COLUMBIA, Mo. — Are doctors too busy to deliver life-changing diagnoses to patients in person, or have we gotten so used to receiving information instantly that people would rather learn medical test or biopsy results, no matter how emotional, over the phone? Perhaps it could be a mix of both in explaining a new survey that found most breast cancer are receiving breast cancer diagnoses via phone conversations.
Researchers from the University of Missouri School of Medicine discovered that 60 percent of breast cancer sufferers learned of the diagnosis from their doctors over the phone. It’s a figure that’s jumped dramatically after the authors surveyed patients who received their diagnoses between 1967 and 2017.
Prior to 2007, only a quarter of women had been told the news on the phone. But after 2007, the number of telephone diagnoses ballooned to more than 50 percent. The figure grew to 60 percent in 2015.
“When we analyzed the data, I was completely surprised to find such a clear trend,” says lead author Dr. Jane McElroy, a professor of family and community medicine at the school, in a statement. “Historically, physicians have decided to use their best judgment when delivering a diagnosis, whether it’s in person or over the phone. Nowadays, some patients clearly want to hear this information over the phone.”
As a result of the study, Missouri’s School of Medicine is updating its curriculum and training methods so that students studying to become doctors can learn how to appropriately discuss such difficult matters without doing so in person. It’s long been held that face-to-face meetings are best when discussing diagnoses for any serious ailment with a patient, but that mindset may be changing with the times.
“We are now including additional training for first-year medical students to talk about situations and techniques for breaking bad news over the phone,” says Dr. Natalie Long, an assistant professor of clinical family and community medicine at the school, who believes mobile devices have altered the approach to medicine. “The digital age has changed our perception of how we want to get news. I think younger patients just want to know news faster.”
Long says doctors should now discuss with patients beforehand their preferred method for learning test results. Physicians should also make sure the patient is first in a good place to talk before moving forward, show natural empathy, and check in to ensure the patient has a strong support system to lean on after hanging up. Follow-up plans should also be set immediately, as well, suggests Long.
“Anytime you break bad news, patients only hear a fraction of what you tell them,” says Long. “So, that’s where the follow up is really important.”
The full study was published August 7, 2018 in the journal Supportive Care In Cancer.