How To Break Bad News - Tips And Tools For Resident Physicians

One of the most challenging tasks for a physician is breaking bad news to a patient. Defined as “any information which produces a negative alteration to a person’s expectations about their present or future” , bad news causes distress in both the recipient and the bearer of the news. 1,2,3 The latter often experiences feelings of professional inadequacy, guilt, personal conflict and fear of a negative perception by the patient. 4 Conversely, when receiving bad news, patients’ emotions run the gamut from denial and ambivalence to acceptance and overwhelming despair. 5 It is no wonder that physicians often shy away or disengage themselves from conversations in which bad news must be delivered. However, modern medicine has shifted focus from a paternalistic, biomedical model towards a psychosocial model of increased communication, patient involvement and autonomy. This new model requires physicians to be skilled in divulging relevant information, both positive and negative, in an honest and empathetic way. 6