Physicians Practice - February 2008 - (Page 42)

IN PRACTICE the assumption being that those who have better communication skills will go into those ﬁelds where it’s most needed, and that’s the wrong assumption. Communication skills can be taught; they are not necessarily inherent.” Robert Buckman, a medical oncologist at Princess Margaret Hospital in Toronto and the author of 14 books, including “How to Break Bad News: A Guide for Heath Care Professionals,” bears good witness to this assertion. He says his “old school” medical education left him completely unprepared when it came to confronting patients with discouraging lab or test results. “Like everybody else, when I was an intern and a resident, I had no idea what to do,” he says. So he watched other physicians who he considered to be good communicators, and he copied their examples. Today, Buckman says he can handle even the most extreme patient reactions to bad news, including one case of a patient throwing a chair around his ofﬁce. Buckman says he simply allowed the patient to “vent,” which was what that patient needed to do at that moment. Acknowledging a patient’s distraught state is one of the most effective methods of reaching out to them and responding empathetically. SHIFT YOUR VIEWPOINT Of course, you have no way of knowing an individual patient’s preconceptions about any diagnosis you deliver. Still, you can at least try to avoid some of the more common errors doctors sometimes unwittingly commit during such patient encounters: • Slow down. Many physicians mistakenly overwhelm patients with a glut of information about their diagnoses too quickly after “dropping the bomb,” says Gillick. She says that no matter how intelligent a person may be, it’s human nature to be unable to process an excess of information after receiving a negative diagnosis. Rather, convey explanatory details and treatment options in limited amounts — perhaps during a follow-up visit or personal phone call. So what makes bad news bad? “I think of it as anything I am talking to a patient about that could be bad news for them,” says Puchalski. “You have to view it through the patient’s perspective.” “We can get a little cavalier about it,” she explains. “Most people agree that bad news is usually the very serious things, like a diagnosis of cancer, or ALS, or Parkinson’s, or something that’s potentially very life-limiting and serious. … But it could be that a diagnosis of diabetes brings to the patient a memory of an uncle losing his legs due to amputations, and they see this as a really horrendous, life-long illness.” 42 | PHYSICIANS PRACTICE | FEBRUARY 2008 WWW.PHYSICIANSPRACTICE.COM http://www.medplexus.com http://www.medplexus.com 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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