The Uncertainty Effect

Economists see uncertainty harming the US economy and individual businesses. Physicians see uncertainty harming US medicine. Physician entrepreneurs see both.

There are many reasons why doctors have the potential to make great entrepreneurs. One reason is their ability to deal with uncertainty. In medicine, there are no guarantees, only probabilities, judgment, and intuition. Like business people, doctors make decisions with incomplete information. Sometimes they have to do things based on their gut. In fact, they do so more than they would like to admit. Typically only about 25-35% of medical decisions are based on scientific evidence.

However, that skill does not make physician entrepreneurs immune from the pervasive and common side effects of uncertainty in the medical practice and business environment:

1. Change fatigue

2. Burnout and depression

3. Fight or flight reaction

4. Pulling back on investments and capital improvements, like IT systems or advanced technologies

5. Greater risk aversion

6. Fear

7. Irrational, perturbed decision making

8. Focusing even more on the now instead of the new

9. Downsizing and layoffs

10. Overwork, stressing people with more work and trying to do more with less

Uncertainty is part of the art and practice of medicine. Uncertainty in health policy and the business of medicine is inevitable as well. However, like any drug in the wrong dose, toxic side effects become more common, and, in some instances, can be fatal.