Starting back in medical school, oncologist Anthony Back observed a disconnect between the way doctors talked to terminal patients about next steps, and the way doctors talked to each other. He worried that patients weren't receiving news about the need to transition to end-of-life care in a way they could process and understand. So he conducted a study: he filmed several of these talks between doctors and their patients. Then he showed the videos to another group of patients with terminal diagnoses, and caregivers whose family members had recently passed, and asked them to critique the conversations.
Back's conclusion: the doctor must convey to ideas: that the patient is in a ‘new place’ that must be dealt with, and that the opportunity exists to enjoy the time he or she has left.
Sound Medicine host Barbara Lewis recently spoke with Dr. Back about his findings.
You can find an abstract of his paper, "Reframing the Goals of Care conversation: 'We're in a Different Place'" here. Dr. Back also published a paper about coping with clinicians' sense of hopelessness in the face of suffering, which can be found here. Anthony Back is an oncologist specializing in gastrointestinal cancers at the Seattle Cancer Care Alliance and the University of Washington.