The Miscommunication Landmines of Medical Lingo

The Miscommunication Landmines of Medical Lingo

[David Epstein, MD, discusses judicious use of medical jargon to prevent miscommunication and misunderstandings with patients and their families.]
If you listen to the buzz of activity in any medical setting, you will hear comments like:
  • “I’m going to order a CBC, LFTs, and a CMP for the patient in DKA on the floor.”
  • “The patient in room 12 is failing extubation and I’m going to put him on BiPAP and check an ABG in 30 minutes.”
  • “The teenager came into the ER with a chief complaint of dizziness and headache, but denied any drug use or suffering any head trauma.”
The language of medicine can be confusing and uninterpretable to those not immersed in the world of medicine.
There is a lexicon of technical terminology, acronyms and abbreviations, words that are known and are used differently in the medical arena, and other classifications of medical jargon. It is an accepted form of speech in medicine, but it can be confusing for patients and their families. As medical personnel, we take it for granted that we are understood in our environment, but that is not always the case.
Just as there is miscommunication and misunderstanding with traditional language barriers, such as not understanding English, Spanish, or Russian, medicine’s language barrier can also create miscommunication and misunderstanding.
I still remember as a medical student when I was exposed to the word, “anastomosis”.
I had absolutely no idea what it meant when I first heard the word.
I subsequently learned that is the connection made surgically between adjacent blood vessels, parts of the intestines, or other channels of the body. It wasn’t the kind of word that I used…ever…until I went into the medical field. If we go to school to learn specialized words and other medical jargon, we have to be aware of those who did not learn the language because it sets the stage for not only miscommunication but also misunderstandings.

Most in the medical field are not even aware of the medical jargon that is used at the time that they are communicating with patients and families.

One study found that there was an average of approximately 4 medical jargon words or phrases used per patient encounter. It is not malicious or intentional. It is just the way that we are comfortable speaking and communicating with each other.
However, we have to be aware of the words that we use because they can mean something completely different to someone, not involved in the medical culture.

Besides words not being understood, if they are too technical or are abbreviations or acronyms, there are instances where medical personnel use understandable words with a different meaning than is commonly used.

Using words in this manner can not only create confusion but can also produce emotional responses. Some of the most common words or phrases that are problematic in the medical context are “chief complaint”, “deny”, and “fail”. These words have a somewhat negative connotation in the real world. But, in medicine, these words are used without emotional or judgmental undertones. These words are more objective descriptors in the medical story.
However, when we identify someone who complains, fails, or denies, we commonly associate these words with negative feelings in the non-medical world.
  • “He complains a lot about the food at our restaurant.”
  • “She failed her biology exam and has to take the class again.”
  • “He denies the allegations of lying to his boss, but I don’t believe him.”

If these are the everyday contexts in which we use these words, it is not surprising that our patients or their families may be offended or not feel good about the medical team interactions when these words are used to describe themselves or a family member.

Even when the context and meaning are different in medicine, the difference may not be appreciated by the patient or their family because they are not familiar with the medical language and its nuances.
Nevertheless, words and phrases like these are ubiquitous in our medical documentation, oral medical presentations on daily rounds, and even in patient or family medical discussions.
They are misunderstanding or miscommunication “landmines” that are just waiting to make a patient’s or the patient’s family’s medical experience just that more difficult.
If we want to make the medical experience better for patients and their families, we need to really be conscious about what we say to improve patient and family understanding. As we fall back on the commonly quoted adage of “it’s not what you say…it is how you say it”, we need to remember that it is sometimes absolutely “what you say” in medicine, as well as “how you say it.”
Do you have a medical phrase or word that you feel is confusing for individuals who are not in the medical field? Please feel free to put your comments in the comment section!

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