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Teaching doctors to deliver bad news with care

   One of the hardest jobs in medicine doesn't require high-tech devices or sure hands. It's that painfully awkward moment when a doctor has to deliver bad news.

   Patients generally just want the facts cushioned by compassion and encouragement. Yet, as simple as that sounds, the right words often go unspoken.

  Of course, some doctors do communicate well with patients or work at the skill. But others don't, as reflected in the large number of studies about improving the doctor-patient relationship.

   Relaying bad news is difficult. Few people are comfortable talking about death and dying. And, empathy can take time that busy doctors often believe they don't have.

   Doctors also come with different skills and personalities. Some can communicate naturally while others are uncomfortable talking to their patients.

   Patients are different, as well. Some want their information direct. Others require a go-slow approach. Some will handle a diagnosis of cancer with poise. Others will wilt over a negative test result for a condition that isn't fatal.

   One expert put it this way: "It's a situation no one wants, yet there needs to be some interaction. Physicians are people. They are not all stamped out of the same mold. Patients are different and bring with them emotional, family, religious and cultural issues."

   -- Henry L. Davis

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