CL Psychiatry

How to break bad news effectively

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Volume 4 Issue 7 July 2014

Consultation Liaison Psychiatry Focus: ‘Speciality’

Bad news is defined as “any news that drastically and negatively alters a person’s view of his or her future”. The process of breaking bad news is employed in almost all walks of our lives and not only the doctor-patient relationship, but also the doctor-doctor, medical teacher-medical student, and doctor-student-health care worker-patient interaction too is affected by it. Breaking Bad News effectively is the most important part of medical education and yet is the most neglected aspect in India.

Currently protocols for breaking bad news –[ SPIKES & BREAKS ] are purely western society oriented and have not been widely experimented and implemented in Indian setup. I propose and have started implementing – “DISHA: A New Protocol for Breaking Bad News”. The name DISHA is an acronym which stands for: D-Determine [What, where and why is to be said]; I– Inform all, Invite all, Ignite all involved in the process so as to build a team; S-Share the past, the present as well as the future of the receiver and show all that is bright; H-Hope, Health and Happiness are the targets in all circumstances; A-Assistance to the receiver [Assistance by the Giver of bad news, Family, Society and Friends].

DISHA is improving Communication skills and Doctor-patient relations and has added a new dimension in medical education. I strongly advocate for introducing effective models of breaking bad news in undergraduate as well as post graduate medical teaching and also during internship period of training for better and humane health care delivery.

Sushil KACHEWAR | Professor (Full) | MD, DNB, PhD, FICR Radio-diagnosis | Pravara Institute of Medical Sciences University, Loni | Pravara | Department of Radiology
Dr Sushil Kachewar Prof. in Radio-diagnosis,
Rural Medical College, PIMS(DU), Loni Maharashtra, India- 413736
Email-radsgk@gmail.com
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