11 The Social Construction of Uncertainty in Healthcare Delivery

Abstract

We explore the following question: How would healthcare delivery be different if uncertainty were widely recognized, accurately diagnosed, and appropriately managed? Unlike most studies of uncertainty, we examine uncertainty at more than one level of analysis, considering uncertainty that arises at the patient-clinician interaction level and at the organizational level of healthcare delivery. We consider the effects of history, as the forces and systems that currently shape and manage uncertainty have emerged over a long time period. The purpose of this broad and speculative “thought exercise” is to generate greater sensemaking of the current state of healthcare delivery, particularly in the realm of organizational and public policy, and to generate new research questions about healthcare delivery. The discussion is largely based on experience in the United States, which may limit its generalizability.