Make diagnostic doubt visible in healthcare

Patients with persistent debilitating symptoms and normal test results can face a diagnostic odyssey that harms both individuals and healthcare systems. Current frameworks use many labels to categorise suffering in these people; one example being 'persistent physical symptoms' (PPS). Though helpful provisional descriptors, these labels can create diagnostic ceilings, leaving patients abandoned without follow-up or hope. This article argues that medicine's difficulty managing uncertainty creates iatrogenic harm, erodes trust, and can drive healthcare avoidance. We propose a paradigm shift from seeking rapid diagnostic closure to legitimising skilled diagnostic doubt through coded clinical positions such as Systematised Nomenclature of Medicine - Clinical Terms (SNOMED CT)'s 'Uncertain diagnosis'. This requires integrated strategies combining advanced diagnostics, mandatory clinician training in uncertainty and communication, named care coordinators, and ring-fenced research funding. Drawing on recent analyses and patient testimony, we contend that making diagnostic doubt visible is not merely an administrative change but an ethical imperative. Transforming abandonment into advocacy through curiosity-driven; continuous care must not be postponed.