For patient you probably won’t see again, because they are dying, consider saying something to acknowledge the situation. It can be unexpectedly rewarding. Adapted from our paper in Annals.
1. Choose an appropriate time & place
What you say or do:
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This is an internal step—you might notice that you feel irritation, anger, boredom; or you might notice body language like eye rolling or a sideways glance.
You can ignore conflict, but you run the risk that it will reemerge later.
2. Acknowledge the end of your routine contact
What you say or do:
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“Let’s make an appointment in 2 weeks, but if it is too hard to come to clinic, give us a call.”
3. Invite the patient to respond
What you say or do:
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“How does that sound?”
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This gives the patient a chance to weigh in, and enables you to assess their frame of mind.
4. Frame your goodbye as an appreciation
What you say or do:
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“If I don’t happen to see you in person again, I want to make sure that you know I’ve enjoyed working with you. I’ve admired your spirit.”
Or
- “I’ll miss not seeing you in clinic, and hearing about your life.”
5. Allow space for the patient to reciprocate, and respond empathically
What you say or do:
-
If the patient thanks you, be sure to say “You’re welcome.” Don’t say it was nothing—that could inadvertently diminish the work you have both done.
-
“I realize this might seem awkward, but I wanted to make sure you knew how I felt.”
6. Articulate your commitment to the patient’s ongoing care
What you say or do:
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“Of course I am still available by phone.”
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“Your hospice nurse will be keeping me in the loop.”
7. Take a moment to reflect
What you say or do:
- Some clinicians think of this as a gratitude practice—where you stop to take in something that you appreciate.