Physicians experience intense emotions when they communicate bad news. The following points may be helpful for starting the conversation with your patient.
1. Get the physical context right
Where – An interview room may be preferable to the bedside
Who – Consider who needs to be present for the conversation (patient only vs. patient and family)
2. Find out how much the patient knows
What did your previous doctor tell you about your condition?
Have you been thinking that this illness might be serious?
Have you been worried about yourself?
3. Find out how much the patient wants to know
Would you like me to tell you all the details of your diagnosis?
Do you like to know exactly what’s going on or would you prefer that I give you only an outline?
If the condition is serious, how much would you like to know about it?
4. Give the information in small chunks, check understanding frequently, and clarify the information frequently
5. Respond to the patient’s feelings by identifying and acknowledging the patient’s reaction
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