Breaking The Bad News

On the TV show House, House’s oncologist pal Wilson was reputed to be so humane and caring when giving patients bad news about their condition that, when he was done, patients actually thanked him.  Studies indicate, however, that there aren’t a lot of Wilsons out there in the medical profession.  Instead, many doctors botch one of the most important parts of their job — giving patients truthful information about their medical condition when the diagnosis is grim.

photo-hospital-doorwayTelling patients that they have untreatable cancer, or some other fatal disease, clearly is one of the toughest parts of a doctor’s job — and research indicates that doctors just aren’t very good at it.  Some doctors will break the bad news indirectly or use medical jargon that leaves the patient confused, others will do it with brutal directness, and still others will sugarcoat the news with treatment options.  As a result, many cancer patients aren’t well informed about their actual condition, and their prospects. A 2016 study found that only five percent of cancer patients understood their prognoses well enough to make informed decisions about their care.

Why are doctors so inept at giving patients bad news about their condition?  Of course, it’s incredibly hard to be the bearer of bad tidings, especially when the bad news is about a fatal illness, but there’s more to it than that.  Communications skills apparently aren’t emphasized at medical schools, and many doctors see a diagnosis of an incurable disease as a kind of personal failure on their part.

It’s interesting that, in a profession so associated with the phrase “bedside manner,” so many doctors regularly mishandle what is arguably the most important part of their job and so few medical schools make sure that their graduates are equipped to handle that task in a genuine, caring, and understandable way.  I hope I never receive a devastating diagnosis, but if I do I hope it comes from a doctor who knows how to break the bad news.

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