Communicating a serious diagnosis is one of the most delicate moments in medicine. The words with which a patient learns of their illness can remain in their memory for years and influence the way they experience the diagnosis, build a relationship with the medical team, and go through treatment.
On the occasion of World Cancer Day, Dr Margarita Tareyn, clinical psychologist, psychotherapist and member of the team of the Institute of Medical Psychology, Psycho-Oncology and Psychosomatics, discussed the topic on the programme „Bulgaria in the Morning“.
„This is a key moment for the patient. When the doctor has been more insensitive, more abrupt, more direct – this leaves a heavy imprint on the patient, one that they cannot part with.“
Communicating a diagnosis is not reduced to conveying a medical fact. It is clinical communication, for which established principles and protocols exist, including the widely used SPIKES model. These draw attention to the conditions under which the conversation takes place, the patient's readiness to receive information, the clear and gradual communication of facts, the recognition of the emotional reaction, and the discussion of the next steps.
For the patient, this conversation often divides life into „before“ and „after“. In the first moments following a serious diagnosis, the ability to take in and remember a large amount of information may be limited by the strong emotional reaction. This is why the way the doctor is present in the conversation is just as important as the clarity of the medical information.
As Dr Tareyn emphasises:
„The patient is seeking hope and support and wants to feel engaged with the doctor.“
This does not mean downplaying the diagnosis or offering unrealistic hope. It means that the truth should be told clearly, but in a way that does not leave the person alone with it.
For the Institute, communication between doctor and patient is an essential part of quality medical care. Especially in serious and life-threatening illness, professionalism is expressed not only in what we know and how we treat, but also in the way we speak to the person about what lies ahead of them.