Managing uncertainty in the consultation

In this episode, Dr Lucy O’Hagan explores how healthcare professionals navigate uncertainty in consultations, from diagnostic ambiguity to effective patient communication. It covers strategies for gathering information, using reasoning tools, and managing not knowing while maintaining patient trust.

Topics

Intro.
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The importance of acknowledging uncertainty.
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The misconceptions of not knowing.
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Strategies for managing uncertainty.
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Taking a structured history.
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The role of online resources.
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communicating uncertainty to our patients
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reassuring our patients
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Rationalising extra tests.
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Safety netting
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Who do we talk to?
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Tools for managing uncertainty
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Take-home messages
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Take home messages

"It's always too soon to panic".
You don't need to know, but you do need to make a plan, and you do need to safety net.
Go through diagnostic reasoning, this allows you to back yourself so that you can communicate uncertainty with confidence.

Resources

Three questions for uncertainty in consultations - Rickenbach, M. (2023). BMJ : British Medical Journal
Negotiating uncertainty in clinical encounters: A narrative exploration of naturally occurring primary care consultations - Social Science & Medicine, Volume 291, 2021
Everything But the Medicine, A doctor’s tale - Massey University Press (2025)

Presenter

Lucy O'Hagan

General Practitioner & Medical Educator

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Lucy is a GP, writer and mentor. She works at Oratoa Cannons Creek in Porirua, having previously been a rural GP for 20 years. She is a medical educator with RNZCGP including roles supporting struggling registrars and providing professional development to teachers. Lucy writes a column for NZ Doctor magazine, and recently recorded Waiting for Covid pandemic writings.