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Better Words to Say

Steven Z. Pantilat, MD

JAMA. 2009;301(12):1279-1281.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Words matter. What clinicians say and how they say it hugely affect patients.^1-3 Communicating about emotionally and medically complex topics such as advance care planning, preferences for care, prognosis, and death and dying is challenging. Doing so requires clinicians to attend to their own and the patient's cognitive reactions, tone, affect, and nonverbal cues.^4-6 Communicating goals of care is so important that in California it is now the law.⁷ Although poor communication may harm patients by leading to unwanted invasive procedures, generating unnecessary anxiety, or creating feelings of abandonment, good communication can improve outcomes for patients and their families by promoting shared decision making and addressing patient concerns.^1-2,8

A recent study described a novel communication model and a process through which it could be adopted by clinicians.⁹ The 4 parts of this model include seeing communication as a process that unfolds over many conversations, taking a . . . [Full Text of this Article]

"There Is Nothing More to Do"

Author Affiliations: Palliative Care Program, Division of Hospital Medicine, Department of Medicine, University of California, San Francisco.

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