Almost as bad as an incompetent doctor, is the one who handles bad news even worse than the patient.

Let’s face it, most doctors and nurses just don’t want to discuss dying. So here’s what usually happens: the patient gets an unhappy diagnosis, then a lot of mumbling spiced with incomprehensible medical jargon, then leaves the office, and comes home with — absolutely nothing. No understanding of the diagnosis. No comprehension of the therapies offered or how likely they are to work.  No notion of what to do next.

“Doctors are not inherently bad people, but they may well be badly trained,” says Rich Frankel who is a professor of medicine at Indiana University School of Medicine. “At the graduate school level there are just huge gaps in training. And physicians often feel they aren’t serving their patients well if they give them the bad news.”

What to do? Train your doctor. That’s right. “One thing a patient can do is raise the topic with your doctor, simply say, ‘I would like to talk about the end of life,” Frankel suggests. “Most patients want to wait until a doctor raises that topic. Well if you do, you’ll be waiting a very, very long time.”

It doesn’t have to be this way. In fact, he adds, in Great Britain, primary care physicians are taught to have end-of-life talks with patients long before anyone is really sick. The doctor may ask, “If you get a terminal illness, do you want me to tell you it’s terminal, or would you just want me to take over your care. That way a patient can respond, “Don’t tell me about my diagnosis, just tell my grown daughter.” Or: “I want to know everything so I can make plans.”

Most important, Frankel concludes, if you suspect the news from your doctor may not be good, always bring a family member along to listen to the diagnosis and ask those vital questions you’ll be too nervous or fearful of bringing up. “And you can also bring a tape recorder with you to record what is said. Yes it may make the physician nervous,” he concedes.

“But remember, it’s your health care.”

This entry was posted on Thursday, August 14th, 2008 at 4:39 am and is filed under Blog. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.