I had a bad experience receiving medical news on 9/17/18. I am, what I thought at the time, was a very healthy 54 yr old man. I had gone to my family doctor to get a complete physical just since it had been a few years. Had blood work done which came back great. No high cholesterol, no diabetes, no high blood pressure, not overweight or anything like that. I performed both cardio and lifted weights on a regular basis so I was in pretty good physical shape. I was on absolutely no medications for any ailments whereas several of my friends of the same age had sleep apnea, high cholesterol, and high blood pressure. I had no physical pains like stomach pain, arthritis or other complications. I asked my doctor about checking my prostate as a precaution and he suggested I get a colonoscopy instead. I agreed and had one done. Going into it, my wife and I were figured I would get a quick exam, get positive results and leave to continue living normal since I was so “healthy”. After the test, while I’m in the process of changing clothes with my wife standing next to me assisting me the gastroenterologist who performed the test walks up and says my name and then says, “You have colorectal cancer. You’ll probably have surgery in a couple weeks to remove the cancer by having a bowel resection surgey and probably have chemo and radiation after that.” Then the doctor turns around and walks away. He wasn’t there for maybe for a minute or two at most. As the news was being delivered I could see out of the corner of my eye that my wife almost physically collapse. I had to reach for her to stabilize her. I was in total shock. This doctor’s method for delivering this horrible news was about as uncaring as could be imagined and the news seemed trivial to him. He delivered the news like he was telling me that my shoes were untied and walked away. So many thoughts were going through my mind and chief among them was that I was going to die and leave my family alone. After digesting what he said and collecting myself and calming my wife I had to yell across the room to get the gastroenterologist’s attention who had retreated to a central nursing station where he was having a good old time laughing and conversing with several associates around him. I called him over and asked him to explain his findings which he did somewhat. The more I think about that day the more furious I get. He should have assessed the situation to see that we clearly were not expecting any bad news, told my wife and myself to sit down, proceed to inform us of his findings and then remain there to answer any questions about the findings we might have. He also should not have told me I’d have surgery in 2 weeks. I ended up not having a bowel resection for 6 months after that day. Since I have colorectal cancer that hospital typically pretreats the tumor with chemo and radiation and then has a waiting period of a few months before surgery. Unfreaking believable!
how much hand-holding does medicare cover? Seems an inefficient use of resources. just give the family a few handouts and send them on their merry way.
Very thoughtful article! My dad was unconscious in the hospital and on a feeding tube for a few days before a nurse pulled me aside and said, “nobody has talked to you yet about his condition?” “No” “Your dad is considered in end stage care”. So glad of all the doctors we’d seen, it was a nurse who had the guts and decency to confirm that my dad was dying. Indeed, earlier that day his infectious disease doctor pumped us with false hope about how switching up his antibiotic might do the trick.
My wife and I are old enough to have been on the receiving end of a reasonable amount of negative medical news. So this is an issue we’ve had to deal with and think about. As far as we’re concerned, the *most* important thing doesn’t involve a particular manner of speaking. It’s as follows: the doctor must strongly communicate *non-verbally* that s/he is going to stay in that consultation room with the patient as long as it takes for the patient to begin the process of news digestion. That the doctor isn’t going to rush out as they now usually do after a five-minute consult. And, no, they can’t leave that task to the nurse. It may take half an hour but it’s something the doctor has to do. Hand-holding, if you will, but there’s simply no way around it.
Their news has forced the patient to enter a different world, probably a strange and frightening world. The patient must not be forced to enter that world alone. Doctors do not have to fill the silence with chatter. They do have to communicate, in body language and not voice tone but voice pacing, that the patient can take their time and the doctor isn’t going to run out on them. The insurance companies may not want to pay for such time, but it’s the doctor’s absolute medical responsibility to give their time in this manner.
I would imagine that every single half-hour spent in such a manner significantly reduces the possibility of lawsuits and formal complaints, or even plain dissatisfaction. For some doctors this is entirely taken for granted: they know in their gut what they have to do on a human to human basis. There are others, however, who have never gotten the picture. And they need to do so.
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