Get With the PROGRAM: A Guide to Compassionate Communication

Excerpt from article published in The Journal of American Osteopathic Association (JAOA)

Despite growing interest in the importance of compassionate communication and patient experience, many physicians still feel unprepared when faced with delivering bad medical news. To address this need, few methods have been developed to offer physicians a structure for these conversations, with the goal of making the dialogues less traumatic for patients and families and less stressful for physicians. The objective of this article is to provide a systemic approach to structuring difficult dialogues with patients and their families.

  • J Am Osteopath Assoc. 2018;118(10):679-684

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Patients are not looking for a walking, talking search engine; they are looking for sensitivity to their physical, psychosocial, and emotional needs. The “tuned in” physician, who is able to effectively communicate with compassion, is better able to foster relationships with patients he or she encounters.

Effective compassionate communication involves listening to the patient, expressing empathy, explaining what is happening in terms the patient can understand, allowing time for the patient to absorb the diagnosis, and engaging the patient in treatment decisions.  For example, when formulating a treatment plan, the physician must first ascertain whether a patient has insurance, and, if so, what his or her plan will cover. If this important element is ignored, the patient may be unable to adhere to the plan, whether he or she wants to or not.

Although the healthcare industry recognizes the essential nature of patient-centered compassionate communication, patients still often report that their emotional needs are unmet. This is not a complete surprise considering the brief and inadequate training that most physicians are provided in this skill. Communication techniques are addressed early in residency, but several studies suggest that empathy declines as residency progresses.

Communication skills can have a positive effect on how physicians express compassion as they communicate with patients and their families. In the present article, I describe the PROGRAM method of compassionate communication, a technique to help physicians relay tragic news to patients and families and form relationships through effective and compassionate communication.

The PROGRAM method helps physicians both break bad news gently and provide necessary support to people undergoing life-changing events.

Click here to request download of Dr. Orsini’s full JAOA article

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