Breaking Bad News : Rabow and McPhee’s Model
Breaking bad news to patients or to their family members is one of the most difficult responsibilities in the practice of medicine. Although virtually all physicians in clinical practice encounter situations entailing bad news, medical school offers little formal training in how to discuss bad news with patients and their families.
Rabow and McPhee developed a practical and comprehensive model, synthesized from multiple sources, that uses the simple mnemonic ABCDE
A - Advance Preparation
B - Build a therapeutic relationship
C - Communicate well
D - Deal with patient and family reactions
E - Encourage and validate emotions
Despite the challenges involved in delivering bad news, physicians can find tremendous gratification in providing a therapeutic presence during a patient's time of greatest need.
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