‘Telling bad news’: physicians and the disclosure of undesirable information

To address the issue of what physicians tell patients, and how they arrive at that decision, this report focuses on a single episode in breast cancer--the event of telling the patient for the first time that she has cancer. This is a participant-observation account of 118 events, framed from the physicians' perspective. It describes how the 17 surgeons at the Breast Cancer Clinic developed, organized and implemented their disclosure policies, and what strategies they utilized to routinize a task they defined as difficult and unpleasant.