Monday, January 09, 2012

How do YOU deliver bad news?

In my technical writing class, we’ve been talking about writing “bad news” letters, but maybe I should be talking about “bad news” phone calls, too. A good friend of mine got a call from her doctor’s office a few days ago that went something like this:
Not the Doctor: I'm calling to let you know that your mammogram showed a nodule on your left breast and you need to have another mammogram.
My Friend:
A nodule?
Not the Doctor: Yes, and this is a courtesy call to let you know the mammogram center will be calling to set up another appointment.
My friend: When will they call?
Not the Doctor: I don’t know.
My friend: Can I call and make the appointment myself?
Not the Doctor: No, they’ll have to decide if you need to go to a different location.
How Many Ways Can You Cause Someone to Panic?By the time she replayed the conversation to me, she’d already Googled “nodule” and learned that in 85% of cases, the nodule is benign, and when I Googled it, the first link I clicked said: “Although fewer than 20% of breast nodules are malignant, the signs and symptoms of breast cancer aren't easily distinguished from those of benign breast disease.”

But, let’s break it down: The caller relayed no information about the usualness of the return to the mammogram office, no time frame for setting up the next appointment, no sense of whether a second look was “urgent” or “usual.” All of these points can cause panic. The most egregious, though, has to be the time frame. Without knowing when the next step happens, the worry stretches forward endlessly, and begins to feel very heavy.

Now, when we women get our first mammograms, as my friend had done a few days ago, we are told that we might have to return because the baseline mammogram needs to be done carefully, and any shadows or irregularities need further exploration. All of our breasts are irregular, so radiologists further explore many of them. So, she expected that she might get a phone call, but not this kind of call.

This called implied something hideous could be lurking in her left breast. And that she must go to the Office for Examination of Hideous Things to find out what it is. Yet, she couldn’t make an appointment at the Office of Hideous Things because she didn’t know the secret location or phone number.

We decided this phone call was not acceptable at 3:00 on a Monday afternoon, so she called back. And got the answering service. She called the baseline mammogram office anyway and got a recording.
She had to wait. And while she waited, we talked about how this should have gone down, this bad news phone call.

What Should Have Happened
First, the caller needed to relay the information (as she did), but also offer some information about nodules. If she is not qualified to give that information (i.e., she’s a receptionist), she needed to offer to fax/email/mail a doctor-approved article or hand-out written in plain English to my friend.

Second, some kind of communication had occurred between the mammogram office and the doctor’s office, so they should have set up an appointment ASAP for my friend. That’s what women want—the second appointment as soon as possible. If the appointment conflicted with something more important for my friend, she could call and reschedule. I’m betting few people would reschedule.

It’s true that we shouldn’t let the Internet inform our knowledge about specialized things, but we do. We try to fix our own appliances, our own computers, our own cars. We use DIY tips constantly. We listen to stories of success and failure and we take them to heart. The problem is that a lot of stories are exaggerated. Or wrong.

When the mammogram office finally called the next day, the caller delivered the news with a much better tone. They reassured my friend that women often come back for a second mammogram (as she had been warned) and that the mammogram would be looked at carefully by a specialist while she’s there, and the caller repeated that this happens a lot. That last little bit is important information and implies normalcy in our irregular breasts. My friend asked questions and received lots of reassurance. In addition, because the worry doesn’t completely go away, a time frame is in place. The worry doesn’t hang endlessly over her.

Create Your Own Plan for Delivering Bad News
If you have a business that requires delivering bad news, think about the person you are calling:
  • Be truthful about the bad news.
  • Explain the severity of the news: rather standard, needs further attention, or whether it’s dire and urgent. Not the Doctor, could have said, “This finding is very common, and it means you need to have another mammogram with a radiologist present to make sure she understands what she’s seeing. Your file isn’t marked urgent and we have no indicators that you should be worried.”
  • Be able to answer questions or have information ready that can be given to the person. For example: “Your house is filled with termites. I’m faxing you some information about termite damage, and I believe your house has the kind of damage explained on page 4.” Or, Not the Doctor, could have said, “Your doctor asked that I send you some information about nodules and the next step in the mammogram process. Would you like that information faxed, emailed, or mailed to you?”
  • Last, have ready a plan for moving forward. Instructing someone to wait for a phone call “sometime” is not a plan. This last step makes the difference between keeping a client and losing a client. A better response from Not the Doctor would have been: “We set up an appointment for you. If you can’t make this appointment, you can call to reschedule.”
It’s All About Care and Reassurance
We all respond better to a situation if someone is on our side. Having someone take a step for you (make a phone call, offer information, provide reassurance) is nice.
My friend doesn’t panic. She needs information and logic and to understand what’s going on. Delivering bad news in a way that shows your client that you understand their concerns and worries shows that you provide excellent service.

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