Giving Bad News by Phone May Be the Better Way

Communicating the news that a biopsy result indicates malignancy by telephone may be better than delivering the news in person, a team of researchers from the University of Michigan, in Ann Arbor, suggests. Two outside experts do not altogether agree.

“Telemedicine approaches can potentially relieve much of the anxiety associated with in-person consultations while delivering bad news in a timely, compassionate, and patient-centered manner,” write Naveen Krishnan and colleagues in a viewpoint published in the November issue of JAMA Oncology.

Getting the bad news over the telephone can give patients time to absorb their diagnosis and take greater advantage of their next in-person consultation, Krishnan and colleagues write.

“The initial in-person office visit to communicate malignant biopsy results is arguably less interactive than expected. Patients are not only trying to absorb devastating news but also engage in challenging conversations,” they write. “On the other hand, communication of biopsy results through telecommunication can serve as a buffer to the initial in-person visit and provide time for patients to process the results alone or with family.”

The authors cite examples of oncologic services delivered through telemedicine.

One is the Arizona Telemedicine Program’s Telehealth Rapid Breast Care Process, which lets patients receive their breast cancer diagnosis the same day as their biopsy. The program is conducted under the auspices of the University of Arizona.

Another example is the Ontario Telemedicine Network, located in Canada. With more than 1600 sites and 3000 systems, the OTN is the largest teleoncology service in North America, according to the authors.

“The Ontario Telemedicine Network has overcome a number of barriers, including cost, physician compensation, and resistance to telehealth technology adoption,” they write. “In fact, telehealth technology is now an everyday part of health care delivery in Ontario.”

Krishnan and colleagues claim that for patients, message content and timeliness are the two most important factors in relaying biopsy results. Patients are less interested in nonverbal communication on the part of the physician delivering the bad news, they say.

“In this respect, telemedicine allows physicians to focus on content rather than nonverbal communication that patients may not appreciate at the initial in-person visit,” the authors write.

“With increasing clinical time constraints and the shock of hearing a cancer diagnosis in person, telemedicine encounters can facilitate more meaningful future in-person discussions of complex therapeutic options and their adverse effects,” the authors write.

Read more.

 

Leave a Reply

Your email address will not be published. Required fields are marked *

Post Navigation