Medical language that casts doubt, belittles, or blames patients for their health problems continues to be commonly used in everyday clinical practice, but is outdated and overdue for change, says Dr Zoë Fritz (Medicine 1995), Gonville & Caius’ Director of Studies in Clinical Medicine and a Bye-Fellow.
In collaboration with Dr Caitríona Cox, an alumna of St Catharine’s College, a paper published in the BMJ on April 27 draws on existing research to describe how such language, while often taken for granted, can insidiously affect the therapeutic relationship, and suggest how it could be changed to foster a relationship focused on shared understanding and collective goals.
Dr Fritz is a Wellcome fellow in society and ethics, and a consultant physician in acute medicine at Addenbrooke’s Hospital, and both researchers are affiliated with THIS Institute (The Healthcare Improvement Studies Institute).
Language that belittles patients includes the widely used term “presenting complaint” rather than referring to a patient’s reason for engaging with healthcare, they write. Similarly, use of words such as “denies” and “claims” when reporting a patient’s account of their symptoms or experiences, suggests a refusal to admit the truth, and can hint at untrustworthiness.
Other frequently used language renders the patient as passive or childlike, while emphasising the doctor’s position of power, they add.
The authors note that using the right language “is not a matter of political correctness; it affects the core of our interactions” and say research is now needed to explore the impact that such language could have on patient outcomes.
Much of the language highlighted here is deeply ingrained in medical practice and is used unthinkingly by clinicians, they write. Clinicians should consider how their language affects attitudes and change as necessary to facilitate trust, balance power, and support shared decision making.