Tessa Quinn
While it is preferable to deliver bad news in person, there are times when giving bad news over the phone is unavoidable. Receiving a cancer diagnosis over the phone can be extremely stressful and impact a patient's well-being. However, some patients prefer to receive such news over the phone as they can have a true reaction to the news in private. A study found that 54% of patients were told their diagnosis in person, 18% by phone, and 28% in the hospital.
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What You'll Learn
- Patient preference for receiving a cancer diagnosis over the phone
- Higher patient satisfaction with in-person cancer diagnoses
- Psychological distress associated with receiving a cancer diagnosis over the phone
- Physician communication skills for delivering a cancer diagnosis over the phone
- Follow-up care and support after receiving a cancer diagnosis over the phone
Patient preference for receiving a cancer diagnosis over the phone
Receiving a cancer diagnosis is a difficult experience, and patients have expressed a range of preferences for how they receive this news. While some patients prefer a phone call as it gives them time to process the information and prepare questions for follow-up appointments, others prefer an in-person meeting with their doctor.
A survey of 437 patients found that 54% were told their diagnosis in person in the physician's office, 18% by phone, and 28% in the hospital. Of those who received the news over the phone, some felt it was a better option as it allowed them to have a private reaction to the news. However, others felt it was a negative experience, especially if the call was unexpected or at an inconvenient time.
Another survey of 1000 patients focused on breast cancer survivors found that 39% received a face-to-face communication of their diagnosis, with 50% of all patients stating they would have preferred this option. This survey also found that 82% of patients would have preferred to receive their biopsy results within 2 days, while only 40% actually did.
The method and location of disclosure, length of discussion, and discussion of treatment options have all been found to impact patient satisfaction. Patients who heard their diagnoses in person or in a personal setting, such as a hospital room, reported higher satisfaction scores. Longer discussions and the inclusion of treatment options were also associated with higher satisfaction.
Some patients have shared their experiences of receiving a cancer diagnosis over the phone, with varying levels of satisfaction. While some appreciated the compassion and timely nature of the call, others felt it was inappropriate or insensitive, especially when left as a voicemail or delivered without context.
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Higher patient satisfaction with in-person cancer diagnoses
Being diagnosed with cancer is a life-altering event, and the way in which this information is delivered can have a significant impact on patient satisfaction and their overall experience. While some patients may prefer a phone call to avoid an in-person meeting, research suggests that higher patient satisfaction is associated with in-person cancer diagnoses.
In-Person vs. Over the Phone
A study conducted at the National Cancer Institute (NCI) surveyed 437 oncology patients, with 54% being informed of their diagnosis in person in the physician's office, 18% by phone, and 28% in the hospital. The results indicated higher mean satisfaction scores for diagnoses revealed in person (68.2 out of 80) compared to over the phone (47.2 out of 80).
The Impact of Setting and Discussion Length
The location and length of the discussion also play a role in patient satisfaction. Patients reported higher satisfaction when the diagnosis was delivered in a personal setting, such as a physician's office or hospital room, rather than an impersonal setting. Longer discussions lasting more than 10 minutes were also associated with higher satisfaction, as they provide more time for patients to process the information and ask questions.
The Influence of Treatment Option Discussions
Discussing treatment options during the initial diagnosis can significantly impact patient satisfaction. In the NCI study, 31% of patients who could remember did not have their treatment options discussed. Patients who received information about treatment options during their diagnosis reported higher satisfaction, as it empowers them and provides a sense of agency during a vulnerable time.
Patient Preferences and Psychosocial Factors
While the research suggests higher satisfaction with in-person diagnoses, it's important to consider individual patient preferences and psychosocial factors. Some patients may prefer a phone call due to convenience or privacy concerns, especially if they need to travel long distances for an in-person appointment. Additionally, factors such as age, gender, anxiety, depression, and social support have been found to influence patient satisfaction, and these should be considered when determining the method of delivering a cancer diagnosis.
In conclusion, while in-person cancer diagnoses are generally associated with higher patient satisfaction, it is essential to adopt a patient-centric approach that considers individual preferences, circumstances, and psychosocial variables to ensure a supportive and compassionate delivery of such critical news.
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Psychological distress associated with receiving a cancer diagnosis over the phone
Receiving a cancer diagnosis over the phone can be distressing, and patients often express dissatisfaction with this method of communication. A study found that 18% of patients received their cancer diagnosis by phone, and those who did so were more likely to change physicians due to dissatisfaction. The same study also revealed that patients who heard their diagnoses in person reported higher satisfaction scores.
The delivery of a cancer diagnosis over the phone can be challenging, as it may not allow for adequate discussion of treatment options or emotional support. Some patients have reported feeling confused, disgusted, and distressed when receiving such news over the phone. The lack of visual cues and the potential for miscommunication can further contribute to psychological distress.
Additionally, the level of distress around the time of diagnosis is a significant predictor of longer-term heightened distress. This suggests that the method of delivering a cancer diagnosis can have lasting psychological implications.
Furthermore, up to one-third of people affected by cancer experience ongoing psychological distress. This distress is often under-recognized and under-treated in routine clinical practice due to barriers such as lack of time and experience. Implementing brief screening tools, such as the Distress Thermometer, can help identify distressed patients and ensure they receive appropriate supportive care.
While receiving a cancer diagnosis over the phone can be psychologically distressing, it may be necessary in certain situations, such as when the patient needs immediate medical attention or when in-person appointments are not feasible. In these cases, it is crucial to provide emotional support and ensure effective communication to mitigate potential distress.
