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Monday, January 8, 2018

Want Help Explaining A Medical Procedure? Ask A 9-Year-Old

For some time now the official doctrine taught in medical school has been to avoid medical lingo when speaking to patients--keep it at a 6th grade level. I do not agree with this. I agree with using proper medical terminology which are simply explained. I also support empowering patients to know the proper names of their medical condition(s). For instance, instead of saying "your heart doesn't work right," say, "your heart muscles are weak and unable to function normally. This is called congestive heart failure or CHF. Your ejection fraction (EF) or how much blood leaves the heart with each contraction is reduced to 30%. Going forward, you will need to know the terms CHF and EF and you will need to know that your EF is 30%." Likewise, for diabetes, "your hemoblogin A1C, also called 'A1C' is elevated at 8.6% which means your blood sugar has been consistently elevated around 200 which is dangerous. Your goal is an A1C of less than 7%. You will need to know your A1C as long as you have diabetes." Yes, a lot more words than "your heart don't work right" or "your sugar is high," but I repeat it at each visit. I have patients who have had a diagnosis on their charts for many years and they don't know it or what it means. I met a patient who had cerebral palsy on the chart since birth but only because aware of it as an adult when he came to establish care with me and I simply read off the existing list of diagnosis from the referring note. Likewise, for a patient who had COPD on his chart for 13 years, yet when I read it off the referral note she said, "what's that?" Dumbing down the language to such a degree does not educate the patient or empower self-awareness of disease course and management. Plus, in this age of internet searches, imagine what nonsense a patient may encounter when Googling "heart don't work right."
from Rajesh Harrykissoon, MD