GP's have to live with high degrees of uncertainty over diagnoses. The purpose of history-taking, clinical examination, tests and investigations is to narrow down uncertainty enough to allow a diagnostic label to be put on the condition and so enable subsequent action. Empirical trials of medication and expectant observation otherwise known as masterly inactivity can also be applied.
How far the process is taken depends on the doctor's and the patient's tolerance of uncertainty, the severity and treatability of the suspected disease and the benefits and risks of possible treatments.
It is important to ask whether a planned test or referral is likely to alter the management of the condition and whether it is probable that the patient will the better off for such intervention.
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