Receiving bad news

As doctors we sometimes dread breaking bad news.  There are even courses you can go on to learn how to do it. 

Receiving bad news is much worse!  The usual sequence of bereavement reaction is felt, i.e. denial, anger, acceptance etc.  This remains true when the ‘bad news’ is personal criticism.  I felt this when reading the Medical Director’s response  (p36) to ‘Can Gerry Robinson fix the NHS?’  It came across as defensive and was written, I guess, when emotions were still raw and the bereavement process had just begun.  Denial and anger were very evident. 

I see such responses throughout the NHS.  More time and energy is spent defending, managing and rubbishing criticism than is spent addressing the issues.  I have met people whose entire working day seems to be managing how they appear to be doing something useful rather than doing it!  They must live with a constant fear of being found out.  Awful. 

Of course, TV programmes are entertainment but the central message of Gerry Robinson is true.  The challenge is how to respond positively when the circus has left town and the dust has settled.  In management speak, this is often described as ‘embedding’ a change.  It is pretty easy to initiate a change and maintain it for a few weeks whilst resources are heavily directed on it but, like holding a hard-won military objective, it’s incredibly difficult to make the change permanent. 

Doctors are particularly skilled at playing the long game, i.e. going along with an imposed change for a time, whilst knowing all along that they will revert to the status quo when the ‘managers’ have lost interest.  Everyone else knows it too. 

In later posts, I’ll suggest ways to ’embed’ change.



One thought on “Receiving bad news

  1. Consultants who are currently attending the ‘Communications Dynamics’ course are looking at how they can infuence change at the sharp end, Gerry Robinson style. I’ll keep you posted.

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