Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

How to Support Patients Facing an Upsetting Diagnosis


In medicine, we often inform patients of new diagnoses that are life-altering—sometimes overwhelmingly so. At these times, we must show empathy and check-in frequently with them.

Recently, I had to tell a patient that her CT scan was suggestive of metastatic cancer. I’d been worried about the potential for cancer but had tried to keep the patient optimistic. When I shared the upsetting news, I listened and offered all I could to help.


Because I also take care of the patient’s spouse, I had a separate conversation to convey my sorrow, my immediate support, and ongoing availability. This was a Friday and I knew there would be no more updates until Monday. It was going to be a long weekend for them both.


When a patient hears disappointing news, it often becomes the sole focus of their attention and energy. It may be all or almost all they think about for hours, days, or even longer. Imagine a new cancer diagnosis and how the patient needs to process this, share news with loved ones, and reconsider all they had previously thought about the projected course of their life. This can be completely overwhelming and consuming. Also consider the clinician, who gives as much empathy and compassion as possible, but must move on to address the multitude of other professional duties in their day.


This is an emotional engagement mismatch. Here’s what we can do to help bridge the gap:


1. Recognize the gap exists.

Put yourself in the shoes of the patient and imagine how you would be managing the news.


2. Acknowledge the impact of the bad news with empathetic statements about the likelihood of this being consuming and frightening.


3. Give frequent brief check-ins.

Text, call, or communicate through your electronic portal to let patients know you’re thinking of them. This simple act  gives them the sense that you’re as invested as they are in their illness.


4. Schedule regular formal meetings to address the medical issues and any questions and worries the patient has.




This piece expresses the views solely of the author. It does not represent the views of any organization, including Johns Hopkins Medicine.