Physicians Practice - February 2008 - (Page 41)

IN PRACTICE ‘I’VE GOT SOME BAD NEWS’ BY BARBARA A. GABRIEL GIVING PATIENTS UNPLEASANT DIAGNOSES IS NEVER EASY. BUT YOU CAN SOFTEN THE BLOW BY IMPROVING YOUR COMMUNICATION SKILLS. Bedside manner: To patients, you either have it or you don’t. Do you need it? Frankly, it depends. Some patients will put up with an insensitive demeanor from a highly skilled specialist, while others consider a physician’s ability to empathize with patients to be an immutable part of patient care. Regardless, there is IN SUMMARY Delivering bad news to patients is often the most difﬁcult part of any physician’s job. Arming yourself with helpful tools and well-thought-out approaches can beneﬁt both you and your patient: • Realize that although effective communication skills are not inherent to everyone, they can be learned. patient’s perspective to help you better anticipate and respond to the reaction. techniques or being “fully present” during such conversations so you can keep to your often timestrapped schedule. emotions, rather than ignoring them or becoming defensive, to mitigate the sometimes natural urge among patients to “shoot the messenger.” news to patients can take its toll on you too; draw on your own sources of support. • Look at the situation from the • Employ “creative scheduling” • Acknowledge your patient’s • Remember that delivering bad one instance when a diplomatic and insightful bedside manner becomes critically important: when you are the bearer of bad news. “I’m not sure we realize how much of an impact how we deliver news makes,” says Muriel Gillick, a geriatrician in a large, palliative care-focused multispecialty practice in Boston. “I see lots of patients with various chronic diseases like MS who, years later, are still angry about the way they ﬁrst learned they had the disease, how callous they thought the physician was, or how cold, or how unhelpful.” Many physicians struggle with divulging bad news. Christina Puchalski, an internist with The George Washington University Medical Faculty Associates in Washington, D.C., believes the reason is largely due to the turn medical education has taken over the past century. “As science advanced and we discovered new illnesses and diseases, clearly that became the focus of the curriculum — to be good scientists and very skilled technicians as well in diagnosing and treating our patients,” she says. And that’s important, she says, but she adds that medical educators also assume that appropriate communication skills would come naturally to individuals who had chosen healing the sick as their professions. “In fact,” says Puchalski, “many times you would hear, ‘Well, I’m glad she became a pathologist because she really didn’t have great communication skills,’ FEBRUARY 2008 | PHYSICIANS PRACTICE | WWW.PHYSICIANSPRACTICE.COM 41 http://WWW.PHYSICIANSPRACTICE.COM

Table of Contents Feed for the Digital Edition of Physicians Practice - February 2008

Physicians Practice - February 2008 Contents The Bigger Picture: Your Future is in Your Hands Letters Physicians Practice Pearls: Creating an A+ Practice Noteworthy Cover Story: Conquering Time: 5 Keys to a More Efficient Practice In Balance: A Family Affair Technology: Making EMRs Work in the Exam Room In Practice: "I've Got Some Bad News" The Tech Doctor - The EMR: Savior or Poseur? Ask the Experts NEW! Healthonomics: How to Handle Health Savings Accounts The Administrator's Desk: Finishing School for New Managers Human Resources: Is Your Partner Impaired The Great Practice Makeover: Too Well-Liked for His Own Good? Coding Idealab: 'Why I Blog' Classifieds Advertiser Index

Physicians Practice - February 2008

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