Physicians who care for patients with life-threatening illnesses face daunting communication challenges. Patients and family members can react to difficult news with sadness, distress, anger, or denial. This book defines the specific communication tasks involved in talking with patients with life-threatening illnesses and their families. Topics include delivering bad news, transition to palliative care, discussing goals of advance-care planning and do-not-resuscitate orders, existential and spiritual issues, family conferences, medical futility, and other conflicts at the end of life. Drs. Anthony Back, Robert Arnold, and James Tulsky bring together empirical research as well as their own experience to provide a roadmap through difficult conversations about life-threatening issues. The book offers both a theoretical framework and practical conversational tools that the practicing physician and clinician can use to improve communication skills, increase satisfaction, and protect themselves from burnout.
1. Taking your skills to the next level; 2. Getting a good start; 3. Talking about serious news; 4. Making treatment decisions; 5. Discussing prognosis; 6. Between the big events; 7. Conducting a family conference; 8. Dealing with conflicts; 9. Transitions to end of life care; 10. Talking about dying; 11. Cultivating your skills.
Advance Praise for Mastering Communication: "Clear, concise, and brimming with useful advice, Mastering Communication With Seriously Ill Patients is one of those rare books that manages to be both eminently practical and thoroughly enjoyable. Written by three of the most important figures in the field of doctor-patient communication, this book is a must-read for clinicians who care not only for the seriously ill but for any patient." – Pauline Chen, author of Final Exam (Knopf) and "Doctor and Patient" columnist for the New York Times
"This is a superbly practical and helpful book. It is full of valuable and wise insights into some difficult conversations with clear analyses of the problems and realistic practical examples of how to solve them. I thoroughly recommend it." -- Robert Buckman MD, author of How to Break Bad News
“This book is a tour de force! It takes on the most difficult and profound aspects of being a doctor- but it's practical, concise, real -- you can tell it is written by practicing clinicians. I could not put it down and kept thinking about all the conversations I've had with patients and families that could have gone better. Doctors in training now- and all of us-- are lucky- we have this book.” – Diane Meier MD, Director of the Center to Advance Palliative Care, MacArthur Fellow
"A practical guide to essential skills for effective medical care, this book makes better lives for patients and for their doctors." – Christine Cassel MD, President, American Board of Internal Medicine
“This is a wonderful, short primer on the art and science of medical communication that should be required reading for any practicing physician, young or old. This book will likely not only make the reader a better doctor, but will also increase the satisfaction they derive from their practice.” – Frederick Appelbaum MD, Director of Clinical Research, Fred Hutchinson Cancer Research Center
“Medical students need to read [this book] as they begin their first encounters with patients and then they need to reread it as interns and residents when they find themselves in challenging clinical situations that have not gone well. Fellows in oncology, who are commonly confronted by these everyday conversations, can benefit from this supportive and informative text... The ten chapters have structured outlines and describe communication skills for a specific encounter, like talking about serious news or discussing evidence for making treatment decisions or for saying goodbye. Through case examples and analysis of patient encounters, the authors’ experience combined with available research data on how to communicate is described in a step by step format with techniques and practice parameters that can be readily integrated into one’s own daily practice… The authors are skilled clinicians who have worked to hone their own communication skills through educational programs, clinical expertise and research. They bring this accumulated knowledge and experience to this unique and formative text. In a clear, concise, straight forward style, they discuss the communication skills necessary to master the care of the seriously ill patient." – Kathleen Foley MD, Memorial Sloan-Kettering Cancer Center
"Although physicians are the intended audience, anyone in the helping professions who interacts with the seriously ill could benefit from this book....This useful step-by-step guide tailors the message of developing good communication to some of the most difficult conversations a physician will ever have." - Doody's Review Service