Managing Uncertainty in Medicine with Dr John Launer
Managing Uncertainty in Medicine with Dr John Launer

Practitioner Health Wellbeing Podcast

Dr Zaid Al-Najjar and Dr John Launer talk about uncertainty in medical practice, from diagnostic doubt to fear of complaints and burnout. They discuss how open questions, supervision and reflective practice can make clinical uncertainty more manageable and less isolating.

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37:24•22 Apr 2026

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Managing Medical Uncertainty: Conversations, Curiosity and Coping with Doubt

Episode Overview

Uncertainty is present at every level of clinical work, far beyond diagnosis, and trying to eradicate it completely can increase stress.
Shifting to open, permissive questions helps patients share richer stories and often brings out more useful clinical information.
Fear of missing something, complaints and litigation can fuel defensive medicine and compulsive checking, contributing to burnout.
Regular supervision, supportive colleagues and reflective conversations are key protective factors against isolation and exhaustion.
Simple reflective habits, such as inner dialogue and checking in with patients about how the conversation is going, can make uncertainty more manageable and sometimes even enjoyable.

“I actually regard diagnostic uncertainty as the small tip of an enormous iceberg.”

John argues that what many people call “diagnostic uncertainty” is just the tiny visible part of a much bigger iceberg: there’s uncertainty about treatment, about what patients actually want, about what’s left unsaid, and even the nagging question, “Have I just missed something important?” Rather than seeing this as a problem, John suggests “celebrating uncertainty”, describing it as “the ocean in which we swim all the time that we’re working.” He talks about shifting from a mindset of fixing to one of curiosity and collaboration, asking open questions such as, “Can you tell me a bit about yourself?” or “What are you hoping to get out of this conversation?” You’ll hear practical ideas for busy settings like 10-minute GP slots or an A&E cubicle, including how good, permissive questions can actually save time, reduce repeat attendances and bring out crucial clinical information.

In this eye-opening episode, you'll learn about why uncertainty sits at the heart of medical practice, and why trying to eliminate it completely can leave clinicians stressed, burnt out, and doubting themselves. Medical director and GP Dr Zaid Al-Najjar chats with Dr John Launer, a GP, family therapist, educator and writer who has spent decades thinking about narrative, supervision and, more recently, uncertainty as a topic in its own right.

The conversation also looks at how fear of missing something, complaints and past mistakes can fuel compulsive checking and burnout, and why supervision, team support and reflective practice are so important. John shares simple reflective habits – from inner dialogue before a consultation to debriefing tricky encounters with colleagues – that can make uncertainty feel more tolerable, even occasionally enjoyable.

If uncertainty often keeps you awake at night, this conversation might just help you see it differently – how could your next consultation change if you treated uncertainty as something to work with rather than something to defeat?

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