The People's Perspective on Medicine

Show 1004: Doctors’ Secret Language

Find out what you should know about doctors' secret language and how it can affect patient safety.
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Doctors’ Secret Language

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Have you ever wondered about the big words your doctor uses? Physicians have a language all their own. Not only do they have specialized technical terminology, but they also have their own slang.

What Should Patients Know About Doctors’ Secret Language?

Find out about the argot, jargon and slang that abounds in hospital settings. What does doctors’ secret language tell us about their attitudes? How does it affect patient safety? Those questions lead us to ask what patients should know about doctors’ secret language.

Doctors and Patients Communicate:

We discuss the importance of quick communication of information and emotion, and the disadvantages of leaving patients completely out of the loop. We also explore the concept of Open Notes, a movement to have patients access their doctors’ clinic notes. Although doctors may initially be reluctant to try this, research has shown that patients can detect medication errors, remind their doctors about next steps and become truly engaged in their own health care. The recent study we mention was published in The Joint Commission Journal on Quality and Patient Safety, August, 2015.

This Week’s Guest:

Brian Goldman, MD, is an emergency physician at Mt. Sinai Hospital in Toronto, Ontario, Canada. He is host of the radio show “White Coat, Black Art” on CBC Radio One. Dr. Goldman is an outspoken medical journalist, whose previous book was The Night Shift: Real Life in the Heart of the ER. His new book is The Secret Language of Doctors: Cracking the Code of Hospital Slang.

Listen to the Podcast:

The podcast of this program will be available the Monday after the broadcast date. The show can be streamed online from this site and podcasts can be downloaded for free for four weeks after the date of broadcast. After that time has passed, digital downloads are available for $2.99. CDs may be purchased at any time after broadcast for $9.99.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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I found the discussion about open notes interesting because I have periodically requested and my own medical file including notes. In several cases, I found significant errors such as a comment that was meant to say “is not a recreational drug user” and yet actually said “is a recreational drug user.” To me, this was a HUGE discrepancy in the records and could definitely influence the quality of care I received from others who read the file. (I also requested that it be corrected, which thankfully they were happy to do).

I found that one physician had not been honest with me about my medical situation, and had downplayed or not presented information that would have helped me. I also found that another provider made comments about me in my record that were very disrespectful and judgmental. If I had known they felt that way, I would have found a different provider.

I think every patient should have access to their file notes, and if doctors are afraid of patients knowing what is being written about them, then perhaps they should reconsider what they are writing.

Funny that Dr. Goldman should use the intransitive form of the verb “present”, which is part of the medspeak problem. “The patient presented with fever, etc…” or “presented often”. One would think the English equivalents (“presented fever symptoms” or “presented themselves”), in other words the accepted transitive and reflexive forms, do not require much additional effort.
Even worse is the use of”GSW”, which takes more energy to enunciate (4 syllables) then the straight “gun shot wound” (only 3), meaning that quicker communication is secondary to obscuring it.

Dear PP and Dr Goldman:

This was a great show. I am using takeaways in prompting speakers in a discussion group to unpack CNA or other acronyms the first time they are used.

However… first, I studied Latin for two years in high school, so although I am strictly an amateur, I can get a lot out of Dr-speak with neo-latin (as I like to call it). Not so, of course, for folks w/o that background. …second, doctors use Latin because Latin WAS the standard language of priests and scholars at the time that medical education began to occur in academic settings. They were not putting on the dog, as it were, they were just using what they used everyday, except, perhaps when they went to the vegetable market.

However, third, I was vastly amused by your repetition many times during the show of “pejorative.” This is, of course, simple neo-latin and derives from Latin mal (bad) just as better and best derive from good (bono [or similar]). So after beating up on the physicians for Dr-speak, you were doing some of the same thing to your listeners, though perhaps with a word that is more broadly understood, but still not in the vocabulary of many folks out on the street.

All the best,

I come from an extended family full of physicians. I’m afraid that style of conversation laced with the need to “test” others and prove one’s “superior intelligence” extends to family relationships as well. This deeply ingrained culture will be hard to change. Much thanks to Brian Goldman for bringing up the problem.

When a doctor talks in scientific jargon to my father who’s 100 years old, I think just one thing: “This guy’s a jerk. He’s not even smart enough to realize that the patient has no idea what an ‘ejection fraction’ is. If he’s that stupid, he probably can’t be trusted.” Having been a nurse for three decades, I’ve spent lots of time around young doctors in training. They like to impress each other not only with what they know, but also with how fast they talk. They use the same communication habits with patients.

Re show 1004: One of the best shows in a long time. I agreed with everything your guest said today. Although I’m retired from the health care field, I and my partner are currently very involved as patients, with chronic and life threatening conditions, which require constant communication, monitoring and treatment – tiring interaction with our health providers.

Over the last couple of years several emergent situations occurred which could have been avoided, or at least mitigated, had the communication between health care providers and others and ourselves been more open, clear and forthright. Large medical conglomerates in North Carolina have an obligation to change how the view, treat and communicate with their patients. This needs to start at the top, with administrators, down through teaching hospitals, medical universities, clinics and especially senior health care.

The most common communication problem is the words used in testing and examinations. “Positive” is usually negative for the patient and conversely. Some words like melanoma need some help because they sound so nice.

Doctors don’t want their patients to know what they saying. They also want to flaunt their supposed superior intelligence over that of their patients. For instance, they say metastisized instead of spread. They need to think more about their patients instead of trying to impress them because in reality they come across as a jerks and aren’t impressing anyone.

Didn’t notice in the article when the show would air; can you advise me?

You’ll have to check your local radio station’s broadcast schedule. We’ve got a link to our partner stations here:
https://www.peoplespharmacy.com/find-a-radio-station/
The podcast of this show will be available this Monday, August 31st.

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