Medical students must learn a whole new language that allows them to accurately express their clinical impressions to others. Over time this becomes second nature and soon they can be heard babbling confidently and sounding pretty good. Communication skills are a standard part of medical education, and teachers take great care to ensure that these new language skills do not affect their communication with patients. Most seem to take this into account and do their best not to confuse patients.
With all this good education, why do we hear misunderstandings between doctors and patients? Do doctors really throw up verbal smokescreens to confuse others? A recent article from the University of Minnesota I would suggest.
A survey of 215 members of the public examined their understanding of some common phases used by physicians in their practices. Words like “your cancer screening test came out and the results were negative” were correctly interpreted by 97.7% of people. However, only 21% correctly understood that a doctor who said her X-ray was “impressive” was generally bad news. and “Have you been feverish?” was understood by only 9.3%.
The researchers concluded that medical jargon is alive and well in Minnesota offices, and presumably many other places as well.
Before we all take the view that doctors need to be further intimidated about their communication skills, let’s take a look at this article in context. Study participants were members of the public visiting the Minnesota State Fair. Presumably, they were looking forward to a day of cotton candy and random walks rather than being accosted by researchers offering university-branded backpacks as incentives to participate. They did not expect to be patient that day and may even have been there to get away from health concerns.
The questions were multiple choice, with no opportunity to ask for clarification. All medically trained readers will be familiar with patients asking for immediate explanations of terms, and I hope most will understand the power of the phrase, “By which I mean…”
In some ways, the study methods used by these researchers seem not to accurately replicate the conditions found in your average clinic, and in fairness, they acknowledge this.
Why use certain terms and phrases in the first place? Curiously, the answer is not entirely simple. Today’s Internet-enabled patient is better informed than ever. Popular television shows show doctors and patients in action, using a great deal of medical jargon for realism and artistic effect. The public applauds him.
In the clinic, patients like to be treated like adults and communicated accordingly. They don’t want to be infantilized or patronized, and will certainly let doctors know if they are made to feel that way. Expert doctors know this and will introduce terms followed (hopefully) by immediate explanations to ensure understanding. Too slow with an explanation and the wily patient will ask, “Can I have that in English please?”
Whatever words are used and whatever they are put, some patients are not in a position to take it all in. Fear and anxiety cloud the understanding of the messages in any consultation, and this must be taken into account. There should be appropriate add-ons such as informational brochures, web links, and that all-important opportunity to ask questions now or at a later time.
No one should leave a health office confused and no one made wiser by the use of medical jargon, and no one should be belittled or patronized. The doctor’s skill is to find the middle ground and make patients feel informed and respected, even if they can’t always offer a cure.