July 19, 2021

Choose your words carefully

Bruce Peyser, MD, FACP
Director of Education and Teaching, Duke Primary and Urgent Care
Professor of Medicine, Duke University School of Medicine
Provider, Duke Primary Care Pickett Road

When teaching, we always need to be aware that we convey messages in a variety of ways to our learners and those around us, and the words we choose can matter a great deal. This was summarized recently in Academic Medicine‘s “Last Page,” which is at the back of the journal. (This is one of my favorite sections because it is limited to one page.) The article was entitled, “Using Language that Reflects Who is the Center of our Care,” and provided the example of a patient who presented to the emergency department with upper respiratory infection symptoms and uncontrolled diabetes. The information was presented in the current fashion of a case summary, but an alternative was provided which seemed much more respectful. It’s important to think about patient descriptors to try to avoid patient blaming. You can read the article at the link above.

Another example of how our word choice can matter is exemplified by our problem lists for patients. Some problem lists are reviewed, updated, and corrected on a regular basis, and many of us find it’s easier for learners to see some of these patients in our clinics when these lists are up to date. On the other hand, there are times when the problem lists are not as well attended to, and then it can be more challenging to see and care for those patients. Also, the problem lists can help correctly convey the complexity of our patients. We know our patients are sick and complicated with many medical issues. But documenting this properly in the problem list would help our students and colleagues, and would help our health system properly convey the complexity of our patient population.

One last example about word choice was exemplified and discussed in the Sept. 16, 2019, episode of The Curbsiders podcast. The episode was really interesting in a variety of ways. I especially enjoyed listening to Dr. Kimberly Manning. She tweets and has a blog, and she is very mindful of word choice in her daily work. She said this about her hospital notes: “My progress notes are to the point, and I don’t like a lot of noise.” I, too, prefer notes to be succinct and to the point, without a lot of extraneous material, or what she labels as noise. This particular episode also covered a whole range of topics, including imposter syndrome, the importance of taking vacation, and problems with the pneumococcal conjugate vaccine.

If you are not subscribing to The Curbsiders, I urge you once again to do so. It’s refreshing, informative, entertaining, and educational. And it’s free! Sounds like a no brainer, right?