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I find that literally sitting down with the patient and loved ones after scheduling or carving out a specific time to meet is the key as a first step for both inpatients and as much as you can for outpatients. If you feel rushed it won’t go well. Start by summarizing the situation: “as you know, you came in with pain and weight loss, and now we have our tests back...” then stop and see if the patient wants to say something like “yes I know what you are going to say” or else then proceed in plain language what the diagnosis is. Then make sure you follow up with what the plan is moving forward