Breaking Bad News with the SPIKES Method

A doctor walks into the room, sweat trickling down their forehead, with chewing gum, and a facial expression that could rival Trump. They take a deep breath, then blurt out, "Your MRI results are very bad o. Too bad!"

Now, that's not exactly the best way to break bad news.

Even in our personal lives, we have to deliver bad news. However, in a world full of inflation, heartbreaks, and canceled TV series, a little empathy can go a long way as the bearer of life's curveballs.

Not everyone is skilled to have a chat with the harbinger of doom, especially when it comes to matters of health. The stereotype of the stoic, emotionless medic doesn't exactly warm hearts. People expect more empathy from a rock than from some healthcare providers.

Sure, they didn't teach us the art of breaking bad news in medical school. There were no classes on delivering the 411 on life-changing diagnoses with a sprinkle of compassion. However, after a deep dive into the University of YouTube and gleaning wisdom from those in hospice, healthcare, marketing, and even the engineering industry (because let's be honest, project delays can feel like a tragedy), I have summarized a crash course on mastering the art of delivering bad news.

How to Deliver Bad News: The SPIKES Method

- S - Setting: Choose a suitable environment. Avoid delivering news in a crowded and uncomfortable place. Consider having a supportive family member present in a quiet space to set the right tone.

- P -Perception:Understand the patient's perception. Use empathetic body language, such as having uncrossed arms, sitting next to them, nodding your head, and keeping your body position open.

- I - Invitation:Invite the patient to share their understanding or expectations before delivering the news. This helps tailor your communication to their needs.

- K - Knowledge:Provide the information about the health concern. Choose words wisely, using clear language. For example, say, "Your results came back, and from what we can see, there's a health concern," as it beats "It's really bad o."

- E - Emotions:Acknowledge the patient's emotions. For instance, say, "I can imagine this is a lot to process."

Here's how that plays out:

Doctor Adebayo: Good afternoon, Mr. Afolabi. How are you feeling today?

Patient: A bit nervous, Doctor. I've been waiting for my test results.

Doctor Adebayo: I understand. Waiting for news can be challenging. Before we dive in, let's make ourselves comfortable. ( Doctor Adebayo gestures towards the chairs in the room and sits by him)

Mr. Afolabi: (Sitting down) Thank you, Doctor. So, what do the results say?

Doctor Adebayo: Well, Mr. Afolabi, I want to be transparent with you. The test results show that you have a condition known as Rheumatoid Arthritis. Let's discuss this further. Have you heard about this condition before?

Mr. Afolabi: (Looking concerned) I know it affects the joints, but not much beyond that.

Mr. Afolabi:(Listening attentively) I appreciate that, Doctor. Please go ahead.

Doctor Adebayo:(Continuing)Rheumatoid Arthritis is an autoimmune condition where the immune system mistakenly attacks the joints, leading to inflammation and, over time, potential damage. In your case, the long-term damage to your joints means we need to consider making significant lifestyle adjustments.

Mr. Afolabi:(Nodding) I see. Does this mean I won't get better?

Doctor Adebayo: It's important to manage expectations. Rheumatoid Arthritis is a chronic condition, but with the right treatment and lifestyle modifications, we aim to control symptoms and improve your overall quality of life. Now, considering your work, we may need to explore a job role adjustment to reduce strain on your joints.

Mr. Afolabi:(Taking a moment to absorb the information) That's a lot to take in, Doctor. What about my job? Will I have to quit?

Doctor Adebayo: I understand this can be overwhelming. Losing your job is not our immediate focus. Instead, let's discuss the possibility of adjusting your job role to better accommodate your health needs. This might involve collaborating with your employer to find a role that aligns with your capabilities while minimizing strain on your joints.

Mr. Afolabi:(Expressing concern)Adjusting to a new job role feels like a significant change.

Doctor Adebayo: It is, and I want you to know that we're here to support you through this transition. Our goal is to enhance your overall well-being, and that includes working together to find solutions that suit your lifestyle and career.

Mr. Afolabi:(Taking a deep breath):This is a lot to process.

Doctor Adebayo:Processing such news takes time, and I want to assure you that our healthcare team is here to guide you every step of the way. If you have any questions or concerns, feel free to share them with us.

Now you might be thinking, that sounds easy enough, but here's what people keep doing wrong.

- Avoiding Eye Contact: It's not a staring contest, but maintaining eye contact reassures people you're not announcing their demise.

- Overusing Jargon:This isn't a medical thesis defense; keep it simple and understandable.

- Blaming the Higher Power:Telling someone, "God works in mysterious ways" may not be as comforting as you think. Stick to the facts and leave theology out of it.

Remember, breaking bad news doesn't have to be a scene from a melodramatic soap