About the author:

Howard J. Luks, MD

Howard J. Luks, MD

A Board Certified Orthopedic Surgeon in Hawthorne, NY. Dr. Howard Luks specializes in the treatment of the shoulder, knee, elbow, and ankle. He has a very "social" patient centric approach and believes that the more you understand about your issue, the more informed your decisions will be. Ultimately your treatments and his recommendations will be based on proper communications, proper understanding, and shared decision-making principles – all geared to improve your quality of life.

11 comments on “I Don’t Know …

  • Thanks, Howard. I just spent a week at a seminar in Salzburg about shared/informed medical decision making, which as I’m sure you know is about the 30+ year work of Jack Wennberg and others – the book Overtreated, the Dartmouth Atlas project, and all that. We learned a lot about the cost and resource stress of practice variation, particularly the impact of uninformed patients who “delegate” their decision making to their doctors. It’s more clear to me than ever that informed, engaged patients are a big part of the better future we all envision.My primary, @DrDannySands, now has slides in his standard deck that say some great things:- “The power of ‘I don’t know'”- “Embrace information symmetry”Your item “Do you turn to the computer with them” and “Let’s both look this up tonight” is WONDERFUL. Thanks too for saying this post was inspired by my MITSS speech. For others, that 15 minute talk is here.

  • Thx @epatientdave ! I have mny blogs about Sh Dec Making, over-treatment, over-utilization, etc. We are definitely on the same side of a very important movement! Thanks again./h

  • choosing iConsent when offered iChoice is like saying to HCP ‘You’re the flesh mechanic… you choose

  • I love this! Would rather feel like someone is working with me! The most calm I EVER FELT was when a neuro said to me, “I don’t know what is going on, but we will work this out together. I AM sticking with you.” I felt calm and supported and TRUSTED and like a specialist was WITH ME. I felt like someone had my back. He also referred me out when the time came AND he has my loyalty because he never acted like he knew it all but he was a rock when I needed one.


  • Howard,

    I love this. Being able to say, “I don’t know” is important for all of us. I am so grateful for the supervisors I had who gave me permission to slow down, dig deeper, and engage my patients in learning answers together. Not surprisingly, I’m drawn to physicians who collaborate with me, rather than dictate. Thanks for the reminder.


  • Hello Dr. Luks and thanks for this profoundly important message (and also for linking to my Heart Sisters post on a similar theme: http://myheartsisters.org/2014/01/03/when-doctors-cant-say-i-dont-know/

    One of my readers left a really good comment in response. When comparing two neurosurgeons for treatment of her brain tumor (one who was uncertain but willing to look at a number of options, and the other completely confident in his prognosis) she chose the first, explaining: “Uncertainty means that someone is paying attention.”

    • Love that example! I’m very glad I have found your blog… I will be returning :-)
      Howard Luks

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