Discussion With Patients
Often physicians must communicate information to patients with low vision that patients will perceive as “bad news,” such as that they are not able to drive or that vision will not improve. Communication techniques have been conceptualized in different communication models (Fig 9-14); however, keys to delivering bad news include allowing sufficient time for the discussion, acknowledging patient emotions and conveying that the physician appreciates that the emotions are connected to the negative news. A helpful resource is the free Guide to Assessing and Counseling Older Drivers, which includes a chapter about counseling patients who can no longer drive.
Figure 9-14 Communication models. A, The SPIKES Healthcare Model of Communication was authored by Robert Buchman. B, The Four-E Model of Health Care Communication was developed by the Institute for Healthcare Communication.
(Part B from Buchman R. Breaking bad news: the SPIKES strategy. Community Oncology. 2005;Mr:138–142.)
American Geriatrics Society. Pomidor A, ed. Clinician’s Guide to Assessing and Counseling Older Drivers. 3rd ed. (Report No. DOT HS 812 228). Washington, DC: National Highway Traffic Safety Administration; 2016.
Excerpted from BCSC 2020-2021 series : Section 3 - Clinical Optics. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.