Tuesday, March 4, 2014
"Doctor-ese", OR What the HELL Are You Talking About?
Doctors have their own secret language.
In the comments in my last post, a great friend of mine pointed out how doctors talk WAY over patient's heads. Often.
Part is that is that sometimes it isn't easy to describe stuff in English.
Part of it is that we forget to use English.
Part of it is laziness.
It's easier to use specific words and we figure if we use the word in context, the patients will learn the correct terminology.
This is true. Sometimes.
Patients or caregivers for patients with chronic medical problems end up with honorary degrees in medical terminology at the end.
I try to use a word and then define it. I hope that patients "get it." And I tell them to stop me if I'm saying something they don't understand.
As a physician, it is such a relief when we have a nurse or doctor as a patient because we can use medical terminology. It's very difficult to constantly translate in your head from "medical-ese" or "doctor-ese" into plain English.
When you can just say: "Your Ejection Fraction is 30% which means you really need to restrict your sodium content in your diet to 1200 mg a day and exercise aerobically daily,"
Instead of: "Your heart is really weak and only pumping 1/3 of the blood that goes into it-- out. That means you have to stop eating salt and salty foods so you don't hold on to a lot of water in your body. You need to start reading labels. You need to know that salt is sodium on labels and you need to count how much sodium is in everything you eat and only have 1200 -1500 mg a day. Also you need to exercise hard enough for 20-30 minutes every day that you can't hold a conversation. Walking fast, swimming, biking so that you are short of breath...." and on and on. You see what I mean.
(By the way, the above is an example, not advice. I individualize my instructions to people based on their ENTIRE medical history. The above only is an example, not recommendations to every person with a low Ejection Fraction)
We also are being pushed to see more patients daily and a lot of this requires time we don't always have. We don't have RN's in the office anymore because they're too expensive. So we pawn off the instruction to a dietician. That requires the patient go to see the dietician, or the diabetic educator. Often, they don't go or CAN'T go because of work restrictions. Then they get worse. Then they miss work anyway. It's frustrating.
I would love to have a pocket translator for medical language. I could say, "Your edema is much worse and you're getting a diabetic ulcer on your right great toe."
The pocket translator could then say, "Your legs are swelling up too much and you have a potentially serious problem with an open sore on your big toe. That's bad because it can cause your toe to get infected, and that's how amputations start in diabetics. You need to follow your diet , look at your feet, keep them clean and dry and keep the swelling down by elevating them whenever you can. Also, wear shoes or foot-gear all the time, even in the house."
Since Doctors don't have pocket translators, remember that your doctor is human and sometimes forgets to translate.
Don't be shy about stopping them and saying,
"What the HELL are you talking about?"
"Could you please translate that into plain English?"
Your doctor will thank you for reminding them because honestly, we WANT you to understand, we WANT you to get better, and we WANT to succeed as physicians by having our patients succeed.