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The Worst Things You Can Say to a Patient

The Worst Things You Can Say to a Patient

In life, once something bad has been said, you can't take it back. In medicine, damaging words can be the biggest obstacle between a provider and a patient's relationship.

We asked our advisory board to share with us some of the worst things that a practitioner can say to a patient during their visit. Some of these damaging words are innocuous and some of the comments go much deeper than that. Other comments reflect the difficult things that providers will have to say to a sick patient, which are not necessarily mean-spirited but reflect a harsh reality.

Here's what they had to say.

(What are some of the worst things you think a practitioner can say to a patient? Share your thoughts below in the comments section or by tweeting us @PhysiciansPract.)

Click here to download a PDF of this slideshow.

Source: 
Physicians Practice

Comments

Excuse me, I have to make notes in the government mandated idiot box.

MARTIN @

I tell my patients that I am required to document many items that have relatively little value in their management but if I don't the government will doc my pay in 2019. They have no problem with it because it is the truth.

JEFFREY @

Well...at least you're not going to die... at least for now

CRISTINA @

You have six months to live!

AHIMSA @

Never, ever, look at your watch with a patient in the room. You can see time on the computer/pad, or on the patient's wrist. But never make it obvious you are thinking of where else you could/should be.

CARL @

One physician once told a mother whose child had just died "You're young, you can have other children". This added to the hurt and did not comfort her at all!

BARBARA @

Your BMI indicates that you are morbidly obese

Suzanne @

Why tell the truth to these poor obese snowflakes? It's not their fault

DANIEL @

Don't rush the patient!!! This is a major complaint
Keep your eyes focused on the patient
If you type while listening read back history gives confidence you are listening
Sit down
Ask for questions at end of plan

EVELYN @

I remember years ago a woman came to my office totally offended by another doctor who told her she would look reall beautiful if only she lost some weight.
I agreed with how offensive the remark was and she became one of my nicest, most loyal patients.

ALAN @

maybe the poorest article I've seen yet, in terms of lazy writing and lack of direction....do you guys actually get paid for stringing this crap together? how about a few thoughts on 'what works, what doesn't work' regarding doctor-patient communication?

STEPHEN @

"You're fine. There's nothing wrong."

If they keep coming back to your practice because they're not feeling better, there's something wrong. Keep looking, keep listening, never stop learning, algorithms are not the gospel, and don't forget drug side effects!

Jordan Scott MD
Allergy/Immunology

JORDAN @

"It's all in your head"

Phyllis @

As a PA for 17 years, I've unfortunately heard patients complain, often through tears, about certain doctors. There are two statements that by far distress them the most:
1. "There is nothing more I can do for you." There is ALWAYS something more you can do: listen, empathasize, curbside a colleague, refer for 2nd opinion, suggest counseling services, find a support group, enlist hospice care, manage pain or mood symptoms, find patient assistance programs for expensive drugs, call periodically to check in, etc. Offering a hug at the end of the visit makes patients feel better no matter how difficult things become; never underestimate the therapeutic power of human connection. While cure is not always possible for the body, compassion goes a long way toward healing the soul.
2. "There is nothing wrong with you." If a patient is suffering, there is something "wrong." Whether you find objective or pathologic disease on a diagnostic test is not the point; if the patient is experiencing distressing symptoms, it's your job to make a definitive diagnosis and manage them. Patient education about functional or somatic symptoms, and incorporating an integrative/mind-body management approach, is essential - not only in alleviating angst, but also in reducing the cost of care caused by an unsatisfied patient's over-use of resources in search of an answer.

Anne @

Annie, it is clear by your comments you are high in emotional intelligence with patients. You "get it" in how to communicate effectively with patients. That is your "brand".

I believe most doctors mean well, yet some, due to personality, perception of their main duty, stress, feeling rushed, or undeveloped skills in communication and emotional intelligence, fall short of quality compassion.

I imagine you are loved by the people you help.

The second point you mentioned, so true. "...if the patient is experiencing distressing symptoms, it's your job to..." Help them alleviate that physical and emotional distress. Social awareness about their state, empathy for them, self control of not "feeling" motivated to "find a way".

Michael Toebe
Conflict Management Care

Michael @

Hospital managements have to take the blame on behalf of doctors who don't do all these good things that doctors are supposed to do. You write as if doctors are ignorant of these aspects of medical practice. That is not so. The hospitals they work for don't give them enough time to even listen to the patients. With 20 minutes for a follow up visit and 45 minutes for a new patient (and this includes notes and dictation), the doctors simply don't have time. If they see less patients, they are punished by stopping their pay rise or cutting off their bonus.

PRASHANT @

You are aboslutely right. Also since what you recommend is becoming rarer in the medical office the interpersonal communication that the PA affords (which used to be in the Dr.'s province), is the reason why there is an article in todays news of the rising popularity of PAs in Dr. Offices.

ALAN @

I once asked a patient, for whom I was considering suggesting an expensive non-insurance covered therapeutic device, what "her family resources were? ". Wow was she upset... walked out of room and reported to husband! Both left in a huff. I guess they thought I might charge them more if they were rich.
But have since found some people are offended if they believe I don't think they have resources for an expensive optional treatment plan, :-(

g @

Your question was not the problem, it was 1) her interpretation of it 2) her reactive response and 3) unfortunately, not trusting you had her best interests at heart (a misunderstanding).

What might help is prefacing that type of question with a short reason for asking it, which would convey the types of solutions you could suggest and recommend. That way, it leaves less open to interpretation as to the meaning and a hurtful impact.

Michael Toebe
Conflict Management Care

Michael @

usually worst scenario is seen when patients chalange your skill and say Doctor if you understand then treat me ..... in this challenging situation it is seen some physicians irritate a lot and ...... WORSE WORDS BY PHYSICIANS ARE ::::: IF YOU THINK I AM NOT COMPITENT THEN YOU CAN GO TO SOME OTHER DOCTOR:::: . drmirza90@hotmail.com Dr Mirza Mudassar baig from pakistan

mirza @

There is nothing wrong in telling a patient "you don't know" as long as you add " I will find out" or I will send you to someone who does know" or "we need to investigate this some more".

Thomas @

I agree that there are times you have to tell the patient you don't know the cause of the problem. Anyone who is taking care of patients with chronic idiopathic urticaria has to understand. You half to relate that you don't know why. Of course it requires some explaining. I explain that there is a lot about disease that we don't understand and always offer a second opinion if needed. I have never had a patient get a angry to this approach. Joe Anderson, Ogden

JOSEPH @

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