By Vicki Rackner, M.D.

Betty said, “I’ve been so busy taking care of my parents that I put off my own yearly mammogram.  A little voice inside me told me that I needed to get it done.  When I finally went to the doctor, the radiologist saw a cluster of calcium spots and recommended a biopsy.  I had it done today.  Now starts the hard part.  Waiting.  I have an appointment with the surgeon next week.  I have a bad feeling about this whole thing.  If this news is what I expect it to be, I doubt I’ll hear anything except the dreaded diagnosis…the big C.  I wish my doctor would just tell me the news over the phone.  Then I could have my good cry, and be more prepared to listen when I go to the appointment.”

In my own experience as a surgeon, I’ve found that bad news about health is occasionally not a surprise. Many patients have an idea about changes in their bodies. They seem to intuitively know whether the chances are potentially dangerous or just a mild annoyance.  And they are often right.

Still, it’s always hard to hear bad news.

Preparing for the News—Good or Bad

Delivering bad news is hard for doctors, too.  Communicating with your doctor at the time of a checkup makes it easier for the doctor to know how to communicate test results later on. Tell your doctor the best way for him or her to tell you any news. Would you prefer the doctor to tell you in person?  By phone?  Would you prefer the receptionist tell you the news? You know yourself well enough to know what works best for you.  When you tell your doctor, you can help your doctor help you.

Yet, very few patients really speak up with questions such as “When will the results be back?” or with requests like this: “Could you please tell me the test results over the phone?”  They’re not sure whether it’s within their rights to speak up for themselves in this way.

When you see the doctor, it’s reasonable to expect the same courtesy you get at most restaurants. Just as you know how long the wait will be before you’re seated at a restaurant, you have the right to know how long you will wait before the lab results are back.  The hungrier you are the longer the wait time seems.  Or as they say, the definition of “just a minute” depends on what side of the bathroom door you’re standing.  You’re hungry for the results from your doctor. 

Waiting for Test Results

Some lab results are available in a day or two. Some special tests require more time.  However, if your doctor tells you it will be a week or so before the results are back, you can respond:  “Really!  Could I possibly get the results sooner?” It never hurts to ask, and it is okay to press your doctor.  After all, it’s your waiting time. Imagine how much better you would feel if your wait time were cut down.  Sometimes doctors are busy and may not realize how important decreasing that wait time can be.

Donna said, “I can deal with bad news.  It’s the uncertainty…the waiting that’s so hard for me.”  Make a plan that will make the wait easier.  Maybe you need to read everything you can about the disease you fear.  Maybe you need to write down all of your fears  This might be a good time to do the things we all know we “should” do but may not get around to, like prepare a will or discuss “advanced directives” or the medical choices you would want made if you are not in a position to decide for yourself. Talk about end-of-life care with your family.  If relatives say, “Mom, you’re not going to die. The biopsy will be fine.” Say “I hope it is fine. The best time to make these decisions and to plan is when we are healthy. I’m just using this biopsy as an excuse to do something I should have done long ago.”

When the Results Come Back

When your test results come back, you may have an emotional response, regardless of the news.  That’s why it is important to discuss with your doctor beforehand how you want to hear the news. When you receive good or bad news in an environment that is comfortable for you, it makes accepting the news a bit easier.

Your doctor may be ready to forge ahead with plans for treatment (perhaps before you are ready). After you get your test results, whatever the result, make an appointment to sit down with your doctor and discuss the next steps. If you hear the results during an in-person doctor visit, make sure your doctor spends as much time with you as YOU need.

Your doctor and other members of your health care team are there to serve you.  When you have ideas about what makes it easier for you to be an involved patient, and then communicate this to your doctor, you and your doctor and other members of the health care team will all benefit.