Sunday, June 10, 2007

Bad News Skills

Oh right, my son picked up a lot of those in high school. This particular study, however, did not deal with THOSE kind of skills, but rather the skill with which doctors deliver bad news.

The researchers ran a 4-day communications workshop called Oncotalk for medical oncology fellows. These doctors were in the last phase of their training as oncologists, and soon to be cancer specialists who doubtless would face bad news deliveries on a regular basis.

During the 3-year study, the fellows were observed pre- and post- workshop participation talking with standardized patients, as in "I'm not a patient, but I play one during this study." Postworkshop, participants gained an average of 5.4 bad news skills. The number of doctors mentioning the word cancer in bad news encounters rose from a paltry 16% before the skills practicum to 54% after.*

Being a reluctant bad news deliverer on a regular basis, I've given a lot of thought to this. That "C" word cancer is sitting in on the conversation whether you mention it or not, and I think it becomes a bigger presence if left unmentioned. I used to think that delivering bad news on the phone was wrong, then I saw how people freaked out when called by my office staff to come in to discuss test results. No one is calling anyone to come in and hear that their mammogram was normal.

Equally important is delivering good news the instant it is known. When test results come back to our office, they are immediately reviewed for critical information that needs to be conveyed immediately. But good news or bad, there is one anxious person waiting by the phone to hear about those negative scans and those benign biopsies.

*Can you imagine an oncologist NOT saying the word cancer when they tell a person that they have it or that the tumor is now out of control?

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