A study by researchers at Stanford University found that changing the way they describe crime, as a “beast” or a “virus”, can affect whether people are more likely to support an increase in law enforcement or social reforms to solve the problem. Words have the ability to frame and direct how a person thinks, and some studies have observed similar issues in the healthcare setting.

African American asthmatic described symptoms as “tight throat”

Researchers studied if different ethnic groups in northern California described or experienced asthmatic symptoms differently after an asthmatic attack. The results from their study found that African American asthmatic tended to describe their breathlessness with upper airway terms e.g. “tight throat”, “voice tight”, “itchy throat”. On the other hand, white asthmatics described the same symptom with lower airway terms such as “deep breathe”, “out of air”, “hurts to breathe”. Furthermore, they noted that none of their participants described their symptoms with “shortness of breath” or “wheezing”, the traditional medical terminology for the symptom.

While patients are not likely to describe their symptoms with such terminology during an actual consultation with the doctors, it is interesting to note that there are similarities in the cluster of words that patients from the same ethnic group use. Healthcare professionals can be more mindful when patients of a different ethnicity consult them, as they might describe symptoms differently from what healthcare professionals are used to.

More family members choose to “allow natural death” for patients

How doctors frame the patient’s situation can also affect the decisions made by their family. Researchers in the United States examined if the family members of a critically ill patient will go for cardiopulmonary resuscitation (CPR) when doctors change how the situation is conveyed. 60% of the participants chose to allow the patient receive CPR if their heart stops, instead of the “Do Not Resuscitate” (DNR) order. However, it decreased to 49% when doctors framed DNR as “allow natural death”. The researchers noted that phrasing the choice as “allowing natural death” might reduce the family’s feelings of guilt, as DNR might invoke a sense of taking something away from the patient by not choosing to act.

Despite the availability of healthcare information online, most patients still rely on healthcare professionals to explain their health condition. The words that the healthcare professionals use, and the social norms invoked by their words, do have subtle influence on how people perceive a situation. Thus, healthcare professionals should take note of the words they use, especially when it is a life-or-death decision.

Patients voice out more concerns if asked with “some”

Similarly, how doctors ask patients can affect if patients will voice out more concerns in a consultation. Data from the National Ambulatory Medical Care Survey revealed that 40% of the patients in the United States have multiple concerns they wish to address in consultations with doctors, but most only address one primary concern while the remaining were unmet. When doctors asked patients “is there something else…“ or variants using the keyword “some”, 78% of the patients answered affirmatively and voiced out other concern. Thus, this reduced the number of unmet concerns in a consultation. However, when doctors asked using “anything” e.g. “is there anything else…”, there was no statically significant difference compared to the control group.

Unmet concerns of the patients in a consultation can be detrimental to their healthcare outcomes. As the study suggests, healthcare professionals can modify their question to use “something” to raise the chances of addressing the other concerns of the patients. This can help to maximise the effectiveness by addressing more concerns of the patients in a single consultation.

The studies above showed how the communication between doctors and patients could be affected by choice of words they use. It is not possible for healthcare professionals to watch what words they use with their patients all the time. Nevertheless, they should bear in mind the effects of words and use it to their advantages when communicating with their patients for better healthcare outcomes. MIMS

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