Speaking civilian, not ‘medicalese’

July 8, 2011

I love medical words. Seriously, where other than the world of medicine do you get use words like siphonapterosis, cholecystoduodenostomy, or pheochromocytoma? They just roll off the tongue, and I get the same sensation saying them I as I do when I eat fine European chocolate. Sort of a lusty, tongue-coating warmth.

As fun as they are to say, the lust for them has to exist for the recipient as much as it does for the speaker. If I am talking to a fellow doctor, a long medicalese w0rd can convey paragraphs worth of information in a just a few (admittedly unwieldy) syllables.  Even though they are long and seemingly complex words, if every one involved digs their meaning, they become a sort of shorthand and we can get down to the healing portion of the work at hand. Everyone is on the same level, and information transfer from one brain to the next is smooth.

If the person listening is a non-doctor, though, as better than 99% of the world is, these wonderful words that pack so much meaning into just a few letters strung together work the opposite magic. The listener ends up confused, ill-informed and tunes out the speaker.  The transfer of information from one brain to the next comes to a screeching halt. Not only is the information not transferred, future attempts at communication falter because the listener no longer trusts the speaker and stops caring what they have to say because they know they won’t understand it.

We have seven brand new, fresh-out-of-the-package doctors at Purdue right now. They constitute our new class of interns. They have just spent four years filling their Broca’s area with these lusty European chocolate words, and they are itchin’ to use them. They have rightly earned the privilege of acting like a doctor, and, along with the stethoscope and lab coat, the lingo is part of the costume that we wear as we play doctor.

This, on occasion, causes problems.

We live and die by clients. They bring the animals in for us to treat, they pay the bills that keep the lights on, and they need to be an active and informed part of the medical decision making. But, they are usually neurotypicals and their mother tongue is usually Normalese. If they are flummoxed by a barrage of medicalese and don’t know what is going on, the process gets that much harder. The interns all go through the same arc of learning. They confuse the first couple dozen owners with their ginormous medical lexicon, suffer through the same quizzical stares and then, gradually, learn to speak civilian.

I did the same thing. I went through the same process. I don’t hit the mark all the time (due to my love of big words, sometimes I let some slip through) but I think I have developed a pretty good ability to talk to pet owners on their level and tone down the jargon. I think it helps people see that I am human, too, (for the most part) and I can explain things without resorting to buzzwords.

What has been your experience? Have you had conversations with your MD or veterinarian that left you wondering what is going on? Have you nodded through these, thinking ‘what the hell is he talking about?’ Or, have you stopped them and said ‘what does that mean?’  Do they communicate clearly so you can understand what is going on, and what the options are, or do they leave you with a head full of questions and ears ringing?

Filed under: gratuitous blogging,pets, connected,veterinary medicine — Dr. Tony Johnson @ 7:39 am

13 Comments »

  1. Heck, I’ve had incomprehensible discussions with veterinarians and doctors that seemed to be in ordinary English. I remember one with a vet especially vividly, about a cat with HCM secondary to HT: ‘He’s already had a stroke, the prognosis isn’t good.’ A stroke?! But no, it turned out it wasn’t the neurological event; rather, he had a saddle thrombus. (He also recovered from that, and lived another several years, dying just a few weeks shy of 20.)

    I always ask. Unfortunately, the same vets and doctors who tend to do this in the first place are also prone to explanations that are, charitably, clear as mud. The vet above, for instance, who was my cat’s oncologist – he was in for radio treatment of the HT – kept using the term ‘stroke,’ and offered explanations so very heavy in medical jargon that they might as well have been in Urdu. I finally wrote it all down – some of it phonetically – phoned my regular vet, and had him translate.

    Comment by Eucritta — July 8, 2011 @ 9:22 am

  2. High school Latin has been a real resource, though not a panacea. Uh, cure-all.

    Terminology or not, my vet tends to assume that because I have a high level of knowledge about *some* areas, such as genetics, some orthopedic topics, some specific diseases and conditions, trauma first aid, and many things that have analogs in human medicine, that I am at the equivalent level on topics that are totally unfamiliar to me.

    Such as when our kitteh was diagnosed with eosinophilic granuloma.

    Whut?

    Oh well. I found out soon enough, and continuously for the next ten years.

    Comment by H. Houlahan — July 8, 2011 @ 9:38 am

  3. My vet knows, after all these years, that if I don’t understand something, I’ll ask…and ask…and ask. I don’t leave her office until I’m completely out of questions. I think it’s reasonable for her to expect me to ask about what I don’t understand, but I just don’t think everyone does. She told me once that patient compliance was the #1 problem they encountered, and I have to think that a big part of that is that the clients don’t understand what the vet told them and they don’t ask for clarification.

