Breaking The Bad News Every doctor understands just how difficult and unpleasant it can be having to break bad news to their patients or patient's relatives. In fact, it is one of the most daunting tasks a physician can face. If a physician is not properly trained and guided on how to go about this, it may cause them to gradually withdraw emotionally from their patients as a form of coping mechanism. Unfortunately, medical school does not offer much formal training on how to deliver bad news to patients and their relatives. It is quite understandable why this is not a task any doctor looks forward to. On one hand the doctor wants to keep hope alive as long as possible. On the other hand he is wary of how the patient will react to the news and how to deal with the strong emotions it may evoke. Also more often than not due to the pressure of the workplace, he has to break this news in a way that is not the most suitable. Inspite of all this, every good doctor must try as much as is within their capacity to break bad news to their patients as gently and compassionately as possible. How should you break bad news to your patients? Several guidelines have been proposed on the best way to deliver bad news. However, what is more important than developing the "skill" of breaking bad news is actually improving your communication skills. Some studies have shown that most patients would prefer that they are given full disclosure and in clear and concise terms, without heavy medical jargon. A few tips on how to deliver the bad news include: 1. Prepare yourself beforehand. Get to know as much as you can about the medical condition as questions would be expected. 2. Make arrangements for a suitable environment preferably without interruptions. 3. Find out what your patient already knows and how much they would like to know so that you don't overburden them with information or give too little. 4. Be frank but compassionate. Do not sugar-coat things or use confusing medical jargon. 5. Be prepared to deal with families' reactions. Answer their questions as kindly as possible. 6. Do not be overly pessimistic. In medicine there are no 100% guarantees. If there is even a tiny ray of hope, let it shine through but in a realistic way. Breaking bad news will never be a fun thing to do no matter how adept at it you become. But doing it in the best way possible we will go a long way in helping everyone involved cope with it.
