“I understand.” “Your results are unremarkable.” “Do you have burning chest pain?” A recent report in the Journal of the American Medical Association (JAMA) finds that the words physicians use are more important than they might realize. In fact, they could contribute to your economic success and your reputation as a physician.
The article points to four word-usage failures that doctors may find alienate, offend or turn patients off, as well as lead to poor decision-making and worse health management for their patients. The four include:
· Using leading questions—“Do you have symptoms such as x, y and z?”
· Saying “I understand” after delivering a serious diagnosis
· Calling patients “poor historians” when they're unable, reluctant or have difficulty reporting their symptoms or medical problems
· Using the words “unremarkable” or “normal” when referring to medical findings or test results
Whether you’re talking about hypertension outcomes, cardiac outcomes after a heart attack, transplant outcomes or adherence to medications, many studies point out that if a patient and a physician have a good interaction—building rapport and trust—patients have a better medical outcome, says Stephen Parodi, MD, chairman of the Council of Accountable Physician Practices (CAPP), a coalition of some of the nation’s largest and most progressive multi-specialty medical groups, and an infectious disease physician with The Permanente Medical Group in Napa, Calif.
The importance of Semantic Precision
A doctor’s word use reflects the clarity (or clumsiness) of his or her thinking and decision-making.
Other word use fails doctors have made, besides using complex medical jargon, include calling women “girls” and telling patients “it’s all in their head.”
In monitoring the viral load of patients with HIV, Parodi says he’s careful about using jargon like “undetected level of the virus,” explaining that the patient is not cured or no longer has HIV but that their medications are working and the test cannot detect the virus in their bloodstream. “What words we use here matter,” says Parodi.
Emergency physicians have to be especially careful in choosing words. They also often have cultural and educational barriers to overcome. “I actually never tell a patient that their results are ‘normal,’ says Kimberly Brown, MD, MPH, an emergency physician in Memphis, Tenn. “If a patient comes in for chest pain, and I’m explaining their chest X-ray results, I say, ‘I see that your lungs look great, there is no pneumonia, there is no collapse of your lungs and no broken ribs.’” Providing patients with the specifics helps them understand why tests are ordered and what their results really mean.