Breaking Bad News to Patients with Grace

Dr. Jones examined the x-ray and let out a heavy sigh. Her gynecology patient of over 20 years had a tumor in her breast. The patient had many normal mammograms in the past, and Dr. Jones assumed this one would be no different. Unfortunately, the mammogram’s findings were clear and impossible to misinterpret. The doctor closed her eyes, collected herself, and prepared to phone her patient. 

Have you been in a situation like this before? If you’ve been in the medical field for a while, you probably have. All doctors know that breaking bad news to patients is among one of the most difficult parts of their jobs. Even those with decades of experience struggle to inform a patient of unwanted news. Below, we’ve compiled a list of some of the best tips for breaking bad news to patients in the best way possible.

8 Tips for Breaking Bad News to Patients

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1. Prepare Yourself

Before speaking with the patient, make sure you’re familiar with the relevant clinical information. Be prepared to provide information about the patient’s prognosis and treatment options. Additionally, it’s beneficial to think through what you’re going to say. Consider practicing beforehand, and be sure you know words or phrases to avoid. Also, consider brainstorming resources you can offer the patient, such as websites, support groups, or therapists.

2. Set the Context

Before sharing the bad news, it’s a good idea to ask the patient how much they already know about their condition. This is especially beneficial if your patient is seeing multiple physicians. In addition, it’s best to provide a sort of warning statement before getting to the news. Statements like “I’m afraid I have some difficult news” help the patient prepare for what’s to come.

3. Be Honest and Clear

One of the worst things you can do when breaking bad news to patients is sugar coat the information. Do not try to soften the blow by using euphemisms or medical jargon. For example, instead of saying “there is a lump in your breast,” say “you have a tumor” or “you have cancer.” While it may be tempting to sugar coat the diagnosis, it will only make things worse. Speak frankly and honestly, but also compassionately.

4. Keep it Simple

When explaining the news to your patient, try to limit your use of technical or medical terminology. Your patient and/or their family may not understand the words you’re using, and it will only make the situation more complicated and confusing. Make sure the patient thoroughly understands the information you have explained.

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5. Allow Time for Reaction

After sharing the information, pause, and give the patient time to react. All patients react to this kind of news in different ways, so respond to their reactions and help them through it. Do not rush right into the discussion of treatment options; give your patient time to process the news.

6. Let Them Ask Questions

At first, patients may be in shock and won’t ask any questions. If that’s the case, ask the patient if there’s anything you can answer for them regarding the news you’ve just shared. If they do ask questions, make sure you answer them honestly and thoroughly.

7. Offer Encouragement and Validation

It’s wrong to give a patient false hope, but you should offer realistic hope. Even if a cure isn’t likely, offer encouragement about treatment options and support. Ask the patient about their emotional needs and support systems, or offer referrals if needed. Doctors should express their commitment to supporting the patient through the entire process.

8. Follow Up

Whether over the phone or in person, it’s a good idea to follow up with your patient within a week of delivering the bad news. Check in to see how they are doing, and offer reassurance that you’re available if they need anything. Usually, patients begin to cope with bad news fairly quickly, so you may be surprised by their progress in coming to terms with their situation.

Despite the challenges associated with breaking bad news to patients, doctors remain a therapeutic presence during a patient’s time of need. How do you handle delivering bad news? Let us know in the comments below.


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