Skin Stories: How Should the Doctor Tell me Bad News?
Edited By:Raja Sivamani , MD, MS, AP
Editor’s Note: Alexis writes for the Skin Story section of Dermveda dedicated to expressing discourse from the patient perspective in medical care. One of the most anxious moments for a patient is when they are receiving bad news about their health. Alexis explored this experience through personal communication with those that have had to hear bad news and writes an open letter to physicians and doctors from the patient perspective on advice to deliver that information.
My health is always a primary concern and receiving bad medical news can be devastating, as it can change my life forever. Depending on whether I’m told I have cancer, a life-threatening disease, or even a new allergy, it's hard to hear these things for I will have many mixed feelings about my medical state. What the doctor says to me from this point can make a huge impact on how I move forward from bad news. Some things that matter to me are:
Giving a Heads Up
Hearing difficult news is even worse when I’m unprepared to handle the news. When doctors provide a warning of what is to come with openers such as, “I’m sorry I have to tell you this” or “I’m afraid I have bad news,” it allows me to prepare myself for what they have to say.
A Calm Setting
It's easy for things to become hectic in a hospital and one way to counteract this is to be in a private setting. When delivering tough news, it is nice when a doctor talks in a calm setting, free from any distractions. It can also be helpful for some people to bring another individual with them for support. Although some people would prefer to take the news alone, others do not feel as comfortable confronting the issue alone and want the company of a close family member or friend.
When doctors let me know that they understand how receiving bad news puts me in a difficult situation and time in my life, it makes me feel understood and comforted. Expressing empathy is essential in delivering news and explaining the patient’s diagnosis. It is important that doctors express that this is a distressing time for patients and are able to gauge how the news is taken.
I know we have reached a new age in medicine where we are beginning to heavily rely on technology as a main mode of communication. Should this apply to receiving health news? It might be useful for people to get a test result online but there is much debate about whether highly damaging news should be delivered this way. It seems to depend on the person. I have talked to people who feel strongly about a face-to-face interaction with their doctor regarding personal news. Many people nowadays get bad news on the phone which can be done in the comfort of one’s home, but I would also suggest the option of being able to add someone else to the call for support.
These are just a few factors that matter to myself and other patients when you need to break bad news.
A thoughtful and thankful patient
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