By Kathleen Berger

The digital age is changing the way doctors break bad news to patients, breast cancer patients included. A recent study at the University of Missouri School of Medicine shows fewer breast cancer patients are getting the news in person, finding out over the phone instead at an increasing rate.

Breast cancer patients undergo a series of tests and procedures before receiving the phone diagnosis, making the process particularly challenging and scary for them. It all starts with a mammogram, then an ultrasound and finally a biopsy.

Natalie Long, MD, assistant professor of clinical family and community medicine at the MU School of Medicine admitted it’s ideal for doctors to break the bad news face-to-face.

“You’re able to look at someone, you’re able to see how are they reacting to the news, and change how you’re delivering things based on that,” said Long.

But more frequently patients and doctors are opting for a phone call instead.

Researchers at the MU School of Medicine surveyed nearly 2,900 breast cancer patients.In 2000, about a quarter of patients learned abouttheir diagnosis over the telephone.By 2005, 50 percent received the news that way.And in 2015, the number climbed to more than 65percent.

“I could speculate that part of it is the digital age. I think that these days, people are more interested, more connected, more used to getting information more instantaneously. And so that transcends to health care,”said Jane McElroy, PhD, professor of family and community medicine at the MU School of Medicine and lead author of the study.

The study has prompted professors at the School of Medicine to change the way they teach future physicians by preparing them to have tough conversations over the phone. They have developed new training methods to better prepare future physicians.

“You still need to really check in and make sure that you’re addressing emotions, being empathetic, listening, and then setting a follow-up appointment to talk about it in person is really critical,” Long said.

“This patient-centered approach to notification shows we are leading the next generation of physicians,” McElroy said. “When we looked at how other hospitals are confronting this dilemma, we realized we’re on the forefront of this discussion by training our medical students before they have to deliver difficult diagnoses as physicians.”

The study also found that among patients who heard the news in person, about 40 percent were alone at the appointment.