This week, I was at Columbia University’s Mailman School of Public Health, giving a webinar through the Region 2 Public Health Training Center. It was about addressing unconscious bias in our language.
While I was there, I was participating in, or overhearing, multiple conversations about health and healthcare. Some while walking across campus, some while taking elevators in various parts of the medical center.
And this traveling in and out of conversations brought into strong focus for me: when we’re talking about health, sometimes it feels like we’re speaking different languages.
I don’t mean world languages or regional dialects. I mean the ways people talk when we are talking about health and well-being and healthcare. What we take for granted, the words we use, and more.
This is about paying enough attention to your language–and making small adjustments–so you can speak in a way patients will understand. Or the public. Or your colleagues across campus.
Speaking different languages?
Over the past few years, I have been able to interact with many people who are aware of and concerned about the language they use. Health professionals and patients. Administrators, educators, and policy activists.
Across–and within–these groups, the terminology is different. The topics are different. The knowledge, assumptions, and motivations are different.
In short, people’s ways of thinking, talking about, and ‘doing’ health, wellness, and health care are different. No news here.
Yet, a defining goal of health communication is better health for all.
So, as I was moving among building and groups at Columbia’s Medical Center Campus, I was thinking about what it takes to talk across different health languages.
Talking across different health languages
Health professionals are trying to do this ‘talking across’ all the time.
For example, I frequently hear clinicians express concern about their own effectiveness in articulating their knowledge to patients ‘at bedside.’
Some of the public health professionals I spoke with at Columbia are concerned with being able to effectively synthesize research, and present it to clinicians or to the public in a way that will inform thoughtful action.
And IPE (interprofessional education) is growing in importance, as teams learn how to communicate across specializations and roles.
So I thought it would be helpful to park it for a few minutes on the fact that language and learning are social.
That is, all these differences in how we talk and think about health are a result of our participation in various communities. Our professional communities. Our neighborhoods and families and multiple social groups.
Who are the people in your neighborhood?
The various contexts we move through each day all have their own rules and norms.
People are more comfortable speaking in some places, to some people, than others. We feel more or less confident in our knowledge depending on where we are, and who’s listening. We feel a more valued part of some contexts than others.
And there’s plenty of variation within contexts. What is acceptable or normal in one is not necessarily so in another. Success or comfort (or lack thereof) in one does not automatically translate into another.
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For instance, we know about ‘academic silos.’ Those silos are the places each of us learned to talk, think, read, write, and act in ways that are necessarily specific to our area of expertise. This is a significant socialization process.
Our understandings of health are also socially mediated.
What we hear and say and learn and pick up in our communities informs our conceptual basis, as we read, write, talk about, think about, listen to, process, and act on what it means to be healthy.
We are socialized into the ways we talk, think, act, and more. And over time we come to inhabit these ways as ‘normal.’
And so, when we speak (or write) we reveal our perspective on quite a few things. Like how we think the world works. What we take for granted. What we think is important. We constantly make sense of the world and our place in it. And we have what we believe to be good reasons for doing what we do.
Being aware of your ‘normal’
We take our perspective as normal. And this set of lenses can be incredibly difficult to shake off.
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 that this normal is socially arrived at – is a difficult but massively important first step.
Patient encounters are interesting examples of many different ‘kinds’ of health languages. Your patients or clients have ideas about health and healthcare, shaped in their communities, through a lifetime of experience. Certainly, the average American just doesn’t know a lot of things that health professionals know. And sure, there are some funny ideas out there around health and bodies and health care.
So there’s the different health languages in the conversations between patient and provider.
But there’s also quite a number of other health languages at work – think just for a moment of all the written texts. The pamphlets, lists, forms, and of course, the electronic medical record. All of these are loaded with ideas about what’s right, proper, or normal when it comes to health, well-being, and health care.
We all have been socialized into various ways of thinking about and talking about health, well-being, and health care. Part of our jobs as professionals is to recognize each of us has what we consider ‘normal’ or natural.
And to start to talk across difference.
How to start today
Everyone can communicate. But in health communication, it’s not a level playing field.
When it comes to health and well-being, you as a health professional are in the position to shape the conversation. In part, this means you have the power to start where people are, and begin the work of talking across difference. Bridge-building, if you will.
Here are three things to remember—and handy phrases to use–the next time you are talking with patients or clients:
- Check for your own understanding of their perspective. “If I hear you right, what you’re saying is this…”
- Use your patients’ words back to them. As closely as you can get to what your patient actually said. “I thought it was helpful to me/quite insightful how you described y. Let’s go over the choices you’re facing with y.”
- Ask clarifying questions about issues that emerge. “You mentioned x. Tell me about that.”
If you’re a really talented reader, you’ve already picked up on the fact you could also use these statements with your colleagues across campus. Or with focus groups.
Or with someone in your neighborhood.
If you are interested in taking your language use seriously, why not start with your metaphors? This workshop shows you how to break down the metaphors you use, understand their cognitive and affective aspects, and evaluate them in use. On demand, right on this site.
