There is Room for Improvement in Doctors' Communication Skills when Delivering Bad News Such as a Cancer Diagnosis

There is room for improvement in doctors' communication skills when delivering bad news. A cancer diagnosis should be delivered in a comforting and professional manner, but many patients are dissatisfied with doctors in this regard. Patients may receive the news in a public setting in a rushed and detached way. Some receive the cancer diagnosis second-hand and some are left hanging after receiving a devastating diagnosis without a discussion of treatment options or even a full understanding of their diagnosis.

A Study Confirms: Many Doctors Lack Communication Skills

A new study, discussed by MedlinePlus, has confirmed that some doctors are lacking in communication skills when delivering bad news like a cancer diagnosis. Forty-four percent of 437 patients surveyed said that after delivering the bad news, their doctors spent less that 10 minutes discussing their condition and 31% reported that treatment options were not discussed with them. Thirty-nine percent said they had no one with them when they received a cancer diagnosis.

The study revealed that patients sometimes receive the cancer diagnosis indirectly. One woman received her breast cancer diagnosis from a message on her answering machine. One patient was called about arranging an appointment to see a neurosurgeon. When she asked why she needed that appointment, she was told that she had a brain tumor and the call was abruptly ended. Some patients were told of their cancer diagnosis impersonally, in a public setting.

It is no surprise that patients were more satisfied with doctors who arranged a private, personal setting for delivering bad news, especially when plenty of time was allowed for discussion.

My Personal Experience with a Doctor Delivering Bad News

Late one Friday afternoon I was told that an MRI showed that I had a cyst on one of my ovaries and a cyst on my liver and that my endometrial lining was thickened. The doctor had a terrible approach for delivering bad news. He was matter-of-fact, hurried, detached, and showed absolutely no expression of concern.

I asked, "What are the chances I have cancer?" His communication skills were horrible and he left me hanging with this scary news. On his way out of the room he told me that I'd have to see a gynecologist to find out about the ovary and endometrial lining and another specialist for the liver.

Since both of my parents died of cancer, my best friend had just died of ovarian cancer, and a number of other family members had also died of cancer, I was petrified.

Andy's Doctor Knew How to Deliver a Cancer Diagnosis

I was particularly impressed by Andy's story, posted in a chat room where people discussed how they found out they had cancer. Andy's doctor preceded the delivery of the cancer diagnosis with, "You'll be happy to know we have identified your condition, we know what we're dealing with! AND you'll be even happier to know your condition is both treatable and curable." The delivery of that news was followed by what Andy called "a proper discussion of what would now happen."

Andy believes that due to his doctor's good communication skills and professional delivery of the cancer diagnosis, he did not automatically assume that he was going to die. He believes that the communication skills of his doctor could be the basis of his survival, giving him the right mental attitude to face his ordeal in spite of a cancer diagnosis. Knowing that his condition was treatable and curable allowed him to accept the cancer diagnosis without debilitating fear.

How Should A Doctor Deliver A Cancer Diagnosis?

Research shows that patients prefer to hear a cancer diagnosis face-to-face, directly from their doctors, and in the privacy of the doctor's office. Doctors should discuss the cancer diagnosis in an honest, unhurried manner, giving the patient time to react and then respond empathetically. Patients are more satisfied with their doctors' communication skills when plenty of time is allowed for their questions to be answered. Doctors can improve their communication skills by putting medical jargon aside and using plain English. Audiotapes of the discussion are often suggested since patients have difficulty remembering what was said. Under the foregoing conditions, very few patients were dissatisfied with their doctors' communication skills or reported lacking trust in them.

Summary

A cancer diagnosis may be the scariest diagnosis a patient can hear. Some patients believe it is a death sentence. There is definitely room for improvement in the communication skills of doctors when delivering bad news such as a cancer diagnosis. Receiving the cancer diagnosis in the right way can increase a patient's sense of well being and ability to cope, face treatments, and survive. Doctors can increase patient satisfaction by delivering bad news in an honest, unhurried manner in a face-to-face, private setting with plenty of time allowed to answer questions and explain the cancer diagnosis in layman's terms.

Sources:

No author given. Many Docs Deliver Cancer Diagnosis Badly: Study. MedlinePlus.

Various posters in chat room. How Did You Find Out It Was Cancer? Cancer Research UK.

Debra Beaulieu. Patient Relations: Best Practices for Delivering a Cancer Diagnosis. Fierce Practice Management.

Peter M. Ellis and Martin H. N. Tattersall. How Should Doctors Communicate the Diagnosis of Cancer to Patients? Informaworld.

No author given. Hammersmith Communication Skills for Doctors. Hammersmith.

Leonard Holmes. Horses Help Doctors Improve Communication Skills. About.com.

Allison Hampton. Talking Matters. Developing the Communication Skills of Doctors. Scottish Executive Health Dept.