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Previous Volume 346:1096 April 4, 2002 Number 14 Next

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To the Editor: In her Shattuck Lecture (Nov. 29 issue),¹ Dr. McNeil appropriately emphasizes uncertainty in medicine as an important source of overuse, misuse, and underuse of medical technology. However, the difficulty with the term "uncertainty in medicine" is that it is not clear whether it refers to the condition of individual clinicians or that of clinicians as a group. Unfortunately, physicians are seldom individually uncertain, reflecting a prevailing culture within clinical medicine and surgery that is accepting of divergent opinions about the most appropriate screening, diagnostic, and therapeutic interventions. I would suggest that a more accurate term than "uncertainty . . . [Full Text of this Article]

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