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As a cardiac electrophysiologist, I have had to discuss bad news with patients and families more times than I would like during my career.  How a physician goes about this process can make an enormous impact in the lives of those affected by the news that must be delivered.

Precious little time is devoted to teaching this essential communication skill in the training of physicians today.  I can remember back to the early days of my internship at the University of Virginia when I had my first patient death.  I had been a “real doctor” for less than a week.  I was caring for a gentleman in the CCU who had suffered an anterior MI and was in cardiogenic shock.  He was on multiple pressors and his BP remained dangerously low.  He had lots of tubes and lines and was supported by an intra-aortic balloon pump.

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