The influence of “bad news” and “neutral/good news” on patients' perception of physician empathy during oncology consultations

Abstract

ObjectivesBeing met with empathy increases information sharing, treatment coherence, and helps patients to recover faster. However, we do not know how the content of the conversation about disease progression, new treatments, or other issues concerning serious illness affects patients' perceptions of the physician's empathy, and thus, the quality of the conversation. This study aimed to test the hypothesis that patients will rate their physician lower following a “bad news” consultation using the consultation and relational empathy (CARE) measure.MethodsA total of 186 outpatients from the Department of Oncology were recruited for this study. After meeting with a patient, the physician filled out a form, placing the patient in either the “bad news” group, or the “neutral/good news” group along with information about the patient and the consultation. The patient was given the CARE measure after the visit.ResultsThe patients who had received bad news rated their physicians a significantly lower score on the CARE measure, even though the effect size was small, than those who had neutral/good news. On average, bad news consultations were 11 min longer.ConclusionsPhysicians need to be aware of the patients' need to be known and understood, in addition to having skills to attend to emotional cues and concerns, since the current study's finding could be a sign either of the content being projected onto the physician or that the physician is focused on the message rather than on the patient.

Physicians’ Lived Experience of Breaking Bad News in Clinical Practice: Five Essentials of a Relational Process

“…Findings from multiple studies in various settings show that recipients tend to blame the messengers, find them less empathic (Tranberg et al, 2024), and ascribe to them malign intent even when the status quo is out of the messengers' control (John et al, 2019). Even though physicians are expected to encourage and allow their recipients to express themselves within reasonable limits (Lee et al, 2002), physicians themselves become vulnerable in these situations, and several studies have shown that they therefore suffer physiological stress reactions (Studer et al, 2017), along with feelings of anxiety, guilt, exhaustion, failure, and frustration (Bousquet et al, 2015).…”