Friday, December 23, 2022

Decoding doctor-speak, redux

Eleven years ago, I wrote a post for my U.S. News Healthcare Headaches blog titled "Decoding doctor-speak: translations of common medical terms" that walked non-health professionals through explanations of common blood tests such as the complete blood count, basic metabolic panel, liver function tests, and low-density lipoprotein; and diagnoses such prediabetes and metabolic syndrome. It turned out to be an enduring hit; the cross-posted version on Common Sense Family Doctor has been viewed more than 11,000 times. But have I or physicians in general have gotten any better at keeping insider medical jargon out of our conversations with patients?

A few weeks ago, JAMA Network Open published a cross-sectional study that assessed the general public's understanding of English phrases that have different meanings in a medical context (jargon) than they do in everyday life. Researchers surveyed 215 adult volunteers without a history of medical or nursing training who visited the 2021 Minnesota State Fair. Of the 13 questions concerning various terms, the percentage of participants who answered correctly ranged from the high 90s ("negative" cancer test results being good news) to 20 or less ("impressive" x-ray results, NPO = nothing by mouth, occult infection).

More people believed that the phrase “had an occult infection” had something to do with a curse than understood that this meant that they had a hidden infection. Fewer than half knew that their neuro examination being “grossly intact” was a good thing, possibly because the word “gross” more often means “unpleasant” than “in general” in common usage. These terms may not necessarily be recognized by clinicians as jargon because they do not land in the commonly understood category of technical, medical terminology. However, they have been shown to be used frequently in clinical settings.

Although I now have more than twice as much clinical experience as I did when I wrote my original blog post, keeping my "doctor-speak" free from jargon remains a work in progress. It's easy to fall into the trap of thinking that patients understand what I'm saying if they are nodding or not asking questions, but as often as that may be true, it could also mean that they are too intimidated or embarrassed to admit that I've lost them. And the burden of assuring that effective communication occurs ought not to fall primarily on the patient. So I resolve to keep trying to do better.