PHM Session: Say What? Diagnosing and Treating the 7 types of Jargon Overuse
Presenters: Mike Pitt, MD, and Jordan Marmet, MD, University of Minnesota Masonic Children’s Hospital, Minneapolis, Minn.
Effective communication between clinicians and patients is essential to good care and has been shown to improve patient outcomes. Plain language is essential to good communication, and yet physicians and health care professionals regularly use jargon—technical terminology of a given group—in discussions with patients and their caregivers.
Drs. Pitt and Marmet presented their work in classifying and quantifying the use of medical jargon on inpatient rounds in the context of other research about lay people’s understanding of medical terminology. Breaking down the jargon commonly used can help clinicians and educators target areas for intervention.
Medical jargon can be divided into seven categories:
- Medical terminology
- Abbreviations or acronyms
- Medical vernacular
- Unnecessary synonyms
- Medicalized English
- Euphemism jargon
- Judgmental jargon
The majority (85%) of observed jargon falls into the three categories of medical terminology, abbreviations or acronyms, and medical vernacular.
Medical terminology is the language we all work so hard to acquire in medical school, to ease the communication among members of our field, like names for diseases (bronchiolitis) organisms (E. coli), tests, procedures, drug names, and even the names of medical specialties (nephrologist). We use abbreviations and acronyms so much that some of us don’t even remember the full words–such as NPO (nil per os, Latin for nothing by mouth). Yet we commonly use these terms with patients and use abbreviations or acronyms such as CBC (complete blood count), EKG (electrocardiogram), and MI (myocardial infarction). Patients may even be unfamiliar with the term ED (emergency department), which can have more than one meaning. Medical vernacular is words that may be familiar, heard in any episode of “House” or “Scrubs,” but many patients do not know the real meaning: words like “febrile,” “sepsis,” or “remission.”
Health care professionals are known for needlessly using complicated words in place of simpler words that already have a shared understanding. The use of unnecessary synonyms such as “upper extremity” for “arm,” “ambulate” for “walk,” and “erythematous” for “red,” can lead to misunderstandings. One study cited that 81% of patients in an orthopedic clinic thought there was a difference between a fracture and a break, with 75% thinking a fracture was better than a break. Medicalized English refers to words that have a different meaning in medicine, words such as “diet” or “appreciate.” “Impressive” is a generally positive term until it is used to describe an “impressive pleural effusion” on a chest X-ray. Euphemism jargon is used when we think we should use softer, easier-to-hear terms, such as “passed on,” or a “spot” on an X-ray.
The last category, judgmental jargon, includes words that may reflect bias or sound derogatory, even if that’s not the intent. Common phrases we all may have used that could convey judgment or mistrust include “denies alcohol use,” “non-compliant,” or “failed treatment.”
Studies have shown that clinicians use about four undefined jargon words per patient encounter. Because even one misunderstanding between patient and clinician could lead to potential confusion or harm, we must improve our ability to communicate with patients in ways that are clear and meaningful.
- The use of plain language is essential for effective communication between clinicians and patients and leads to better health outcomes.
- Medical professionals regularly use jargon and terms (more than four per patient encounter) that are often misunderstood by patients.
- The seven categories of jargon are medical terminology, abbreviations/acronyms, medical vernacular, unnecessary synonyms, medicalized English, euphemism jargon, and judgmental jargon.
- Classification of medical jargon can help diagnose and treat its overuse, and improve communication, by measuring it and giving real-time feedback.
Dr. McDaniel is a pediatric hospitalist and associate professor at the University of Virginia Children’s Hospital in Charlottesville, Va. She is the head of pediatric hospital medicine and serves as the medical director of acute pediatrics.