Published 5/28/2026
On a recent episode of the AAOS Career Podcast, Rex Lutz, DO, welcomed Odion Binitie, MD, FAAOS, an orthopaedic oncologist and professor at the H. Lee Moffitt Cancer Center, to offer advice about how to break bad news to patients, a challenge all orthopaedic surgeons encounter throughout training and practice.
Dr. Binitie began by discussing his training in pediatric orthopaedics and musculoskeletal oncology. He described how early exposure to oncology during residency shaped his career choice and emphasized the complexity and multidisciplinary nature of cancer care.
Preparing for difficult conversations
Dr. Lutz asked Dr. Binitie how he approaches delivering bad news. Dr. Binitie explained that orthopaedic oncologists are often the first healthcare professionals to tell a patient they have cancer — sometimes during a first encounter. He therefore emphasized the importance of first assessing where the patient is emotionally and cognitively, as assuming too much can create confusion or distress in the patient. He said he starts conversations with simple, open-ended questions such as, “Why are you here?” and “What have other doctors told you?” to gauge the patient’s baseline understanding of their condition.
He also stressed the importance of acknowledging everyone in the room, including family members and friends. He will ask the patient to introduce others in the room with them or, in the case of very young patients, ask the others to introduce themselves. Knowing who is there to support the patient helps guide how and when Dr. Binitie shares sensitive information; for instance, parents may want to explain their child’s diagnosis rather than have the doctor do it.
Balancing compassion and clarity
The discussion then explored how to be direct with patients while remaining compassionate. Dr. Binitie explained that delivering bad news requires active listening and careful attention to emotional cues. He noted that after getting a life-altering diagnosis, patients “probably will only remember 30% to 40% of what you say.”
He described the importance of pausing and recognizing when it is appropriate to stop a conversation and revisit it later. Especially in pediatric and oncologic settings, he emphasized that information often needs to be delivered in stages, so the patient and their loved ones have time to process everything. He also discussed delivering bad news related to complications, stating that surgeons must “always tell the truth” when complications occur and ensure that families hear the information directly from the physician rather than indirectly from staff.
Managing anger and caring for yourself
Dr. Lutz then asked how Dr. Binitie handles anger from patients and families and how he deals with the emotional toll of having to deliver bad news.
Dr. Binitie responded that patients are entitled to their anger. He noted physicians should acknowledge concerns while giving patients grace, but always prioritize safety when situations escalate or there is a fear of violence.
He explained the importance of self-care in the wake of a surgical complication, observing surgeons must have short memories because there are other patients who require care. He compared surgical complications to a quarterback throwing an interception and needing to focus on the next play. Self-care activities like yoga or meditation can be helpful, as can talking to colleagues and getting reassurance that other surgeons have had similar experiences. He also recommended seeking out hospital-sponsored counseling services if available.
Dr. Binitie concluded the discussion by emphasizing that building strong relationships with patients early makes it easier to have difficult conversations later, and he reminded listeners that medicine is a profession defined by resilience and learning from mistakes.
Listen to the episode and subscribe to the AAOS Career Podcast to catch future episodes and gain more insights on professional development, research, and leadership in orthopaedics.