Delivering bad news: A make-or-break moment for the physician-patient relationship

While there is no one right way to give bad news, physicians who do so incorrectly in patients' eyes risk being replaced, according to an article from the Wall Street Journal.

One woman, for example, described how she was told during her pregnancy that her baby had not just Down syndrome, which she'd already learned about, but also a separate, possibly fatal condition. "I'm sitting there with jelly on my stomach and he's telling me the baby has this condition. I didn't have a clue what that was," Kate Hogan Green told the newspaper. "He said the baby will likely not survive. He said that we could terminate." The perinatologist, whom Green fired a month later, then handed her scratchy paper towels as she sobbed, according to the article.

Although the baby did survive, the original physician-patient relationship did not. And the article offered several similar examples. When done well, on the other hand, difficult conversations offer physicians the opportunity to deepen their bond with patients, another patient told the WSJ. To increase your chances of achieving the latter result, consider the following best practices:

  • Deliver bad news in a private, quiet area.
  • Ask patients what they already know about their medical situation and whether it is all right to share the news you have.
  • Use silence to acknowledge sadness or other emotions.
  • Avoid medical jargon.
  • Speak clearly but sensitively.

Even when physicians as as empathetic as possible when delivering bad news, however, they still may be viewed as less trustworthy and compassionate than those who deliver more optimistic news, according to previous research published in JAMA Oncology. That may be why some physicians have said they are not always completely honest with their patients.

To learn more:
- read the article