top of page

BackTable / ENT / Podcast / Episode #105

Difficult Conversations

with Dr. Melanie Sulistio

In this episode of BackTable ENT, Dr. Gopi Shah and Dr. Melanie Sulistio, associate dean of student affairs at UT Southwestern, talk about the importance and art of having difficult discussions with patients and medical colleagues.

Be part of the conversation. Put your sponsored messaging on this episode. Learn how.

Difficult Conversations with Dr. Melanie Sulistio on the BackTable ENT Podcast)
Ep 105 Difficult Conversations with Dr. Melanie Sulistio
00:00 / 01:04

BackTable, LLC (Producer). (2023, April 18). Ep. 105 – Difficult Conversations [Audio podcast]. Retrieved from

Free CME

Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs. Follow the button below to claim your credits on CMEfy.

BackTable CMEfy button

Stay Up To Date



Sign Up:

Podcast Contributors

Dr. Melanie Sulistio discusses Difficult Conversations on the BackTable 105 Podcast

Dr. Melanie Sulistio

Dr. Melanie Sulistio is an associate dean of student affairs at UT Southwestern.

Dr. Gopi Shah discusses Difficult Conversations on the BackTable 105 Podcast

Dr. Gopi Shah

Dr. Gopi Shah is a practicing ENT at UT Southwestern Medical Center in Dallas, TX.

Show Notes

First, Dr. Sulistio explains why the humanity in medicine is centered on a foundation of communication between patients and physicians. She emphasizes that scientific advancements cannot help society if physicians cannot communicate them to their patients. Then, she gives examples of obstacles that may make communication challenging, such as an unfortunate diagnosis, language barriers, family dynamics, biases, cultural backgrounds, and different goals and priorities of each party.

She suggests strategies to overcome these barriers, such as scheduling the appropriate length of time to share the news, checking that it is a good time for the patient to receive the news, and making sure the provider themselves are emotionally ready to share news. She encourages providers to show emotion, but not to the point that the patient has to comfort them. Dr. Sulistio also emphasizes including the support system of the patient in the discussion and evaluating what the patient understands about their condition before beginning the discussion. She warns against assuming that you know what the patient is feeling, bringing up personal experiences, and apologizing inauthentically. Body language cues are also important, such as eye contact and pulling up a chair to meet the patient at their level. She recommends speaking to the nurses, techs, and medical assistants about the patient before entering their room, as they have the most exposure to the patient everyday.

Next, the doctors discuss how to deal with language barriers and translation services. Dr. Sulistio notes that physician humility is an important aspect to these discussions, as providers should never make non-English speaking patients feel like a burden to treat. She notes that although wording may be lost in translation, physicians need to remind themselves to speak to the patient instead of to the translator.

Finally, Dr. Sulistio gives advice about having difficult conversations with medical colleagues and trainees. Before entering these discussions, she makes sure to check on her own implicit biases and emotions. She proposes the idea of compassionate assumption, or believing that other people are always doing the best they can in every scenario. In her opinion, simulation is the best method for teaching medical trainees how to navigate difficult conversations.


Disclaimer: The Materials available on are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.

Become a BackTable Sponsor

Up Next

How to Take a Leave of Absence with Taymi Santiago on the BackTable ENT Podcast)
Coaching Physicians Through the Stress of Malpractice Litigation with Dr. Gita Pensa on the BackTable ENT Podcast)
Is Burnout For Real? Physician Well-Being with Dr. Alain Sabri and Dr. Kerry Olsen on the BackTable ENT Podcast)
Better Neck Health with Dr. Gerry Mattia and Dr. Julie Wei on the BackTable ENT Podcast)
The Challenges of a Dual Physician Household with Dr. Bill Collins and Dr. Varun Varadarajan on the BackTable ENT Podcast)
In-Office Procedures for Chronic Rhinitis with Dr. Stan McClurg on the BackTable ENT Podcast)



Learn about Career Inspiration on BackTable ENT
Learn about Wellness on BackTable ENT

Get in touch!

We want to hear from you. Let us know if you’re interested in partnering with BackTable as a Podcast guest, a sponsor, or as a member of the BackTable Team.

Select which show(s) you would like to subscribe to:

Thanks! Message sent.

bottom of page