End-of-life care matters deeply for patients and their caregivers, but studies continue to demonstrate ways in which physicians fall short when delivering bad news.
Empathy is the key to delivering bad news in a caring, productive fashion, Wolfgang Gilliar, D.O., Dean of the College of Osteopathic Medicine at New York Institute of Technology, writes in Stat. Modern medicine’s focus on technical training leaves residents shorthanded in the skills it takes to forge emotional attachments with patients, according to Gilliar. He points out studies from 2012 and 2014 demonstrating significant improvements in patient care when doctors focused on building emotional connections with patients. Gilliar advocates for “emotional intelligence boot camps” to build effective communication skills before students begin formal medical training.
Even doctors highly attuned to their patients’ emotional needs can run into difficulty when it comes time to hand out bad news. In the New York Times, Mikkael A. Sekeres, M.D., describes his experience having to present bad news to a leukemia patient whose intellectual impairment required obtaining permission from the patient’s mother to treat the cancer’s recurrence. While Sekeres shouldered the burden himself, a new study from the Netherlands suggests solid communication between doctors and patients only represents half the battle. Researchers found issues where a lack of communication among doctors hampered end-of-life care for patients.
American oncologists and internists who spoke to Reuters set out differing expectations about end-of-life care regarding who tells patients what and when. “Most patients in the U.S. have many doctors, and if each is doing their own little thing, no wonder patients are confused,” says Tony Back, M.D., an oncologist and professor at the University of Washington. He advocates for better communication among doctors to counter the likelihood of an awkward situation where an internist starts an end-of-life conversation before an oncologist thinks the time is right to do so.