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Good News or Bad: Tell the Truth


It's important for doctors, who must balance life and death health decisions every day, to occasionally be direct and frank with patients.

“If you tell the truth, you don't have to remember anything."

—Mark Twain

While waiting in a doctor’s office the other day, I read a JAMA article about the newfound difficulties of physicians giving “good news” to patients. (What with the novel wonders of cancer care along with technology, patients are longer resigned to death sentences.)

Wow, today’s doctor just can’t win! Well, good news or bad news, it’s always the doctor’s duty to deliver truths to patients, my physician-father told me.

My dad was the kind of guy who expected a lot of people, including his patients. Both personally and professionally, dad set high standards and he wasn’t afraid to show his disappointment if you let him down.

You’d never get away with calling my father “politically correct.” He was the most outspoken and direct person I ever met—attributes that probably made him a fine doctor. Although he was a keen listener, as far as his patient bedside manner skills were concerned, I’d call them stern but efficient.

He wasn’t harsh with people, but he didn’t sugarcoat things either. If you were a patient, and you didn’t take your meds—or lose weight or reduce smoking—as he ordered, you earned his wrath.

“Human beings don’t always listen to reason even when dealing with their own health,” dad told me. “And my goal as a healer was always to get patients to comply with a treatment plan and thus avoid a profound illness. For some patients, if repetition and kind words didn’t work, I wasn’t afraid to employ some harsher tactics. It usually worked for me and them.”

In today’s society, when everyone must be on constant guard about what they say, I think it’s important for doctors—who must balance life and death health decisions every day—to occasionally be direct and frank with patients. If that doesn’t fit into the now evolving definition of good beside manner, then so be it.

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