Six Tips on Delivering Bad News

Carrie Vaughan, for HealthLeaders Media, March 27, 2009

Nobody wants to be the bearer of bad news. It's difficult and uncomfortable. For senior leaders, it's also part of the job. During the past six months, CEOs in every industry have been forced to deliver unpopular messages—AIG's Edward Liddy is probably the most notable. In healthcare, the conversations have gone something like this:

  • CEO to staff members: "We have to lay off employees."
  • CEO to board members: "We can't access capital, volumes are down, and we're losing money."
  • CEO to community members: "We are cutting services."
  • CEO to physicians: "The hospital can't afford that new CT scanner or MRI that we promised."

Terry Peeples, CEO of Jennie Stuart Medical Center in Hopkinsville, KY, says discussing potential layoffs is probably the most difficult conversation for him because it's so personal. "It hits so many people that you have worked with and depended on to provide your service," he says.

The conversations will never be easy. But there are ways to communicate bad news in a manner that minimizes fallout. Here's some advice that I think is worth passing along.

1. Be direct. Don't delay the message or sugar coat the situation. Employees at St. Tammany Parish Hospital in Covington, LA, know when senior leaders are "beating around the bush," says President and CEO Patti Ellish. "Straightforward conversations with sensitivity to the subject matter are the best approach." These messages should be simply and clearly stated in the first sentence, adds Daisy Wademan Dowling, in this Harvard Business Review blog entry.

2. Be honest. Explain why the decision was made. For board and medical staff discussions concerning quality or equipment purchases, leaders should have a plan that describes how the management team is working to resolve the issues and when improvements or equipment purchases can be expected, Peeples says.

3. Be prepared. Senior executives should heed the Scout motto. It's been around for 100 years and for good reason. Anticipating all of the potential reactions to the news and what questions people may ask will help leaders be consistent in their message and provide relevant information.

4. Remain calm. It's important for leaders to exert calmness, says John Baldoni in this blog entry on how Liddy successfully delivered an unpopular message in front of an unfriendly crowd. "If a leader comes unglued, it gives opponents ammunition to attack and supporters no reason to follow," he says.

5. Apologize when appropriate. Apologies can help diffuse controversial situations. Own up to mistakes the organization made that may have contributed to the current situation. But make sure the apology is heartfelt, experts say. Otherwise it will only make matters worse.

6. Befriend the media. Having a good relationship with the media helps when delivering bad news to the community about cutting services, Peeples says. By working together, the information can be conveyed in a more positive light.

Senior leaders who flub these conversations by delaying them too long or doling out pieces of information without a clear plan on how to resolve the challenges can splinter the organization and create an environment of mistrust. Difficult conversations are an opportunity to be inclusive and bring the organization closer together.

Carrie Vaughan is leadership editor with HealthLeaders magazine. She can be reached at
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