Why do people guess and hope rather than test and know?

FEW GPs would have heard of Reinhold Niebuhr, yet most would be familiar with the American theologian’s serenity prayer. His famous invocation, that we are granted the serenity to accept the things we cannot change, could well serve as the philosophy behind many a management plan.

The recognition that many health issues have no specific treatment is something GPs come to terms with early in their career, and impart to patients frequently thereafter. Sometimes bad things just happen and there is little anyone can do except focus on psychological adjustment or palliation.

Yet some nasty

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