Receiving Bad News Over The Phone

by Jane Ashley

A disturbing new trend is emerging in the diagnosis of cancer. More patients (60 percent, in fact, of breast cancer patients) receive their diagnosis of cancer over the phone. It seems that some patients would prefer to learn the results of their tests as quickly as possible, even it’s via a phone call. Perhaps younger patients who use “phone and text” as their primary means of communications don’t want to wait for an appointment — they want to know ASAP.

60 Percent

But is this the best method to deliver a serious diagnosis like cancer?

The University of Missouri School of Medicine study reminds us that communicating face to face about a significant diagnosis like cancer has always been considered “best practice” at hospitals and medical centers across the U.S. After conducting this study, the University of Missouri School of Medicine now begins teaching first-year medical students techniques to break bad news over the phone. An important part of breaking the bad news that a patient has cancer is to learn in advance how the patient wants to be informed of the results. Some younger patients or busy business professionals may opt for via text or phone call while many other patients would prefer making a follow-up appointment to learn of the results in person.

A major obstacle about getting a cancer diagnosis over the phone is that most patients won’t hear or remember most of the conversation after they hear the word “cancer.” Our brains shut down. Many of us don't know what kind of doctor to call after we receive this news if a pathologist delivers the news. Some patients may decide on alternative treatments and never consult an oncologist or surgeon.

When life-changing news like a cancer diagnosis is delivered over the phone, there may not be adequate follow-up with the patient about the next steps that they should take. Some patients may fall between the cracks if they assume that someone is going to follow up with them and make appointments for them.

Fewer Patients

How have WhatNext members have gotten their diagnosis?

WhatNexters represent a broad base of patients. We’ve received phone calls from a nurse practitioner, a receptionist, the pathologist, a nurse social worker, the doctor who ordered the scan or biopsy, a message to the patient’s spouse and even during a physical exam.

There isn’t an easy way to receive a diagnosis of cancer. But there is one irrefutable truth. A diagnosis of this magnitude should come from the patient’s doctor. Physicians should not delegate a cancer diagnosis to another staff member nor give the diagnosis to another family member nor leave a voice mail.

What are other important considerations about delivering a cancer diagnosis?

First, the physician needs to deliver the news with compassion and empathy. They should use words that convey or suggest that the upcoming conversation may not be what the patient was hoping to hear. A physician may start the conversation saying, “Unfortunately, we didn’t get the results we were hoping for.”

Physicians should allow a patient time to digest the news. The physician should offer reassurances and make an appointment to discuss treatment options. A patient should never feel hurried or dismissed when a physician calls. 

Physicians Should Ask

Physicians should also ensure that the patient is in a suitable place to talk. If the patient is driving their car or is at work or is in a store, physicians should arrange for the patient to call them back at a specific time. I can attest to that advice — I was working as a territory account executive and got a call from my boss. He asked, “Is this a good time for us to talk?” I told him that I was driving on the interstate. He asked me to call him back when I got off the expressway. So I took an exit where I knew there was a restaurant parking lot and returned his call. He told me the bad news that I was part of a big corporate layoff and that the next day was my last day. He told me that I’d get an email with instructions for a video conference with full details and for me to drive home. Imagine my feelings driving home knowing that I’ll have to tell my bad news to my husband. Just imagine someone’s feelings as they drive home knowing the emotional news that they must deliver to their spouse or other family member.

A patient shouldn’t be driving, at work, in a store or a restaurant when given the diagnosis of cancer.

Unfortunately, our medical community is becoming more time-starved as paperwork and regulations eat into valuable time that should be spent face-to-face with patients. We’ll probably be seeing more diagnoses given over the phone. Let’s hope that medical practices appoint a specific person who is properly trained to deliver those life-changing three words that “you have cancer.”

How did you receive your diagnosis? Please share in the comments.

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Watch the video below to see how the WhatNext website and social network can help you through your diagnosis, you don't have to face a cancer diagnosis alone!

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