TY - JOUR T1 - Safety netting: now doctors need it too JF - British Journal of General Practice JO - Br J Gen Pract SP - 214 LP - 215 DO - 10.3399/bjgp18X695849 VL - 68 IS - 670 AU - Roger Neighbour Y1 - 2018/05/01 UR - http://bjgp.org/content/68/670/214.abstract N2 - ‘Risk’, said the billionaire philanthropist Warren Buffett, ‘comes from not knowing what you’re doing.’I don’t think many surgeons would agree. In their line of work, risk is inescapable, no matter how sure they are of what they’re doing. But Buffett’s epigram is at least in part true in general practice. One of the defining hallmarks of our discipline is managing the uncertainty that goes with the complex interrelatedness of our patients’ problems. We pride ourselves on what Aristotle called ‘phronesis’, namely ‘flying by the seat of our pants’, or ‘knowing what to do when no one knows what to do’. A diagnosis in general practice, rather than a label for what a patient’s condition is, is just as likely to be a list of what it might later turn out to be. And there is no shame in a general practice management plan often being just what seems, on the day, to be the best thing to do under the circumstances. But with clinical doubt comes a duty to take precautions.It is now over 30 years since I introduced the notion of safety netting to describe the risk management and contingency planning I thought should be present in every general practice consultation.1 What I had in mind at the time was summarised in the three ‘thinking ahead’ questions I suggested we should ask ourselves before concluding any consultation: If I’m right, what do I expect to happen?How will I know if it doesn’t?What would I do then?It … ER -