Course Key Takeaways:
1. Specific communication techniques can increase the physician's or advance practice professional's comfort with difficult conversations and saying "no" to patients, reestablish rapport, and promote the therapeutic relationship.
2. Management and documentation of the patient's informed refusal requires the same elements and care as obtaining the patient's informed consent.
3. Documentation of the physician's or patient's refusal is critical and should include the wording used and the basis of the refusal.