This is the second part of the two-part series on the importance of word choice in doctor-patient communication. Here we look at the other words and/or language that may negatively influence the perception of patients, and also damage the doctor-patient relationship.

5. “Bad”


While some practitioners try to soften the impact by saying things like “we just got the report and it’s not good”, the crux here is that such terms do not value-add to the situation at all. Using this word can make the patient feel that their condition is hopeless and that their efforts of recovering are futile. Instead, the focus should be on how patients can keep up the good work, or even try some new options.

6. “Chronic”


The word “chronic” does not quite have a negative impact on patients, but rather, most people seem to have a misunderstanding of its definition.

When practitioners say an illness or condition is “chronic”, they simply mean that it is persistent or long term. Yet, most people seem to think that what it actually means is “serious” or “incurable”.

It is one of many words that expose a gap in patient and practitioner knowledge, and there have been many campaigns, such as the Plain English Campaign, that have rallied for healthcare practitioners to use simple English when conversing with patients, and to break down symptoms and diagnosis to a layman level such that they are clearly understood.

Using complicated jargon may result in patients being misguided about their condition and may cause them to overreact unnecessarily.

7. The language of war


Metaphors are everywhere, and in the field of healthcare, no other metaphor is more pervasive than that of comparing fighting an illness to fighting a war. Granted, doctors often use the metaphor of a battle or war to make the recovery process easier to understand. Some even say that they feel it encourages patients, making them feel empowered not to become a victim or the loser in the battle.

That, however, is where the situation gets problematic. In a world where illnesses are now often controlled and managed, rather than eradicated or annihilated, using the language of war, which necessitates two distinct sides – the winner and the loser, can propagate an incorrect sense of false hope in patients.

Just as how the most valorous of soldiers can falter in a formidable adversary, using the language of war places unfair pressure on patients and practitioners alike to “win the battle”. In actual fact, some conditions can never be “killed”, just controlled. Ultimately, though, it all boils down to a patient’s culture and experiences to determine how they may respond to metaphors in healthcare such as these.

8. Connotations matter


Connotations are ideas or feelings that are invoked, in addition to a word’s literal meaning. It is not difficult to segregate words into ones that have positive connotations, and ones that have negative connotations. Perhaps one of the most pertinent situations where connotation matters is when family members have to make the decision to “pull the plug”.

Ronald M. Arnold and other researchers from the University of Pittsburgh found in a web-based survey in 2013 based on a hypothetical situation that the percentage of participants who allowed CPR vastly differed when “allow natural death” was used instead of “do not resuscitate”. In the latter, a whopping 60% requested CPR, which has a 10% success rate. In the former, only 49% requested CPR.

The researchers concluded that this had something to do with the word choice, as saying “allow natural death” would make the family members feel that they were honouring the last wishes of the patient, as compared to “do not resuscitate” which implies that they did nothing to save them. MIMS

Read more:
Sorry may be the hardest word, but it can avoid medical malpractice suits
How to apologise and make amends with your patient
Measures needed to combat health illiteracy

Sources:
http://www.upmc.com/media/NewsReleases/2013/Pages/doctors-choice-of-words-influence-cpr-decision.aspx
http://www.huffingtonpost.com/richard-c-senelick-md/medical-jargon_b_1450797.html
https://www.theatlantic.com/health/archive/2014/08/the-trouble-with-medicines-metaphors/374982/