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How do patients react if their doctor expresses uncertainty? A handful of studies have investigated this question and come to very different conclusions. Some studies find that patients react negatively to uncertainty, seeing it as a sign of incompetence. Other studies find that patients don’t appear to mind hearing uncertainty from their doctors, or even appreciate it.
These conflicting results seem mysterious until you look more closely at what each study is testing. In the studies that found that patients react negatively to hearing uncertainty from their doctors, “uncertainty” refers to statements such as these:
I mean, I don’t know really how to explain it. I haven’t come across this before. I’m not quite sure what’s causing your headaches.
Meanwhile, in the studies that found that patients react positively to uncertainty from their doctors, “uncertainty” refers to statements such as these (from clinicians discussing risk factors for breast cancer):
The evidence about breastfeeding is pretty weak. But one determining factor, which is a bit stronger, is age of first pregnancy. But you know, like all things, there are trade-offs. It’s only a very weak determinant.
You’ve got two first-degree relatives and an aunt, so that does certainly put you in a higher risk category . . . how high is not easy to determine—probably somewhere between 1 in 5 and 1 in 10.
These are clearly two very different kinds of uncertainty. One can hardly blame the patients in the first group for being put off. If a doctor says, “I’m not sure what’s causing this,” it’s reasonable to wonder whether a better, more experienced doctor would be able to diagnose you. In the second group, however, the doctors sound like experts even while they’re giving an uncertain diagnosis. They’re offering useful context, such as the fact that a woman’s age during her first pregnancy is a stronger risk factor than whether or not she breastfeeds, and they’re giving informative estimates, such as “probably between 1 in 5 and 1 in 10,” rather than simply saying they “don’t know.”
When people claim that “admitting uncertainty” makes you look bad, they’re invariably conflating these two very different kinds of uncertainty: uncertainty “in you,” caused by your own ignorance or lack of experience, and uncertainty “in the world,” caused by the fact that reality is messy and unpredictable. The former is often taken as a bad sign about someone’s expertise, and justifiably so. But the latter is not—especially if you follow three rules for communicating uncertainty.
Show that uncertainty is justified
Sometimes your audience won’t be aware of how much uncertainty exists “in the world” on the topic you’re speaking about, and they’ll expect you to give answers with more certainty than is actually possible. That’s okay; you just need to set their expectations. Remember how Jeff Bezos warned a CNBC interviewer in 1999 that Amazon’s success was not guaranteed? At the same time, he put that warning in perspective, pointing out that while it was clear that the internet revolution was going to produce some giant companies, it was very difficult to predict in advance which specific companies those would be. He illustrated the principle of unpredictability with an example from the recent past: “If you go back and look at the companies created by the PC revolution, in 1980, you probably wouldn’t have predicted the five biggest winners.”
In fact, if you show that certainty is unrealistic, you can be more persuasive than someone who states everything with 100% certainty. When an attorney meets with a potential client for the first time, the client typically asks how much money they can expect to be awarded. It’s tempting for the attorney to give a confident, optimistic estimate, but the reality is that he doesn’t yet have enough information to go on. Instead, here’s what a prosecutor interviewed in How Leading Lawyers Think says in such a situation: “I tell them, ‘any attorney who answers that either is lying to you or does not know what he’s doing, and you should run like hell.’”
Give informed estimates
Matthew Leitch is a British consultant who used to work on risk management for PricewaterhouseCoopers. On his website Working in Uncertainty, he describes what he’s learned about commanding respect while communicating uncertainty to clients. One lesson: Give informed estimates and explain where they came from. For example, he might tell a client, “there’s no hard data to rely on for this so I’ve taken the average estimate from three senior marketing managers,” or “a survey of 120 companies similar to ours showed that 23% had experienced an incident of this type.”
Even if reality is messy and it’s impossible to know the right answer with confidence, you can at least be confident in your analysis. A venture capitalist described one of the best pitches he’s ever seen, from a young entrepreneur named Mike Baker:
Mike diagnosed the online advertising industry so thoughtfully and painted a vision for where it was heading that was grounded in his own experience and a lot of data. . . . He was so articulate in describing, “If I’m right, this is going to be unbelievably valuable. I might be wrong, and that’s the risk, but if I’m right, I can execute on it, I know this technology, and I have the right partners lined up to take advantage of it.”
Showing that you’re well-informed and well prepared on a given topic doesn’t require you to overstate how much certainty is possible on that topic. Venture capitalist John Doerr said that he wanted to invest in Amazon just based on seeing Jeff Bezos “bounding down the steps,” but of course that’s not the full story. He was also impressed with Bezos’s technical proficiency. When he asked about Amazon’s volume of daily transactions, and Bezos was able to pull up the answer with a few keystrokes, Doerr “swooned.”
Have a plan
One reason people don’t like hearing uncertain answers is that it leaves them at a loss for how to act. You can reassure them by following up your uncertainty with a plan or recommendation. If you’re a doctor, that might mean helping your patient decide what treatment works best for them given the uncertainties, or assuring them that you’ll continue closely monitoring their condition with them. If you’re a consultant, having a plan might involve designing a test to pin down some crucial factor with more precision, or proposing a multi-phase plan to allow for occasional reevaluation.
