What your doctor is thinking when they say, ‘I’m afraid I have some bad news’

Screen Shot 2019-05-13 at 16.29.26.pngI’m afraid I have some bad news.

The above sentence probably wasn’t pleasant to read. Maybe it gave you a sinking feeling in the pit of your stomach or made your blood pressure spike. But in medicine, this ominous phrase is often used as a “warning shot” to give patients the chance to brace for the impact of oncoming news before it is delivered.

Does it work? It depends on who you ask.

Every physician must occasionally deliver bad news, be it tragic (“you may never walk again”) or merely uncomfortable to discuss (“you have chlamydia”). As a research assistant at one of the top teaching hospitals in the United States, I’ve come to realize how little we understand about teaching doctors to communicate with patients and deliver hard-to-swallow information.

Recently, doctors have been looking to the scientific community for objective guidance on the best way to handle distressing conversations, but current research — complicated by difficult ethical constraints and technical limitations — can’t always tell us genuinely useful information……more

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