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Bad News – You May Be Bad at Delivering Bad News

March 7, 2023

Written by Megan Hilbert

Spoon Feed
When delivering bad news, authenticity is the name of the game.

Why does this matter?
Making the decision to practice medicine comes with the privilege, but also burden, of being witness to incredible human suffering. It is an important skill for physicians to be able to deliver bad news well when the time comes.

Throw out the script
This opinion piece highlights the difficulty of delivering bad news to patients. During medical school we are taught a bevy of acronyms and approaches to delivering bad news. We can, however, become so tied to these tools that we lose the forest (patient sitting in front of you) for the trees (completing the task of having the discussion).

In the Emergency Department, we are there on potentially someone’s worst day. We are, unfortunately, no strangers to delivering bad news, but are we doing it well? There is a cacophony of sounds and tasks constantly pulling at our attention. The environment is not the best for focusing, yet that is what our patients deserve from us.

Do I have anything earth-shattering or ground-breaking to offer you today? I do not. But I do have a call to action. The next time you need to deliver bad news, consider straying from the stiff algorithms and scripts. Try to find a quiet place with minimal distractions. Be mindful and present with your patients, really listening to what they are saying. Focus less on saying exactly the right thing; instead, try to proceed compassionately. I know it can be hard, but there is the potential that if we deliver bad news well, we can make someone’s worst day just a little better. And isn’t helping people the reason we went into this field in the first place?

Delivering Bad News Badly. JAMA. 2023 Feb 14;329(6):463-464. doi: 10.1001/jama.2022.24765.

What are your thoughts?