Delivering Bad News: 5 Tips for Radiologists

Interacting with new faces every day comes with the territory of being a radiologist, or any medical job for that matter. You may enjoy treating new people or it may be something your inner introvert can’t stand about working in the medical field. Whether you’re as sociable and personal as Katie Couric or as cold and closed off as a moody teenager, delivering medical news is not about you. Medical news, good or bad, is serious and should be treated with care. So, what does it take to be a master at delivering medical news to radiology patients? Here are 5 tips to help you communicate like a pro.

1. Prepare Your Words

This first tip should be a no brainer, but is nonetheless important to mention. From a professional standpoint, it is imperative that a radiologist is prepared to answer any and all questions a patient may have about their diagnosis. Understanding the ins and outs of this person’s treatment is your job and you owe it to your patient to have a firm grasp on what their medical future holds. If it helps, write down the facts and points of concern to remind yourself of the most important things, but remember to prepare for unexpected reactions and questions.

2. Be Aware of the Space

That is literally the space in which the news will be given. This is especially important when delivering bad news. Radiologists should be sure to give news in a private area and also be mindful of their presence and tone as they enter that precious space. For example, if a radiologist is about to tell their patient that their CT scan shows a possible brain tumor, entering the room while whistling with a grin on your face is completely inappropriate. Instead, enter with a relaxed pace, friendly (but not overly excited) smile and gentle greeting. What might be another day at the office for a radiologist, could be life-changing for the patient so make your actions mirror that.

3. Deliver the Message Right

Working in the medical field is all about relationships. For a radiologist, maintaining a solid relationship with your patients is how you plan someone’s medical future, gain the trust they have in you to care for them and, let’s not forget, the chance that they may refer other business to your practice.

The delivery: At first contact, introduce yourself (if you haven’t already) and discuss the patient’s care up to this point so you can gauge how much they already know. When delivering bad news, be direct with your information to avoid any mixed messages, but steer clear of medical lingo and jargon that will go over their head. Speak slowly and clearly with a sensitive tone and once you’ve completed the news, pause. Let the patient take in everything you’ve said and wait for them to speak first. Become comfortable with silence. Use empathetic statements to show you care and make the patient feel comfortable in your presence.

For further study on delivery, Sloan Kettering’s Dr. Epstein teaches two pneumonics: SPIKE (setting, patient perspective, information, knowledge, empathize/explore emotions and strategize/summarize) or NURSE (name emotion, understand, respect, support and explore emotions).

4. Use Nonverbal Communication

Nonverbal communication is done through facial expressions, hand gestures, posture and eye contact. Sometimes when you’ve got a hundred patient cases on your mind, you’re trying to remember if you fed your dog and you genuinely don’t want to give dreadful news to someone, it can be hard to remember to match your body language with your words. This will be a conscious effort you have to make, but it will help build trust with your patient and may even help to keep them calm. Practice delivering news in a mirror or on video. Carefully study your own body language and facial expression to judge whether or not your nonverbal delivery matches your verbal delivery.

5. Don’t Leave Them Hanging

It’s one thing to deliver the message, but helping patients know where to go from there is just as important to comforting them and helping them understand their illness. Be sure to look at the case from all angles to provide them with a number of options (if possible). If the illness is out of your control, give them reputable recommendations on where to go and assure them you will be in contact to ensure they’re in the right hands. Even if you can no longer help this person, they are someone you’ve most likely built a relationship with and ending it abruptly will only make your patient feel alienated and alone.

Delivering bad news to patients is never easy, but what radiologists should remember is that this situation is far worse for the person on the receiving end. With the right preparation, empathy, sensitivity and compassion, radiologists can hopefully make an unfortunate situation just a little bit easier for their patient and, in the long run, keep their reputation and professional relationships intact.

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