Stop talking to patients as if they’re children, doctors warned
DOCTORS have been told to stop using ‘belittling’ language amid claims they often talk to patients as if they are children.
Some ‘outdated’ words used by medics appear to cast doubt, dismiss or blame people for their health problems, experts warn.
Phrases such as ‘treatment failure’, ‘presenting complaint’ and ‘send home’ are frequently written on medical notes or said during appointments.
But researchers warn that they can create stigma, put patients off seeking care and ‘insidiously affect the therapeutic relationship’.
They say using the term ‘presenting complaint’ rather than referring to a patient’s reason for engaging with healthcare is belittling and has ‘negative connotations’.
Similarly, using words such as ‘denies’ and ‘claims’ when reporting a patient’s account of their symptoms or experiences suggests they are refusing to accept the truth or are untrustworthy. Instead they should say someone ‘reports’ no chest pain, for example.
other frequently used language renders the patient ‘passive or childlike’, while emphasising the doctor’s position of power, they add. For example, doctors ‘take’ a history or ‘send’ patients home. The terms ‘compliance’ and ‘non-compliance’ in relation to taking medication are also deemed unsuitable for being ‘authoritarian’.
Doctors are advised to focus on the reasons why patients might not be taking their pills and change their language accordingly. one patient told the University of Cambridge researchers: ‘Being described as “non-compliant” is awful and does not reflect the fact that everyone is doing their best.’
Language that implicitly places the blame on patients for poor outcomes is also problematic, argue study authors Caitriona Cox and Zoe Fritz. For instance, the term ‘poorly controlled’ referring to conditions such as diabetes or epilepsy can be ‘stigmatising’ and make patients feel ‘judged’.
The authors believe that using the right language is ‘not a matter of political correctness’ but affects the ‘core of our interactions’.
They say words should be changed to ‘foster a relationship focused on shared understanding and collective goals’ and call for further research to explore the impact that language could have on patient outcomes. Writing in The BMJ, the researchers said: ‘In the UK, guidance by the UK National Institute for Health and Care Excellence (NICE) on shared decision-making focuses on the importance of communicating risks, benefits and consequences of interventions to patients.
‘Yet some language used either to communicate directly with patients, or when discussing patient care with other healthcare professionals, might inadvertently disempower patients.
‘Language that is belittling, doubting, or blaming continues to be commonly used in everyday clinical practice, both verbally and in written notes.’
‘Using language that’s belittling’