Clinical Competence

Communicating prognosis, the anticipated course of living with an illness, is a core clinical skill and a foundation of the patient-clinician relationship. Clinicians find such communication challenging. Concerns about professional helplessness when caring for a patient with a disease with a poor prognosis and the desire to avoid difficult patient and personal emotions can lead to an understandable reluctance to share difficult news with patients and families. Clinicians also struggle to find the right words to balance hope with concern when sharing difficult news.1 While receiving prognostic information is difficult for patients, not receiving prognostic information can create anxiety and may distance patients from their clinicians, who are often aware of the prognosis but do not share it with patients. Delaying or avoiding communication about prognosis also risks patients not having the information they need to make decisions and leads to missed opportunities to set and achieve goals that reflect what matters most to them..