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Doctor Delivers Bad News Via Video

Discussion in 'Health & Wellness' started by Rihana, Mar 12, 2019.

  1. Mar 12, 2019 #1
    Rihana

    Rihana Moderator Staff Member IL Hall of Fame

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    Doctor delivers end-of-life news via 'robot,' leaving family frustrated



    It is all over the news. The man's family calls it a robot delivering the news. It was a live doctor delivering it via video that was on top of a machine that was wheeled in.

    A quote from the link above:
    "The evening video tele-visit was a follow-up to earlier physician visits," Gaskill-Hames said in a written response. "It did not replace previous conversations with patient and family members and was not used in the delivery of the initial diagnosis."

    There is outrage in reader comments online, most feel sorry for the man and his grand-daughter having to hear the doctor talk through a video, and blasting the hospital for not having a doctor deliver the news in person.

    What do you think?
    .
     
    Last edited: Mar 12, 2019
    Rihana, Mar 12, 2019
    Rihana, Mar 12, 2019
    #1
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  2. Mar 12, 2019 #2
    Rihana

    Rihana Moderator Staff Member IL Hall of Fame

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    After feeling the initial outrage for the family, I read some more and reflected on what happened.

    The family already knew the diagnosis. There had been previous conversations between doctor and patient, family members, and they knew the reality. Ideally, such news should be delivered by a doctor in person, and with the required family members present, but, that could take more time. That would leave the family and the patient with lesser time to decide, say good-bye's, etc.

    Calling it a robot is very inaccurate. The doctor did his best. He repeated himself, waited many times for response.

    Maybe, patients can be offered a choice -- do they prefer to talk with doctor only in-person and do not wish to talk via video, even if that means a delay or reduction of doctor time with patient.

    I do think the hospital could have done it better. The nurse standing quietly behind the machine could have done more. The oxygen machine's noise making the video hard to hear is also not good management. But overall, saying that such news should never be delivered by video is not practical. Maybe a patient would prefer to take more morphine earlier and not wait for the doctor's in-person rounds to get that option?
     
    Rihana, Mar 12, 2019
    Rihana, Mar 12, 2019
    #2
  3. Mar 13, 2019 #3
    GeetaKashyap

    GeetaKashyap IL Hall of Fame

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    I belong to the old school.

    Death is a very sensitive subject and even in the face of it, it is still difficult to accept for the patient or the relatives in most cases. I knew an old cancer patient whose death was imminent, still against all hopes he willed to get better and return to his village and die there. But a day before his death, his oncologist spoke openly about his imminent death to him and then on till his death a day later, this old man was extremely depressed and he died leaving the entire family raging against the insensitive doctor. But for the doctors, it is a routine and many times, they end up coming across as insensitive. Recently I asked my niece who would be completing her MD next year on the emotional aspect and her reply was, 'we don't involve emotionally and we in fact, do not feel anything seeing blood, major injuries, bodily fluids, death or even preserved cadavers. To us it is knowledge and profession. But...we should develop more bedside manners while dealing with the patients for their better healing. The famous 'Doctor's touch' still matters.'

    I am not sure if the grand-daughter was the principle authority to be spoken to. Irrespective of whether the communication had been done in the past or not, personal interaction (away from the patient) would have been more appropriate.
     
    Last edited: Mar 13, 2019
    GeetaKashyap, Mar 13, 2019
    GeetaKashyap, Mar 13, 2019
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    Rihana, Gauri03, shyamala1234 and 1 other person like this.
  4. Mar 13, 2019 #4
    Gauri03

    Gauri03 Moderator Staff Member IL Hall of Fame

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    I agree with Geeta here. From the little I read the family was waiting on a last minute hail Mary, and the doctor informed the grandpa that they couldn't find viable lung tissue so the procedure was not an option, which essentially meant it was over. I don't doubt the doctor was sensitive and followed protocol but having a TV screen tell you that you are waiting for death must have been disorienting at the very least. No matter how empathetic the human on the other side is, a video feed by its very nature is cold and detached. The doctor should have handled this in person.
     
    Gauri03, Mar 13, 2019
    Gauri03, Mar 13, 2019
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    GeetaKashyap and Rihana like this.
  5. Mar 13, 2019 #5
    Rihana

    Rihana Moderator Staff Member IL Hall of Fame

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    Yeah rewatching the video, at one point, the patient asks a question. Very sad that he is asking it to a machine effectively.

    I wish they had had a local doctor (need not be a specialist) be there in person when the specialist was delivering the news via video. The specialist could be the one to say the diagnosis,then the local doctor talks about it with the patient.

    A compassionate combination of technology and in-person touch is needed.

    It was also odd that the patient and his grand-daughter were not expecting an update. For such patients, a little planning is needed so that important family members can be there. His wife and daughter will forever feel bad that they chose that time to go home to take a shower or break. The video doctor is asking the patient to effectively decide about morphine, and consider the side-effects of the morphine, treatment vs comfort choice, without having his wife next to him. Not well managed.
     
    Rihana, Mar 13, 2019
    Rihana, Mar 13, 2019
    #5
    GeetaKashyap likes this.
  6. Jul 25, 2019 #6
    Neha2210

    Neha2210 New IL'ite

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    It’s ok doctors are not very compassionate
     
    Neha2210, Jul 25, 2019
    Neha2210, Jul 25, 2019
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