The providers I hear from tell me that they’ve been doing a good job cutting down on their use of medical jargon. And I believe it! Lately, in my experience as a patient (and pet owner, and patient family member), I’m hearing providers use more and more everyday language to explain or define medical phenomena.
It’s tough – and important – to catch yourself using medical jargon. But you know that successful health communication is about more than eliminating jargon.
In this episode, you’ll learn why it’s the meaning of terms – more than any specific term or groups of terms – that’s really where the action is. And you’ll learn three ways to get to a meaning that works for you and your patient.
“Are we using technical terms? That are not appropriate for any patient?”
This was a physician group administrator talking with me on the phone. This group had reached out to me, and I was asking about the problems they were facing. This was one of the first things the administrator said. I hear versions of this question from many providers.
You know by now that high quality patient-provider communication is a key element of a patient’s health. But we all – patients and providers–have been socialized into various ways of thinking about, and talking about, health, well-being, and health care. Part of your role as a health professional is to recognize every one of us has what we consider ‘normal’ or natural ways of talking about health.
I’m here to help you start to become more aware of your own language—and your patients’—so you can be more effective in the ways you communicate with all patients.
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Alright, first, when it comes to technical terms, don’t beat yourself up. It can be tempting to think about communication as simply the transfer of information. Imagine, it’s like: I have this thing–it’s information!–and I want to give it to you so you can have it, too. So I’m going to communicate with you. I’ll talk to you, or give you something to read or look at. And there we go, done! Kind of like sharing chocolate or photos of your pets. I have it, and I give it to you, and now you have it too.
Except ideas and information don’t travel between people as neatly as pocket snacks or funny photos. I’ve written before how one of the biggest trip hazards in health communication is the specialized language used in medicine. Like the physician group administrator indicated, this specialized language of technical terms isn’t appropriate for any patient – regardless of their social and cultural background.
But communication difficulties aren’t limited to those times providers are talking with patients. Across–and within—groups of health professionals, the terminology is different. In short, people’s ways of thinking, talking about, and ‘doing’ health, wellness, and health care are different. We are socialized into the ways we talk, think, act, and more. And over time we come to inhabit these ways as ‘normal.’ Take a moment and remember the socialization processes around your professional knowledge, all those new ways of talking and thinking. Can you remember: what was your language like before then?
Now, in health communication, we want people to understand something that we believe is important to their health and well-being. There are several steps to this process. Being aware of your normal – and what you take for granted – is a massively important first step. So let’s take a look at what you’re taking for granted when it comes to some of the words you frequently use.
It can be tricky to stand back and look at your own language, but that’s why I’m here. And I’m going to turn to one of my favorite sages, Jim Gee. Gee is very good at exposing some of what we take for granted when we communicate, read, watch, play video games, and more. If you’re hardcore into thinking that communication is a simple transfer of information, spoilers ahead! Let’s see as Gee pulls the curtain back on what we take for granted about something as seemingly simple as what words mean.
“Meaning is not a thing that sits fixed in the mind… It is not something that sits in dictionaries. Nor does it reside in the minds of experts and ‘well-educated’ people to the exclusion of others. Rather, meaning is primarily the result of social interaction, negotiations, contestations, and agreements among people. It is inherently variable and social.” (p.21)
For nearly a century now, researchers concerned with language have known that meaning is locally made, dependent on context. So, rather than examining language in abstraction from its actual everyday use, many linguists and language researchers conduct detailed examinations of language as it’s used by real people in real life. To put it another way, in order to understand the particular meaning and significance of a word or phrase, how it functions, and its practical uses, we would have to know the context in which it was used.
It’s hardly surprising that the various contexts that surround us when we talk, read, listen, and write are what gave language its meaning and significance. Our own experiences tell us that the same word or phrase, spoken in different situations, can have different meanings and significance. This is because meaning is locally made. Take “coffee,” for instance, again I’m going to turn to Professor Gee:
“In fact, most words do not have fixed meanings. Take even so simple a word as ‘coffee’. If I say, ‘The coffee spilled, go get a mop,’ I am talking about a liquid. If I say, ‘The coffee spilled, go get a broom,’ I am talking about beans or grains. If I say, ‘The coffee spilled, stack it again,’ I am talking about tins or cans. If I say ‘Coffee growers exploit their workers,’ I am talking about coffee berries and the trees they grow on.”
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The funny this is, we all know this. We just don’t often have to stop and think about this quality of language.
Like I said, we are socialized into the ways we talk, think, act, and more. And we tend to work with, hang out with, and otherwise be surrounded by folks who talk, think and act in ways kinda similar to ours. Much of what we do with language escapes our conscious awareness. We rely on assumptions, and ways of talking, acting, and being, that we use almost automatically. That’s not to say we’re doomed to life-on-autopilot, or that the meaning of everything is totally up for grabs (though sometimes both of those things feel true).
It might help to think of words and phrases in everyday use as carrying general meanings around with them. The many possible meanings of the word coffee, for instance. You knew about all of those and probably more. When we hear or see a word, we choose from among these possible meanings, based on our specific context. In other words, we choose one meaning, from among all the potential meanings we know a word may hold, by using cues from our specific situation.
The problem comes when we think other people share our same meaning. And this is easy to do, because as I said earlier, we are generally surrounded by folks who more or less do share our same meaning.
But you have power here. Let’s take the patient encounter as an example. You get to be clear with each other about what words mean. You have the chance to make sure there is shared meaning around important terms. Like medical jargon; sound-alikes; figurative language, especially metaphors; terms that have one meaning in everyday life, and a different meaning in a specialized context (like “critical” and “orientation”); and those quirky names that pharmaceutical companies give their products.
But wait, there’s more! As I’ve pointed out before, in the patient encounter, you have first say in determining what’s on the conversational table. Another way of putting this: you have more relative power to make topics talk-about-able. So use that power to find out what you both are thinking or assuming about the meanings of terms. For instance:
- Check for your own understanding of your patient’s perspective. “If I hear you right, what you mean is this…”
- Use your patients’ words back to them. As closely as you can get to what your patient actually said. “I heard you call it x.”
- Ask clarifying questions about differences in meaning. “You mentioned x. Tell me about that.”
Your patient conversations are places where words have meaning. So don’t let autopilot take over. Because trouble comes when you and your patient do not share an understanding of the meaning of a word.