And if you’re an entrepreneur, having a plan means being able to make a strong case for what you are going to do to make your business a good bet—a bet that you feel confident about taking, and that other people can feel confident investing in, even though success isn’t guaranteed. In his 1999 CNBC interview, after acknowledging that Amazon was a risk, Jeff Bezos went on to explain why it was nevertheless a good risk to take:
It’s very, very hard to predict. But I believe that if you can focus obsessively enough on customer experience, selection, ease of use, low prices, more information to make purchase decisions with, if you can give customers all that plus great customer service. . . . I think you have a good chance. And that’s what we’re trying to do.
Julia Galef is the host of the podcast, Rationally Speaking, through which she has interviewed well-known thinkers such as Tyler Cowen, Sean Carroll, Phil Tetlock, and Neil deGrasse Tyson. Her 2016 TED Talk “Why you think you’re right—even if you’re wrong” has been viewed over 4 million times. She is the author The Scout Mindset, released in April 2021.
From The Scout Mindset by Julia Galef, published by Portfolio, an imprint of Penguin Publishing Group, a division of Penguin Random House, LLC. Copyright © 2021 by Julia Galef.
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Diane Selkirk, her husband, Evan Gatehouse, and their daughter, Maia, are used to being in close proximity to each other. The couple and their daughter traveled around the world on their sailboat, the Ceilydh, for eight years. Selkirk estimates their living space was about 400 square feet. She worked as a freelance writer while Gatehouse did contract work.
But there’s something different about the three of them living and working together in an 800-square-foot apartment during the pandemic, she says. On the boat, if she needed to concentrate and her family was being loud, “I could kind of whack them away,” she jokes. But that doesn’t work as well in a small apartment when two parents are working full time and their daughter is a student who has to cram for exams and fill out college applications.
But now the pandemic’s massive work-from-home experiment is beginning to draw to a close. Some companies, for better or worse, are accelerating their return-to-office plans. Firms that made announcements about endless remote work arrangements are now speeding up those office reopening plans.
And for some partners who have been navigating the challenges of living and working together under the same roof for more than a year, the prospect of one or both spouses returning to the office is a mixed bag of emotions. One survey by Groupon estimated that the additional togetherness is the equivalent of an extra four years of marriage. And while some research has found that forced togetherness brought couples closer, other research found some negative feelings brewing too.
Should they stay or should they go?
“I would say to my husband, ‘I married you forsaking all others, but not forsaking all others,” says psychologist and leadership consultant Camille Preston, founder and CEO of AIM Leadership. “I was going to have dinner with others. I was going to socialize with others.”
Preston says that it took a lot of communication and negotiation to come up with a system that allowed both of them to work, manage the household, and parent harmoniously. And while she’s looking forward to the time when she resumes her travel schedule and he heads back to the office, like many couples, they’re going to have to figure out all of that again.
“So, if my workplace wants me, but my husband doesn’t have to [go back] until October, does that mean he picks up the laundry and the [kids at daycare] and the groceries? How do you renegotiate all of that?” she muses. Everything from when the dog gets walked to when the laundry gets done will have to be decided.
Datis Mohsenipour, director of marketing for Outback Team Building and Training, says his firm has had a hybrid model for some time. His partner will go back to work full time in September, but they both have reservations, even though learning to work together in the same space has been challenging. “Her office did have a COVID scare before and it was handled quite slowly and poorly in our opinions,” he says.
Risk is another conversation couples need to have when one or both are going to be out with other people more, Preston says. When one person is out in the world and the other is home, how do you manage your risk tolerance for the virus? “That is going to be hard as people came up with their risk assessments—this is what we’re comfortable doing, this is what we’re not comfortable doing,” she says. “How do you recalibrate that?”
Adjusting to the new normal
Selkirk and Gatehouse have worked out a system where they touch base about each other’s schedules to ensure they have the quiet time they need for calls or work that requires focus. She says it will be a big change when he goes back to the office, but there may be some benefits. First, she won’t have to use the noise-canceling headphones his employer purchased for her as much. She’ll have more quiet time to work. And she notes that since they’ve both been home full time, their work-life balance has changed. “He spends a lot more time sitting at his computer in the evenings and stuff and just sort of being there, as opposed to being integrated with us,” she says.
Michael Hammelburger, CEO of the Bottom Line Group, a financial consulting firm, says the early days of working together took some adjustment. His wife had been working from home in her basement office and she could hear the footsteps upstairs or when her husband was coming down the steps to her office. “I didn’t have any ways to buffer myself,” she says. “I’m taping podcasts or I’m having client meetings, and all of a sudden he was here and I’m like, ‘What are you doing? Why are you in my space right now? Oh, you want a kiss? Great. Give me a kiss. Now go.’”
But after he went back to the office a few days each week starting at the beginning of June, she says she misses the companionship and rituals they developed, like daily walks and lunches together. He has the option to work from home Mondays and Fridays now, but she doesn’t anticipate that will last. “So, I’m trying to capture the moments when we have them and enjoy them. Because I do know that, at some point in time, he’ll be back in five days a week without a doubt,” she says.
Preston says that the next wave of change will be a different kind of challenge, but a challenge nonetheless. Couples will need to overcommunicate with each other and work on finding the best balance for them. “It’s not going to be one size fits all,” she says.
