how to break bad news and have hard convos

without wanting to shrivel up and disappear

EXTRA EXTRA READ ALL ABOUT IT:

this week’s convo with Dr. Rachel Ward

This week I had the pleasure of chatting with Dr. Rachel Ward, one of the friends I made from The Making Of Retreat - as a dentist, practice owner, runner, wife & mom, she had so many nuggets of wisdom to share about:

  • Breaking bad news to patients 

  • Having difficult conversations like telling someone they are not healthy

  • Unresolved cases that haunt us

  • Saying I don’t know tactfully

  • Creating patient loyalty when you’re the new kid on the block

These are 3 nuggets that stood out from our conversation:

Ben Affleck is us, we are Ben Affleck.

1. How to tackle that conversation we all dread:

“I’m fine, there’s nothing wrong with me” - as you stare at clinical, radiographic, and diagnostic signs that someone is indeed not fine and needs treatment.

It’s always uncomfortable feeling like you have to be the bearer of bad news when clearly someone’s expectations are not aligning with reality. They’re expecting to come in for a routine check up, and now you have to hand them a hefty $$$$ plan.

This is where our questions are important guides, because they help us understand what motivates someone, what they’re able to participate in, and where we can go from here.

Dr. Rachel Ward shares one of her favorite ways to approach these hard convos:

“do I have permission to be honest with you?”

I love this question because it brings up an important truth: our job is to be honest and tell people the things they don’t want to hear.

We know that, and deep down our patients know that too. But sometimes that gets lost in translation - this phrase signals yes, I just went from taking about your weekend plans and the weather to dropping this info bomb. It takes the “personal-ness” out of what we’re about to say - we’re not judging you or shaming you, but we’re being honest.

Another phrase I love is something my boss, Dr. Markowitz has taught me:

“has anyone told you this before?”

this is great because it opens up a conversation, either:

  • yes, they have heard this before and you can feel less of that burden of being the bad guy, and use previous conversations as back up for what you’re about to say

  • Or, they haven’t heard this before - and usually say “no, why?”. Now they’re curious, interested, and you can have the important conversation.

me n u

2. How to address an angry patient

I have Dr. Rachel break down, case style, a situation I had with an angry patient that I could have handled better (check out the first few minutes of the episode to hear the tea)! We breakdown the concept of:

THE ANGRY BOAT: in customer service, there is this idea that there is only room for 1 angry person in the boat, so when someone is angry you have to get in the angry boat with them & be angrier 

…and why I really struggle with this lol. Whoever created this was definitely a straight male.

But hear me out, I do think there’s something there. I’ve noticed it’s easy for me to show the positive, happy emotions - especially as women we’ve been conditioned to be non confrontational, not show “too much” or be too emotional. And so when it comes to showing anger or disappointment, I struggle with that vulnerability.

How does this relate to patient care? Inevitably when things go wrong, we need to help patients feel heard and show empathy - and sometimes that involves being able to be articulate that we’re with them, we feel angry or upset for them too.

Whether you believe this tactic or not, I think it’s good food for thought.

One thing we realized I could have done better is allowed certain parts of the conversation to flourish and certain parts to end quicker/be redirected. One way to do that was to ask better questions, like this one Dr. Rachel shares:

“What do I need to know about this to help you”

This would have given the patient space to immediately air out their grievances and help me understand promptly where the concern is coming from. People aren’t always clear with how they feel, we may assume they’re feeling pain when really it’s fear or worry, stressing about time off from work or coordinating with travel plans.

Another way to get straight to the source:

“What is your biggest concern with this”

Is it the cost? You won’t have to pay for this. Is it time off from work? We’ll rush the process for you.

This question could have saved us so much time and prevented the further heightening of conversation between the patient and I.

3. When you’re the new kid on the block, here’s how you make an entrance:

When Dr. Rachel started at 2 group practices, her schedule was slow and she knew she needed to establish herself with the patient pool.

For every new patient she met, she wrote a hand written letter saying it was nice to meet them, she hopes they have a great time with XYZ trip or family gathering (whatever was discussed) - something personal to show that she cared about the person she met and not just their teeth. 

This is an incredible tip that I will definitely be using, and it is such a simple way to show we care.

For more nuggets on patient communication and handling those cases that haunt us, check out this week’s podcast episode here! And now, onto the last segment of this newsletter: your BUZZY BITES, the pop culture news stories of the week to make small talk with - so you can talk to anyone about anything.

BUZZY BITES:

  1. Paris with the W: Winners at the Paris Olympics will receive medals made from pieces of the Eiffel Tower! An 18 gram chunk of iron taken from the Eiffel Tower has been split and embedded into the center of each gold, silver, and bronze medal. Read more here!

    Source: The Today Show

  2. PUCKER UP!: Rihanna announces Fenty beauty brand partnership with the Paris Olympics and Paralympics in a monumental collab! 600 volunteers of the Olympics are being gifted make up kits and tutorials on how to use these products to achieve their own special looks. Read more about this iconic partnership here!

    Source: Fenty Beauty

  3. APOCALYPSE READY: Costco is selling “Apocalypse Buckets” - buckets with 150 meals worth of preserved food that will last 25 years. The meals are freeze fried or dehydrated, and the bucket costs $79.99. Read more about the why and the how here!

    Source: COSTCO

Message me if this post resonated with you! That’s all for this week’s newsletter, tune into next week’s for more fun! Reply if you are dental, pharmacy, medical or anything else! Would love to hear from you!!

Thanks for reading - if you liked what you read please share this with a friend! See you next week,

xoxo, Connie