A reader asks:
On rare occasions, a doctor won't say anything while I'm on the tissue-covered table and silently escorts me to a small room with ugly upholstered furniture for a conversation. I think the idea is that this is a more "comforting" environment, but to me, it's just another strange medical space. Perhaps you could explain how your compatriots decide where to speak to patients?Yes, some doctors have this weird idea that bad news is only tolerable when given in a sitting room with upholstered chairs and fake plants.
The trouble, of course, is that patients suspect this and therefore getting moved to the little room with comfy chairs significantly worsens your already nerve-racking visit. You know the bad news is coming, so the comfy room feels like a cell where you await your sentence.
As I've mentioned before, giving bad news is always a rough part of this job. We want to be as gentle as possible, but I think the little room is more for our comfort than yours.
Doctor D believes the most important thing about news is to give it straightforwardly and in a private place. Last thing your doc needs to do is to give it in crowded ER when your neighbor is listening on the other side of the curtain. Of course, the small, busy ER where Doctor D works has lots of curtains and no cute little room. D has even been known to take people in the medicine closet for a talk when it's the only safe place to protect their privacy.
But when privacy isn't a concern, the last thing I want to do is move you somewhere where you know you are waiting for bad news. I'll tell you straight up what I'm thinking. Doctor D believes people care more about hearing news directly, honestly, and kindly than they do about the location where they are told. I have used offices or these little sitting rooms in the past, but only because the patient wanted me to tell a lot of family members that wouldn't fit anywhere else.
I start directly and tell you straight up wherever we are. I know their will be lots of further discussion and questions. I'm always glad to finish the conversation wherever you would prefer to talk.
What do you think? Would you be upset by being told in an exam room sitting on that tissue-covered table? Would you prefer to be moved to the room with the comfy chairs? Let Doctor D know if he should change his strategy!