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A recent study in the Journal of Clinical Oncology shows that training doctors in the delivery of bad news to dying patients significantly improves their ability to communicate this kind of bad news. This shouldn’t be a surprise to anyone. What is a surprise is how infrequent and poorly conducted such training is for the average doctor. For some, the ‘training’ consists of being pushed into a room with a dying patient by the supervising physician and being told to deliver the bad news. That’s not training – that’s hindering.
It is sad that it takes studies like this to make anyone pay attention. And it reminds me of the excellent training I got (along with man other doctors) from Judah Folkman. A couple of years ago, shortly after he passed away, I wrote a piece about how Dr. Folkman helped me in my training when he specifically taught me and the rest of my second year medical school class how to deliver bad news in specific, concrete and immensely helpful detail. It will stay for me forever.
More importantly, much of it is applicable to all of us. Clearly some, like asking for an autopsy, is medically specific. But much of the rest is good no matter what the bad news or to whom you are breaking it. The basics are: Insist on a private place. Sit in a chair. Insist that they sit down. Then deliver the news and say that you are sorry about it so they know you care. Then wait. And keep waiting until they have something secific to say to you. Answer all the questions you can straightforwardly. Make no excuses or explanations and don’t philosophize. Be sympathetic.
That’s it. The reasons and the medical specifics are in the longer tribute article I wrote – click here if you want to read it.
