Orlando—Breaking bad news is one of an optometrist’s toughest tasks, yet medical instruction typically grazes the surface of formal preparation for it. Without adequate educational groundwork, the distress of delivering bad news may lead to emotional detachment between optometrists and their patients.
Jay Lytle, OD, FAAO of Columbus, OH, discussed physician burnout at the American Academy of Optometry 2019 annual meeting. Armed with optometry-focused best practices and evidence-based clinical methods, Dr. Lytle equipped fellow optometrists with tools to improve patient satisfaction and prevent the negative effects of physician burnout as a result of delivering bad news.
What is bad news?
According to Dr. Lytle, bad news is “any news that negatively alters a patient’s view of his or her future.” In optometry, this may refer to a glaucoma or vision loss diagnosis. It may also denote the news that a patient’s favorite eyeglasses frame is discontinued or that he is not a candidate for an elective surgery he needs.
While bad news is typically associated with a terminal diagnosis, it may also refer to a finding that impedes on a patient’s lifestyle in any negative way.
Most physicians report that they deliver bad news one to two times a week, but Dr. Lytle says that number is probably higher.
“The person who determines whether news is bad or not is the patient,” Dr. Lytle says.
Why is it so difficult to break bad news?
ODs face many difficulties associated with breaking bad news. Until recently, it was common practice to conceal a terminal diagnosis from the patient. That practice has changed and today, doctors have a legal obligation to deliver bad news.
“It’s our responsibility,” Dr. Lytle says.
One of the most common concerns is that, upon hearing bad news, patients deteriorate emotionally or physically.
In addition to that, breaking bad news is unpleasant. Many physicians don’t want to remove hope from their patients, and there may be uncertainty around how to effectively communicate bad news.
“Physicians may feel guilty—as if they have failed a patient,” Dr. Lytle says. “They could also be worried about staying on schedule with the rest of their patients.”
Research shows that physicians tend to withhold emotions or become overly optimistic when delivering bad news. But with proper education in evidence-based clinical methods like ABCDE and SPIKES, physicians can avoid stress and burnout.