Practical Plans for Difficult Conversations in Medicine: Strategies That Work in Breaking Bad News

Although they receive extensive clinical training, medical practitioners are given little or no instruction about the best way to break bad news. In this book and DVD set, Robert Buckman, author of How to Break Bad News, offers solid, practical, and practicable guidelines for such conversations as the diagnosis of a serious or fatal illness, the death of a loved one in the hospital, or a disclosure of medical error. This is a book about communication techniques that work in everyday clinical practice. It is not a series of prefabricated scripts but a collection of strategies and approaches that any clinician can use to effectively communicate with patients. Using basic, honest communication tools, Buckman shows doctors how to approach conversations dealing with the most sensitive medical topics. He explains what to anticipate in various situations and provides guidance on keeping the discussion as constructive as possible. For each of several scenarios, Buckman supplies alternative responses, indicating which can work best and why. Each protocol is given an acronym to provide a mnemonic aid to help clinicians respond quickly and effectively. The accompanying DVD illustrates the protocols with recordings of unscripted and unrehearsed conversations with standardized patients, showing how the strategies can actually work in real situations in a realistic time frame. Based on sound, proven strategies and peppered throughout with illustrative examples, Practical Plans for Difficult Conversations in Medicine provides the tools and knowledge necessary to start and sustain a genuine conversation at a moment when the first thought is "I have no idea what to say now."

Table of Contents:
Preface Introduction: Prescribing the Doctor as Part of the Treatment 1. Some "Can't Go Wrong" Tips 2. Breaking Bad News: The SPIKES Protocol 3. Disclosing Error: The CONES Protocol 4. Managing Conflict and Escalation: The HARD Protocol 5. Giving Information Effectively: The SAFER Protocol 6. Some Particularly Difficult Conversations Conclusion: Putting It All Together and Making a Difference in Communication Acknowledgments Appendix: Notes to Accompany the Scenarios on DVD Notes Index

About the Author :
Robert Buckman, M.D., Ph.D. (1948-2011), was an oncologist and professor at the University of Toronto's Princess Margaret Hospital. He was the author of numerous journal articles and book chapters as well as of books, including How to Break Bad News, What You Really Need to Know about Cancer, and Human Wildlife, all three published by Johns Hopkins.

Review :
Buckman offers the tools and knowledge base to help a medical practitioner start and maintain a professional conversation during extremely sensitive times and circumstances... Highly recommended. Choice Practical Plans for Difficult Conversations aims to ground its ideas firmly within the real world of clinical medicine. All of the examples are set in real situations and this is the book's main strength. Readers will recognise, immediately, the areas that do cause problems, and will be able to imagine themselves within each scenario. Times Educational Supplement The book, stylistically, is written in a relatively non abstruse manner. Indeed, the book's contents are characterized notably by relative ease of reading. The 'empathic response' is explained in detail, in Chapter 1. In Buckman's view, the empathic response is the most direct and simplest way of acknowledging the emotions of another person; and the belief of Buckman is that it is the most useful communication technique for any difficult conversation. In subsequent chapters, Buckman, in a characteristically practical, insightful, and thoughtful way, identifies and describes the components comprising various communication protocols, designed to closely fit particular types of medical situations. Metapsychology