AFTER a loved one’s death, families often go to their GP for explanations on cause of death, queries on whether the death could have been prevented, and reassurance that the symptoms and moods experienced during their grief are normal. Some may consult with their doctor for symptom management if their grief is prolonged.

However, while we receive a doctor’s support, we rarely consider that GPs can also be grieving their patient’s death.

Usually, the first death of a patient is a devastating and life-long memory for a doctor, as it brings raw emotions and a sense of failure regardless of the efforts made to save that life. This is particularly true if the death is unexpected, or if the GP has treated the patient and their family over many years.

Realising that a patient’s life is going to end soon could trigger intrusive thoughts about the patient and family and a doctor’s own overwhelming feeling of helplessness. It is not unusual for young doctors to be unprepared for the emotional distress they’re about to experience through their careers – diagnosing incurable illness, communicating poor prognosis, supporting a patient and their family at the time of broaching the news, and then at the time of the patient’s death. Doctors constantly have to put on a brave face when confronted with the death of a patient, yet also need to acknowledge the concerns of the relatives and friends, show compassion, convey their availability to counsel and guide them, and refer them to other relevant support services if needed.

And while there is literature on how we as doctors should communicate with the family of a dying patient, little is out there on how GPs are supposed to effectively cope with their own grief.

The death of a patient can be soul-destroying and a learning experience at the same time. Yet, throughout the medical training years, GPs are not generally or intensively taught how to accurately predict when a patient will die, trained for very long on how to tactfully deliver bad news, how to support families going through anticipatory grief, let alone prepare for dealing with the angst they will inevitably experience themselves.

Many colleagues opt for silently grieving, as they may feel that expressing themselves could be a sign of weakness or lack of professionalism. However, this unresolved grief can have important consequences. And although different individuals and occupational groups can adopt a variety of strategies to handle sorrow, silent grief might lead to doctors’ depression, distraction, stress, lack of productivity, guilt, burnout or even decision to change careers.

The good news is, instead of blaming ourselves, ignoring grief and suffering its drawbacks, with experience, the way doctors cope with grief can change. Humans are intrinsically social creatures that benefit from connecting. So normalising grief support is the natural thing to do. Sharing experiences and emotions with significant others and colleagues who are in the medical field, giving ourselves permission to display emotions on the job, calling or writing to the deceased patient’s next of kin, and taking time to process these away from the workplace are just a few strategies.

With a growing older comorbid population, we need to emphasise to medical students and new doctors that caring for themselves is just as important for caring for their patient. A good start is the integration of open discussions on grief responses and coping education in the medical curriculum. There are informative websites with resources, health care grief support groups for face-to-face encounters, online communities of like-minded individuals to safely and anonymously debrief, free counselling for GPs, and the MyGrief application for confidential support 24/7.

All this support for young and new doctors can make them aware that grieving the death of a patient should not be a solitary journey.

Dr Lou Lewis is a GP at Matraville Medical Centre with over four decades’ experience who has seen and supported his patients through the ageing process and withstood the inevitable death of many of his older patients.

Dr Magnolia Cardona is a trained GP, Associate Professor of Health Systems Research and end-of-life researcher at Bond University, and an advocate for older people. She is the co-author of Dying safely.



The statements or opinions expressed in this article reflect the views of the authors and do not necessarily represent the official policy of the AMA, the MJA or InSight+ unless so stated.

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6 thoughts on “Managing doctors’ grief following a patient’s death

  1. Barry Fatovich says:

    This is a thoughtful and timely issue. Working in Palliative Care as a GP means that there are regularly people, I form a bond with and in their deaths, a sense of loss. My way of dealing with these feelings varies but includes, visiting the family and offering my condolences and sharing the experiences of the last times, sometimes it’s a phone call, sometimes its attending the funeral in which I almost inevitably learn things I wish I had known. People respond positively and I have found it helpful personally.

  2. Anonymous says:

    Intra operative or postoperative deaths , especially in elective surgery are particularly traumatic for surgeons and anaesthetists ( and the nurses in theatre) as they usually are unexpected and inevitably some blame is felt, reasonably or unreasonably. We learnt to deal with this only by bitter experience, the hardest thing often was talking to relatives afterwards and trying to explain what happened at the same time as acknowledging their shock, grief, and sometimes anger. We hold ourselves to very high standards and such deaths are hard to accept, invariably we question why we did not anticipate it or could we have prevented ? We learn lessons from each death, and find our own ways to cope. One important point; If it happens in the middle of an elective operating list then the remainder of the list should be postponed or turned over to someone else ( as pilots do ) as the surgeon and anaesthetist are not in a fit state of mind.

  3. maryellen yencken says:

    Thank you to the above specialist who have commented. It’s lovely as a GP to hear that you have written to patients families. I believe it would have meant the world to them even if you never heard back.

  4. Samantha Hall says:

    If any doctor or medical student is struggling with processing grief, or with any other issue, there is a confidential doctor to doctor support service in every state and territory. Doctors’ Health NSW offers an independent, free and safe space to talk to an experienced GP at any time (02 9437 6552).

  5. Jodi Lynch says:

    As a medical oncologist, dealing with grief is part of my everyday work. When a patient we care for dies, mourning their loss is very important and sometimes it can be personally challenging. We now more often see people with intensity over a long period as patients are living longer, celebrating the highs and commiserating the lows in life with them. I have always found that writing to the family , reflecting on the positive interactions with the team during their treatment offers solace and acknowledges the hardship and suffering of the patient and family , helping me process what has happened as well. Being present when they are present and finding beauty and joy every day is what is important. Sharing your thoughts with others who are grieving and being gracious, knowing you did the best for your patient helps one find peace and being open to discuss and listen to others vital for wellbeing.

  6. David Wattchow says:

    I agree that the death of a patient is challenging. As well as for GPs it is also acute for specialists, especially where one has done some physical intervention. Death can occur in violent circumstances and also be anticipated (e.g. disseminated cancer).

    For many years I did write to the patient’s relatives after they had died expressing my sadness at their death and also that many persons (nurses etc.) had tried their very best for the patient. I only came across one other surgeon who did this but there may well have been more.

    I never received any feedback from relatives about this but it seemed like a human thing to do.

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