Discussing prognosis with patients can be challenging. Often these discussions need to be initiated and reinitiated. After discussing prognosis with a patient, it is important to give patients structure and to let them know what are the next steps. It is often useful to explain when you will talk about the patient’s prognosis again and to offer to talk to the patient’s family members. It is also important to explain to patients who are not comfortable discussing their prognosis that the door is open and that you are willing to talk about prognosis if that information is important to the patient in the future.

Notice how the clinician in these examples does aspects of the following when discussing next steps:

1. Encourage patients to discuss prognosis with their families.
2. Offer to readdress prognosis at a future visit with the patient and/or family members.

• “Let’s plan on bringing your family in so we may discuss this again” or “I also think we should talk about this with your family”
• “If you ever do want to talk about it I will be happy to chat.”

1. Balaban RB. A physician’s guide to talking about end-of-life care. JGIM. 2000 Mar;15(3):195-200.
2. Back AL, Arnold RM. Discussing prognosis: “How much do you want to know?” Talking to patients who are prepared for explicit information. J Clin Onc. 2006 Sep 1;24(25):4209-13.