The Art of Breaking Bad News

Ask a number of people how they received unsettling news about their cancer and most will remember in striking detail, but a doctor-led program aims to help physicians learn how to break bad news better. Will it help?
BY DEBBIE WOODBURY
PUBLISHED: OCTOBER 30, 2014
Patty Eaton, a pediatric emergency medicine fellow in Florida, completed the program three years ago and now works as an instructor. “As an intern, we’re overworked and can lose sight of why we wanted to be a doctor. This program actually taught me how to help people, help families, support people on an individual level when going through something painful, and that’s why I entered medicine.”

Andrews never walked into her breast surgeon’s office again and had another surgeon perform the biopsy. Unfortunately, he was no better at breaking sensitive news. After the surgery, he met Andrews’ husband in the hallway and told him she had breast cancer. He then left for another surgery, leaving her stricken husband alone to break the news to Andrews.

“We thought it was a death sentence. No one came in to talk to us, no nurse, no other doctor. They just sent us home,” Andrews says.

Patients report that a doctor’s competence in communicating potentially distressing news is critical to establishing trust. Andrews agrees and believes the one silver lining of her experience was that it motivated her to eventually find doctors who better served her physical and emotional needs.

If it’s important to patients, they should discuss their preferences on being told sensitive news, and by whom, with their medical team. Perhaps a patient wants to be told immediately, even if over the phone. Some may want family members present or want to record the appointment to digest the information later. Proactively approaching the situation gives patients the opportunity to identify a person who is best skilled at gathering and transmitting information, providing support and working with them to develop a treatment plan.

In the end, the ability to break bad news well fosters a stronger doctor and patient relationship. “There is no good way to hear bad news, but you don’t want to feel like you are completely alone,” says Andrews.

Talk about this article with other patients, caregivers, and advocates in the General Discussions CURE discussion group.
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