Why Did I Pick “It’s All in the Delivery”?

BBN teaching compassionate communication in healthcare

I've read a few blogs in my life and I must admit that I never really gave them much thought. Sure, some of them were interesting and usually well written. They always seemed to be, well frankly, just there. Until recently, I hadn't realized just how much thought and work it took to publish a quality blog that is worth people taking time out of their busy day to read.

I found myself trying to write an interesting blog about a topic that is my passion: compassionate communication in medicine. I wanted it to be informative but still interesting, a reference for physicians and patients to learn more about the art of compassionate communication in medicine.

The first hurdle was to think of a name. It had to be pertinent but also clever, a name that people would remember. There were so many suggestions and I had many great ideas that flew through my head while driving on the interstate; driving is when I do my best thinking. Yesterday, while coming home from a long shift the choice was obvious, "It's all in the delivery".

"Of course" I thought. Rarely does a week go by that I don't use this phrase. It's pertinent to so many situations. I use it when discussing a baby's condition with a parent, convincing one of my teenagers to spend time with the family or go to church and yes, even when persuading my wife that the shiny new sports car is worth the extra money.

A famous comedian was once asked why his jokes were always so funny. He answered, "It's all in the delivery." Nothing else could be more true when delivering sad or tragic news to patients and their families. How we say things is just as important as what we say. There is a right and a wrong way to deliver the news to a patient or family. Successful comedians and sales people know how they deliver a line can make all the difference. Doctors on the other hand, I don't mind saying, are often clueless about style. We are taught that substance and not style is important. All of us have heard someone say "I'd rather have a good doctor with a bad bedside manner than a bad doctor with a good bedside manner." I guess that's true, but somewhere down the line we need to ask why we can't have both.

I am not crazy enough to write my first blog equating a doctor giving tragic news to a comedian's joke or a salesman trying to sell a new car. But in medicine, more than any other profession, words matter. As physicians, how we say something is just as important as what we say. Studies have shown that the manner in which a physician delivers bad news can affect patients and families up to 30 years later. That's an incredible responsibility. And yet medical education fails to train us.

The good news is that effective and compassionate communication is not hard to learn. And so, I have dedicated this blog to discussing topics in effective and compassionate communication. If you are in healthcare, the topics we discuss will make you a better physician, nurse or healthcare worker. If you are not in medicine, the communication techniques you learn will still be useful. After all, who wouldn't want to learn to communicate better? Who knows, you may become a better salesman, the life of a party or even get that shiny new sports car you always wanted. For physicians and healthcare workers "It's all in the delivery" may be the difference between helping or hurting your patients when they need you the most. For others, it could be the difference between a new convertible or that practical minivan.

I hope that you will continue to read this blog. Together we can transform healthcare through better communication.

Anthony Orsini, D.O.
Neonatologist & Vice-Chairman, Winnie Palmer Hospital for Women and Babies in Orlando, FL
Founder & President, BBN

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