Do Patients Understand Medical Terms?

Do Patients Understand Medical Terms?

"They've heard it before."
"Our patients know a lot about their condition."
"It's a common term."

I watch a TV show where a character's baby was recently stillborn. The doctor told her it was caused by a placental abruption. In the next episode, the grieving woman tried to explain to her mother. "I don't remember what he said," she sobbed. "Eruption? Interruption?"

When our dog had puppies, the vet recommended a shot of oxytocin if too much time passed between deliveries. Eventually, my labor partner called the vet to report that the "oxycodone" had brought one last tiny Labrador into the world.

Finally, I know a woman whose daughter has a rare X-linked genetic disorder called Cornelia de Lange syndrome. Julie can describe the condition in detail, using medical terms. Another friend is an expert at cleaning and changing her 4-year-old's tracheostomy, or "trach," tube, fitting the Passy-Muir valve and monitoring O2 sats.

What makes it common?

Familiar words. Short words. Non-medical words. If you've worked in health care for many years, you might have forgotten that "follow up" and "compliance" can sound a little ominous. And quickly -- think of an everyday synonym for "uterine."

Common language is common when YOU use it a lot. The more you participate in a given community, whether it's hospital adminstrators or Hodgkin lymphoma survivors, the more you tend to speak the lingo.

So straight-up medical terms might be OK when:

Patients are using them in their own families and with other patients. They might not use them precisely or even correctly, but they understand each other.
You talk to someone with a "vertical," or deep, knowledge of their condition. They're highly literate about their own or a loved one's illness.
Providers establish what their patients understand and share terms.

I had a wonderful pulmonologist (aka lung specialist) in my 30s. After a few appointments, we could discuss my VO2 max and FEV with the ease of ordering a drink at Starbucks. Using medical initialisms saved time. It also bonded us as members of a two-person team united against my asthma.

Plain language saves time and money if ...

Why is a plain-language specialist waxing nostalgic about speaking medicalese with her doctor? To show you I understand its appeal. Humans -- primates -- are intensely tribal. We love our in-groups, societies, and clubs, and shared dialects help us bond.

However, using common words is always your safest bet. Plain language is especially important when:

You don't know how much a patient knows about their condition.
You don't have extra time to teach terms and agree on what they mean. ("Your VO2 max is the amount of air ..."). Or you want to teach those terms. If so, you have to explain them in common words.
The condition is new to the patient, not chronic, or both. For example, they just got back from Morocco with a parasitic infection they probably won't get again (if they don't eat salads on their next visit).

Stick with the same words and terms once you establish them. Ann Brady describes a couple who grasped at false hope when a doctor called the wife's ovarian cancer a "mass" after calling it a "tumor" and "cancer" previously. "Cancer" is common; "tumor" is common, but might need explication (some tumors are benign, or not cancer); "mass" is medical language, yet not especially precise (masses can be benign or malignant). Plain language is simple in theory, harder in practice, but always worth its weight in understanding.

References

Brady A. Medical terms in patient education: Using the confusing to explain the complicated. Oncology Nurse Advisor, March 21, 2018.
Fage-Butler AM, Jensen MN. Medical terminology in online patient-patient communication: Evidence of high health literacy? Health Expect. 2015;19:643-653.
Koch-Weser S, Dejong W, Rudd RE. Medical word use in clinical encounters. Health Expect. 2009;12:371-382.

Let's talk about medical terms and your patients.

Do you have a document that needs reviewing ... or just plain writing? Contact me at glong@genevievelong.com or (503) 734-6853.


Health Books for Consumers

Saying Goodbye to the Pet You Love, by Lorri A. Green, PhD., and Jacquelyn Landis

As some of you know, I've always had pets -- Labrador Retrievers and sometimes cats. My office mates don't call meetings, except for snacks, and alert me to FedEx and UPS deliveries. In December, I said goodbye to Carver, my dear Labrador Retriever of more than 14 years. There was another sad parting in January as my cat Vala -- pound for pound, the toughest of all my animals -- succumbed to kidney failure at age 15.

This is a well referenced book by an expert, in the strong New Harbinger series of self-help books. It's possible to get stuck in grief, surprised by it, or wonder why you feel so down when it's "just a pet." But in these days, when we touch more people digitally than ever before but have too few warm daily connections, our pets can be our closest family members. We, and they, deserve help and comfort when they go. This book has it.

The Menopause Solution, by Stephanie Faubion, M.D.
The Mayo Clinic provides great patient education materials, and this book is a reliable resource. For example, while it notes that hypnosis is one of the few non-pharmaceutical treatments to successfully treat hot flashes, it also points out that just one clinical trial has showed this so far (the book was published in 2016).

These days, current health information is as close as the smartphone on your bedside (not good for insomnia at midlife or any other age, by the way). But sometimes, you just want to pick up a book. From what happens to your hair, to helpful tables on blood pressure and mammograms, it's all here.

My sole quibble would be that, well, it's a book. I can't talk to it, as I can talk to my doctor and kick ideas around. It doesn't include absolutely everything. But it's a strong basic resource that can sit patiently on your shelf, and a starting point for shared decision making with your provider.

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Hello! I'm medical writer Genevieve Long. I specialize in writing plain-language materials for patients and other consumers, using evidence-based health literacy principles.

I belong to the American Medical Writers Association and the Plain Language Association International. I also teach in the medical writing program for the University of Chicago's Graham School. In my spare time, I fly fish, walk my Labs, do yoga, and read.

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