Navigating Difficult Conversations with Patients and Families

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Dr. Joshua Schwarzbaum is our guest on the Healthcare Experience Matters podcast this week, discussing the important topic of delivering difficult news to patients and loved ones. As a board-certified emergency medicine physician at SBH Health System in the Bronx, Dr. Schwarzbaum brings extensive experience in engaging in challenging conversations with patients and their families.

Drawing from his work in New York City’s emergency rooms, Dr. Schwarzbaum shares his expertise and insights during this crucial conversation. He is also the founder of Healthy Inside, a website that aims to help individuals find wellness and positivity in the face of life’s challenges. You can learn more about the website here:

To listen to Dr. Schwarzbaum’s first podcast on the “Code Breathe” initiative, you can visit:

Dr. Schwarzbaum emphasizes the importance of looking within ourselves and identifying our own needs when delivering difficult news. This introspection enables us to empathize with others and provide them with the necessary support. By tapping into a healing presence within ourselves, we can ensure that the person receiving the news feels heard, understood, and cared for.

Reflecting on his journey, Dr. Schwarzbaum highlights the fundamental human need for acceptance, love, and care. He acknowledges the unpredictable nature of delivering bad news and stresses the significance of tailoring the conversation to address everyone’s unique emotional state.

“As much as you want to try to make sense of things, we can’t always do it. We can try to, but it often leads us at a loss,” he said.

“How do we as physicians, get in touch with that within ourselves, within that presence, in that place that can automatically provide that healing and the compassion to someone else who we care about?”

With empathy, Dr. Schwarzbaum underscores the transformative power of being present and compassionate in these challenging moments. Through effective and careful communication, he has witnessed the profound impact it can have on patients and their families. Active listening and asking the right questions are also essential in understanding patients’ concerns.

While experience is important, Dr. Schwarzbaum encourages practitioners to engage in introspection and explore their own emotional landscapes to build confidence in managing difficult conversations.

By cultivating resilience and embracing continuous learning, healthcare professionals can approach even the toughest conversations with greater confidence and sensitivity.

Dr. Schwarzbaum uses the analogy of not being able to give someone money if we don’t have any ourselves. Similarly, when delivering difficult news, we must first find inner calmness and clarity before approaching the situation with an open heart.

Although medicine often relies on algorithms and evidence-based approaches, there may not always be a clear-cut algorithm to follow in delivering difficult news. Failing to do so effectively can have various negative consequences.

Patients may be left with unanswered questions, leading to lingering doubts, increased emotional distress, and potential lawsuits. Lacking trust in the healthcare provider, they might seek multiple opinions, resulting in additional healthcare costs. Moreover, patients may feel a sense of unease or dissatisfaction if they do not feel cared for, heard, or understood during the interaction.

As healthcare professionals, it is crucial to acknowledge that individuals come to us seeking healing, and we have the responsibility to prepare ourselves to deliver bad news with sensitivity and empathy.

As he points out, this is a task that requires introspection, compassion, and a willingness to look within ourselves and find that place of understanding. Ultimately, recognizing that everyone is doing their best in their given circumstances allows us to approach challenging interactions with patience and empathy.

Dr. Schwarzbaum’s wisdom and practical guidance provide valuable insights for healthcare providers seeking to navigate the delicate art of delivering difficult news with compassion, empathy, and understanding.

We are incredibly thankful for his time and insights.

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