty along with discussion of how they dealt with it. The stories are well-crafted and realistic, although I found the values implicit in the naming convention used somewhat disturbing. Patients are called things like Granite or Amber, after rocks or gemstones; doctors are noble trees like Birch, Oak, or Willow; while other health professionals (lower ranking?) are named after small plants like Heather or Lily.
I am an auditory learner; I think in words and stories, not in images. For me it is obvious that one word is worth a thousand pictures. Perhaps this is why I found the ‘map of uncertainty in medicine’ unhelpful, and the sketch map of ‘the land of the sick’ merely comical. Or perhaps it was because I found its premise — that one can divide situations of uncertainty and the skills you need to tackle them neatly into ‘quadrants’ — unconvincing, and consequently, the material poorly-organised, that the book failed to enthuse me.
I would have found the book more appealing as something to sit and read if the stories had been the starting point from which to explore theoretical perspectives and strategies to deal with uncertainty, working from the particular to the general rather than the other way round. A reference book with a ‘50 ways to’ format would be easier to use to look up theoretical frameworks or conceptual tools.
There are several books on uncertainty in clinical medicine and I am sure every training practice should have one in its library. Whether it should be this one I am less certain.
Footnotes
- © British Journal of General Practice 2016