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Physician communication skills for delivering a cancer diagnosis over the phone
While it is preferable to deliver a cancer diagnosis in person, there are times when a physician may need to deliver the news over the phone. This may be due to time constraints, as in the case of patients who need to be admitted to the hospital immediately, or due to external circumstances, such as the COVID-19 pandemic. Regardless of the situation, it is important for physicians to possess and employ effective communication skills when delivering a cancer diagnosis over the phone to ensure the best possible patient care.
Effective communication skills are essential for physicians when conveying a cancer diagnosis over the phone. The delivery of such news can significantly impact the patient's understanding, emotional well-being, and trust in the healthcare team. Here are some key communication skills for physicians to consider when delivering a cancer diagnosis over the phone:
Empathy and Compassion:
It is crucial to approach the conversation with empathy and compassion. Recognize the patient's emotional distress and provide reassurance. Acknowledge that this news is difficult to receive and offer support. Ensure that the patient feels heard and valued as an individual.
Clear and Concise Language:
Use clear and concise language to convey the diagnosis and avoid medical jargon that may be confusing or overwhelming. Provide a straightforward explanation of the cancer type and its implications. Avoid using overly technical terms, and be prepared to explain complex concepts in a simple and understandable manner.
Active Listening:
Encourage the patient to ask questions and express their concerns. Actively listen to their queries and address them as thoroughly as possible. Paraphrase and clarify to ensure the patient understands the information conveyed. Create a safe space for the patient to process the news and invite them to share their thoughts and feelings.
Shared Decision-Making:
Involve the patient in shared decision-making regarding their care. Discuss the next steps, including treatment options and the timeline for further evaluations or procedures. Provide a realistic overview of the treatment goals and potential outcomes, ensuring the patient understands the benefits and risks associated with each option.
Offer Practical Support:
Provide practical support by offering concrete next steps and resources. This may include scheduling an in-person appointment, arranging referrals to specialists, or connecting the patient with support services, such as counselling or patient navigator programs, to help them cope with the diagnosis and navigate the healthcare system.
Cultural Sensitivity:
Consider cultural factors that may influence the patient's preferences for communication. Some patients may prefer to involve their family or caregivers in these conversations, while others may prefer to make decisions independently. Respect the patient's cultural background and adapt your communication style accordingly.
Timely Follow-up:
Ensure timely follow-up after the initial phone call. This may include providing a summary of the conversation, offering additional resources, or scheduling a more comprehensive discussion about treatment options. A prompt follow-up can help address any lingering concerns or questions the patient may have.
By employing these communication skills, physicians can enhance the patient's understanding, alleviate anxiety, and foster a sense of collaboration in navigating the cancer journey. While delivering a cancer diagnosis over the phone poses unique challenges, effective communication can help ensure that the patient feels supported, informed, and empowered to make decisions about their care.
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Follow-up care and support after receiving a cancer diagnosis over the phone
Receiving a cancer diagnosis over the phone can be a stressful and overwhelming experience. It is completely normal to feel a range of emotions and to require time to process the news. While some people may prefer an in-person consultation, a phone call can offer the benefit of privacy and the opportunity to process the information in a familiar environment.
After receiving a cancer diagnosis over the phone, it is important to seek follow-up care and support to help you navigate the physical and emotional challenges that lie ahead. Here are some steps you can take:
- Request a cancer care review: You can request a cancer care review, also known as a follow-up care plan, from your primary care team. This review can be conducted face-to-face, over the phone, or through a video call. During the review, your healthcare providers will discuss the cancer diagnosis, treatment options, and address any concerns or questions you may have. It is recommended to have this review within 12 months of being diagnosed, but you can request it earlier if needed.
- Connect with cancer support organizations: Organizations like the American Cancer Society offer 24/7 cancer helplines, providing information, guidance, and emotional support. Their trained specialists can connect you with essential services and resources throughout your cancer journey. They can assist with referrals to patient programs, answer medical questions, and provide support for caregivers and family members as well.
- Understand your follow-up care plan: Your doctor or healthcare provider should provide you with a follow-up care plan, which outlines the recommended steps for your cancer care after treatment. This plan includes information about regular medical check-ups, bloodwork, and other necessary tests or procedures. It also addresses physical and emotional concerns that may arise months or years after treatment.
- Seek emotional support: Dealing with a cancer diagnosis can take a toll on your emotional well-being. Consider seeking emotional support through counseling or therapy. Your cancer team can refer you to a psychologist or counselor to help you process your emotions and manage any psychological challenges that may arise.
- Focus on physical well-being: Maintaining physical activity and a healthy lifestyle is an important aspect of follow-up care. Consult with your doctor about safe ways to incorporate exercise into your routine. They may recommend working with a physical therapist or specialist to develop an appropriate exercise program.
- Keep a record of your treatment: It is essential to maintain a record of your cancer diagnosis, treatment details, and follow-up care needs. This information will be helpful for your current and future healthcare providers. It includes details such as the type of treatment, dose, treatment cycles, and any side effects or management strategies.
Remember, follow-up care is an essential part of your cancer journey, and it can help you feel more in control as you navigate life after treatment. Don't hesitate to reach out to your healthcare providers, support organizations, and loved ones for the assistance and support you need.
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Frequently asked questions
In a survey of 437 patients, 54% were told their cancer diagnosis in person in the physician's office, 18% by phone, and 28% in the hospital.
Telephone appointments are sometimes used due to COVID restrictions.
Patients tend to prefer receiving a cancer diagnosis in person, with higher mean satisfaction scores associated with diagnoses revealed in person (68.2) compared to over the phone (47.2).
