During the past two years I’ve addressed approaches and tactics to use in sharing bad news with patients. Because it’s such a sensitive topic I’m always on the look-out for new or more effective ways to communicate to patients.
I came across an article by Dr. Michael Kirsch who is a regular contributor to medpageTODAY’s KevinMD.com: “How should physicians give bad news to patients?”
The most important point that I think Dr. Kirsch makes comes near the end of his article, “Delivering bad news is a very difficult and unavoidable responsibility of a physician. Do I do it well? I think so, but I’m not really sure. I gave the news to my patient and his wife after I had made arrangements for him to see the necessary consultants in the coming days.
I think that patients’ stress in these situations is eased when there is a plan that we physicians put in place.” I bolded “after” because I fully agree about putting a plan in place for our patients to address their future care and to lessen their stress.
So what do you think about the way you deliver bad news? How about when you receive it? Any particular tips or advice you can offer to the community? Let us know in the comments below.
Last Updated: November 6, 2018
3 Comments
As a student, I heard a very comforting interpretation of the above: Medicine is an art, and needs to be practiced much like a dance. Sometimes we follow; mostly we lead. It matters not how graceful we think we are, our partners are grateful for the loving touch and guidance we offer, when the dancefloor becomes a minefield.
My family received some very bad news in the ER several years ago and I think my family not knowing anything about the medical condition thought the doctors just gave up because they already had a plan in place, so I am not sure if I agree entirely with making the plan before telling the family. Every situation needs to be individualized to the family and situation.
Linda, I appreciate the image of the dance floor becoming a mine field. So very true, and Danelle’s note confirms that these situations need to be looked at individually. I have had patients who need time to “digest” before even thinking about a plan, and some who want to simply know, “OK, so now what?”. When you have a relationship with the patient, you often know them well enough to get a measure of which way to go. For those you don’t know, I think it is good to be prepared with a plan, but you are certainly correct that we need to make sure that plan is communicated well, and not give the wrong impressions.