An Ob-Gyn told me, with some frustration, that she regularly encounters adult patients who have misconceptions about basic female anatomy.
An Ob-patient educator agreed: “Sure. I’m often saying to patients, ‘our plumbing and our other parts are close together down there.’”
Whether it’s about anatomy or something else, misconceptions happen.
Patients may walk into the encounter with misconceptions about what they’re doing when they come to see you. Or about what you’re doing there. They may have misconceptions about treatments, or about human anatomy, or about how the health care system works.
I’m going to share some ways of thinking about misconceptions that can help you keep misconceptions from getting in the way of a good patient/provider relationship. And then I’ll go one step further, and suggest how misconceptions might also be helpful to you.
“How can ‘people’ be so ‘stupid’”?
Misconceptions can add to everyone’s frustration. They can slow down progress. They can make it harder to build relationships. They can have personal health consequences, such as on a patient’s willingness to follow a recommended treatment. They can have public health consequences, such as those surrounding global antibiotic resistance.
How can misconceptions be so prevalent as research suggests they are?
Let’s take a step back and look at misconceptions as a set of ideas that someone holds, alongside lots of other sets of ideas.
We all have ideas about how the world works. From trees to politics to blood cells, we all have ideas, theories, or vague notions about how things work, or ought to work.
We develop these sets of ideas over time. They are based on our own experiences in life. But they are also heavily influenced by our communities–any group of which we’re a part. And they’re somewhat shaped by society at large.
Said differently: We learn about the world, and how to make sense of it, from our experiences and from the people around us.
What does this have to do with misconceptions?
You may have seen one of those articles about how poorly ‘everyday’ people understand scientific or technical concepts. Measure us up against the experts, and we almost always score badly.
Linguist James Gee took a closer look at such studies. He wrote about how scientists and everyday people understand the same words, and some basic scientific concepts, differently.
As an example, he looked at a study where scientists analyzed school students’ answers to questions about the light from a candle (such as, “how far will the light travel?”). The study concludes that everyday people’s understandings of common phenomena (in this case, light from a candle) are unacceptable.
Gee writes, “’How, you might ask, can ‘people’ be so ‘stupid?’ I would argue that people are not, in fact, so stupid.”
That’s because our ideas about the world, and the words we use to express them, work for us.
Gee points out that everyday language works at a level of specificity that is entirely adequate for everyday life. But everyday language would not measure up to scientific standards for exactitude. For example, from the candle experiment, Gee compares the everyday use of the word ‘light’ with the scientific term ‘illumination.’
Within the context of ‘everyday life,’ our language works. Light means light, whether we’re lighting a candle, turning on a light, or a thousand other uses of the term. We know what we mean, and so do the people around us (most of the time).
Gee goes further and points out how in everyday life, we are acting and talking as everyday people, and not as specialists. That is to say, in everyday life, we are not trying to be as correct as specialists, for various reasons. And our language and thinking reflect that.
“People are not, in fact, so stupid.”
As a health professional, your ideas about how the human body works are much more informed than everyone else’s. They are built on millennia of research, supported by your study, and enriched by your years of experience.
The rest of us non-specialists also have ideas about how our bodies work. Like our ideas about light, our ideas about our bodies may or may not have scientific merit. But just like yours, they are based on our experiences, our knowledge, and our communities.
And, importantly: they are entirely adequate for us. Unless something comes along to convince us that they aren’t adequate anymore.
Let’s turn back to patient misconceptions.
The Ob-Gyn I mentioned at the start later expressed to me her concern that adult females were, as she saw it, out of touch with their own bodies. This frustrated her, yet she did not want to hold negative opinions about her patients. And her patients want to be taken seriously on their own terms, as we all do.
So I turned our talk to what I’m suggesting here: these patients’ current understandings may be entirely adequate for them.
But how? How could they be?
In considering this question, the physician and I began to talk about the distressing cultural and social realities that could lead to a woman reaching adulthood, and still having her body seem foreign to her. To put it plainly, we both agreed there’s a lot of social pressure against knowing your body well.
It is important to remember that cultural norms can include silences, taboos, and secrets. These are not limited to women, of course; males also encounter cultural silences, as described in this article on testicular cancer detection.
Like what you’re seeing? Could your organization benefit from some expert help on health communication and education? I’m happy to help. In person or online.
As the physician and I spoke, it became clear to me that her concern was also over these larger problems of cultural norms that could keep a woman from knowing her body more accurately. We discussed how such norms might connect to political battles over women’s health, and socially-constructed ideals of womanhood.
How misconceptions can be helpful
The good news is: a misconception is a window into a person’s thinking—and potentially more.
When it comes to misconceptions, I invite you to try to understand your patient’s understanding. That is, find a part of their misconception that makes sense to you, as this physician did.
Here’s another example.
At the time of this writing, misconceptions about the coronavirus are being spread on social media. I doubt it’s possible to tell how much people believe these statements, versus how much they’re forwarding them just for the heck of it.
But let’s imagine your patient comes to you and repeats this misconception (I found it on Twitter): that the name of the novel coronavirus indicates is somehow related to Corona beer, specifically through a plant used to brew the beer. The plant spread the disease.
Sounds ridiculous and silly. Still, I’ll invite you to take it seriously for a moment.
How could it make sense? Your expert knowledge means you know enough to find the sense or logic in patient misconceptions, even the ones that drive you up a wall.
In other words, I’m inviting you to use your education, and a bit of curiosity, to entertain some possibilities and find the sense in a misconception.
Here’s a possibility: it makes sense in that some diseases have been spread through plants. That’s true. The US has had some high-profile diseases spread through plants recently. Listeria was spread through some improperly handled Romaine lettuce. The CDC only recently indicated it is safe to eat all romaine on the US market.
This is some common ground between you and your patient. You both know some diseases can be spread by plants. Now you have something to work with!
Since the spread of disease through plants is on your patient’s mind, meet them where they are. You might take this opportunity to do a quick lesson on
- different ways diseases spread
- the differences in how diseases can be prevented
- the similarities and differences between the novel coronavirus and influenza (as many health pros are doing).
Consider sharing with your patients a time you had a misconception, and how you came to know what you know now.
That’s how a patient’s misconception can be helpful: Their misconception is the basis for your education efforts.
Don’t let misconceptions drive a wedge between you and your patient
What you’re trying to do is connect your patient’s understanding to yours. Building bridges is particularly important when your patient does or says something you find frustrating because of its likely negative impact on their health.
Some people might argue this is not going far enough, particularly in situations where there are dire health consequences at stake.
I am inviting you to begin to understand a patient’s understanding, not just because it’s good for adult learning, but to help maintain a good relationship between you.
This is because I maintain that a good relationship is a powerful context within which to disrupt some potentially problematic thinking. When there’s some common ground, there’s something to work with. If communication breaks down, there’s no chance for influence.
Keep in mind that:
- whatever your patient says is related to assumptions or beliefs that they hold
- these assumptions and beliefs make sense to that patient
- the misconception is not a misconception in the patient’s mind
- we all want to be taken seriously on our own terms.
With this in mind, you can begin with the misconception, and start to build a bridge between your understandings, regardless of how far away they seem.