    Comment by Sherron — July 8, 2011 @ 2:51 pm

  4. I’ve had the opposite problem. A vet at a clinic that I never visited once and never returned to tried to use baby talk to explain to my why my dog needed a heartworm test (when he’d just been tested 5 months ago and had been on treatment continuously since then).

    It did not go well for her.

    Comment by Janeen — July 8, 2011 @ 5:28 pm

  5. I’ve had the same experience as Heather, but always ask or ask him to write it down. Then I call my cousin who’s a vet & ask her. I would rather have the “real” name for problems & the “street” name too, makes it easier to look things up. Can’t blame the interns for wanting to show off all they have learned either.Lots of years of constant study & rotations behind those scientific big words !

    Comment by original Leslie K — July 8, 2011 @ 5:32 pm

  6. Given the fact that a few of my very favoritest words of all are sphygmomanometer, blepharitis and borborygmus (G!), I suspect I tend to encourage that sort of “bad behavior” when talking to my vet. But that’s okay – I know enough medical terminology that I can generally follow the broad brush strokes of what he’s describing when he uses “jargon”, and I can then infer some pretty good followup questions to sharpen my understanding of whatever the current situation is.

    However, I’m pretty sure he’s aware that the vast majority of his clients didn’t have to take a course on Medical Terminology as part of their schooling, and he almost certainly tailors his approach accordingly.

    But precisely for the reasons you cite – that “a long medicalese word can convey paragraphs worth of information in a just a few (admittedly unwieldy) syllables” – I LIKE it when my vet is comfortable enough to start off by giving me the “medicalese” and then following it up with as much definition as I need, or explore it via followup Q&A. For me, it makes me feel like we zero in on exactly what he’s talking about so much faster that way instead of him dancing around trying to find simple approximations to get the picture across.

    I can see where it turns a lot of people off. But I’m glad he’s savvy enough to know that’s not the case with me.

    Comment by The OTHER Pat — July 8, 2011 @ 6:49 pm

  7. Sometimes I don’t understand what my vet really meant until sometime later. Last time, it was while he was trying to help diagnose her and prescribe medication. Unfortunately, I was upset and didn’t understand the question until the next day. Bummer.

    Comment by Melissa Duffy — July 8, 2011 @ 9:50 pm

  8. My current vet is wonderful. I’ve fired several vets and multiple MDs for the opposite problem: they assumed I was stupid and talked down to me. One MD got angry that I looked up an Rx in the PDR because “it’s written for medical professionals and you’ll just get confused”. That really made me mad.

    Comment by Theresa — July 9, 2011 @ 4:56 am

  9. I would share with newly minted DVMs: I dislike it when a vet speaks loads of medicalese.

    It doesn’t help me or my pet because time is wasted. If the vet is speaking with a vet tech or another vet in the exam room, fine- communication is key. But when turning to explain it to me just speak non-DVM please.

    Same thing when a car mechanic or IT specialist or a venture capitalist is communicating with me. I am not in that world and didn’t learn what you have spent the majority of your life learning.

    Nor did I get the special de-coder ring in my cereal box to secretly figure out what you are saying.

    Comment by Ericka — July 9, 2011 @ 5:04 am

  10. If I don’t understand certain medical terms, I ask my veterinarian to elaborate so I understand. My cats’ veterinarian(s) understand that I didn’t go to school for veterinary medicine. If I did, I wouldn’t need their services. :)

    Comment by Rebecca — July 9, 2011 @ 9:58 am

  11. Wait… I have to look up Broca’s area… that’s near Wernicke’s if I recall correctly…. what were you saying?

    Comment by Deanna — July 9, 2011 @ 6:21 pm

  12. Well, I like to use big words (to educate) and then follow up with the ‘lay’ terminology. I have always been a little irritated by veterinarians and staff who use ‘shots’ instead of vaccinations, and who say ‘Out of it’ instead of something like ‘under the effects of sedation’…but that’s just me.

    Comment by Teri — July 11, 2011 @ 1:49 pm

  13. I’ve had the great luck to be best friends with a physician who explains things in English better than any other medical professional I have ever met. She does it without making me feel stupid. She’s helpful whether I’ve just come from the vet/physician, am writing an article on a certain disease, or have just come out of emergency surgery and am groggily calling her from the hospital. Sadly, she is as rare as can be. They should teach classes on this in vet/med schools.

    Comment by Phyllis DeGioia — July 12, 2011 @ 6:11 am

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