Breaking Bad News During Physician-Patient Interactions

Abstract

The manner in which physicians deliver bad news can drastically affect patients’ satisfaction with care, psychological outcomes, and subsequent behavioral outcomes (e.g., commitment to therapeutic regimens, follow-up visits). Physicians who are unprepared for the difficult task of breaking bad news also experience negative psychological effects. The SPIKES model is a series of communication strategies developed to guide physicians through these pivotal conversations by providing organized, formulaic strategies for presenting distressing information to patients. This case study applies SPIKES to a physician–patient bad news interaction that is all too common—the diagnosis of lung cancer. Specifically, the physician in the case provides his patient with information, empathy, and support through the use of SPIKES communication strategies.