To the Editor.
—The article by Dr Ptacek and Ms Eberhardt1 provides a useful and overdue summary of breaking bad news to patients. As the authors mention, physicians may offer hope and assuage one common fear of patients by indicating to them that pain and distressing symptoms can be effectively managed. From the perspective of a primary care physician, another often unspoken fear that patients may harbor is abandonment by their support systems, including their primary care physician. In some situations, the trust, understanding, communication, and guidance offered by and through this continuing relationship, although frequently unreimbursed and often ignored, may be more important than surgery or chemotherapy to the patient's comfort and sense of wellbeing.In breaking bad news, I would suggest adding a few simple sentences, acknowledging that there will be difficulties and challenges, that the patient and physician will face them together, and that the physician will maintain
Fox GN. Delivering Bad News. JAMA. 1996;276(22):1801–1802. doi:10.1001/jama.1996.03540220025018
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