March 26, 2011 GUEST POST by Bethany Brodie
At the age of 16 ½, I could have told you what LOL meant, the most popular fashion trends, and the latest gossip around the halls, but when told “You tore your ACL and suffer from slight ligamentum laxity, so we’re going to use your patellar tendon to repair the damage”, I was far from in-the-know. Now, after 4 years of studying Biobehavioral Health and 2.5 years as a teaching assistant in Mammalian Anatomy, I clearly understand what my doctor was saying, but, I can testify to the fact that my questions lingered until it was much easier to forget about them than deal with my confusion before surgery.
As an inherent part of the medical field, technical jargon exists to identify and specifically classify different diseases and their associated terms, but unfortunately, most of us lack the necessary education to understand most or even some of their meanings. It is in the doctor’s office, though, that these two paths cross and often fail to be reconciled before moving forward with treatment.
Recent research by Castro et al. (2007), explains how type II diabetic patients encountered, on average, 4 unclarified medical terms per visit as presented to them by their doctors. After further investigation, researchers also found that patients reported understanding the words, but when asked to define them, less than 40% could actually reiterate the meanings of the most commonly used terms. Though doctors and nurses face daily time constraints, it is important for them to remember that the best possible health outcome for the patient is goal, and a necessary step in that process is patient understanding.
There are many steps that medical professionals can take to ensure comprehension without compromising their busy schedules. For example, they can use a medical term in a sentence that applies specifically to the patient’s condition, and then follow that sentence with a brief definition in Layman’s terms. Later, they can also have the patient teach- back what he or she learned during the visit, and ask a staff member to follow- up with a phone call to address any remaining concerns.
By adopting these practices, physicians and nurses are also demonstrating their care and concern while also empowering the patient to take control of his or her condition. Equipped with the knowledge and resources to act, patients are probably more likely to adhere to medical advice. In the end, they cooperate with their doctor, improve their health, and ultimately reduce the medical cost associated with miscommunication and lack of understanding. A positive outcome for all!
This is an issue that I’ve experienced first hand as a student and also have done to others. Often, when we understand something thoroughly, we forget that others may not be at our level quite yet. This happens to me often (it seems like everyday) in the laboratory. When doing research, my research supervisor often tells me things that just go right over my head. Most of the time I nod, trying to protect positive face, and ask a post-doctoral fellow what she meant when she was no longer in the room. This is the same kind of situation in the clinical setting. People who work in the lab every day for so long, such as my research supervisor, forget that undergraduates may not be up to speed on the jargon or technical terms used everyday in the lab. As Bethany stated, this is the same situation occurring in the clinical setting. Physicians have some much knowledge and information stored in their brains that they’re like a high tech computer that’s not very user-friendly. They may use terms such as LDLs, ced rate, systole/diastole, atherosclerosis, etc, leaving the patient lost and confused. Although we may have heard these terms in an anatomy, physiology or biochemistry class, the lay public may lack this knowledge and these terms may go right “over their heads.” Thus, I agree with Bethany’s solution, physicians need to follow these terms with a lay description or a demonstration that accommodates to the patient’s level of understanding. For example, if the physician says: “Your diastolic pressure is elevated…” he or she could follow by saying “this means your heart is working hard during the time when it should be resting…” Physicians should read the person’s non-verbal and verbal cues and if there’s confusion, they should accommodate and follow up with a lay explanation.