When a health care worker becomes a patient, is it lame or appropriate for them to use medical terminology when talking to their care providers?
I am (as usual) on the fence with this one.
A part of me finds it borderline irritating sometimes when people present to triage and say things like, "I've had some discomfort beneath my xiphisternum for the past three days, not sure if it is from the NSAIDS that I've been taking or if it is a hiatal hernia, or what.." Or "my nephew has just fallen skiing, I am pretty sure he's torn or partially torn his ACL, his drawer test is positive and he's not weight bearing".
Naturally the thoughts running through my head will include; "are you telling me this as a secret hint that you are a HCW and therefore should be seen more quickly than the sicker people in the waiting room?", "are you using medical language because of it's precision and beauty, or as an attempt to make my assessment easier?", or "are you having a difficult time accepting that you are a patient and are trying to desperately hold on to your normal power position in this setting?"
And then I realise that I am probably over-thinking the whole thing. Yet the feeling of vague annoyance lingers.
Of course, when I went to the sports med clinic with my shin splints a few years ago I wrote, "bilateral anterior tibial pain" under the chief complaint box. Why didn't I write "shin splints"? Well partly because I didn't know for sure if that is what it was, "leg pain" seemed too vague and I could perfectly describe the area of discomfort using those words. I am pretty sure the MD who saw me thought it was douche-y (the only explanation for his terrible assessment and treatment).
Since then I try to just let go, accept that I am the patient and write things like "knee pain" in the chief complaint box when I go to see the orthopod. Even through it is "midline, subpatellar discomfort on palpation and with weight bearing exercise".
Thoughts?
12 comments:
I think it can easily be any or all of the above. I try not to show any overt knowledge to begin with, because I know it can put HCWs a bit on edge if they think you are in the business.
I also think it, as an HCW, it can lead to some presumed knowledge and might actually impair communication by exceeding the patient's knowledge-base. I would imagine it would make it more... Embarrassing? For a patient to say "I don't understand what you just said", if you've been conversing with them in medical terminology.
AB--I like going incognito as well, just to see what the care is like to the 'lay' person. Always interesting to see how it shifts when they discover you are 'one of them'!
I agree with the possibility of impairing communication.
I had a critically ill neurosurgeon once as a pt who openly said "treat me like a regular patient" when I apologized for explaining a medication side effect to him--figuring he must have known it. He was great, actually because I was really stressed about taking care of him.
When I had to ambulance transfer him after he'd been diagnosed he even said, "damn, that wasn't even on my differential".
I'm thinking it probably depends on the chief complaint. Not totally sure on this, but my impression was that there wasn't much that could be done for shins splints except rest, ice, and maybe stretching.
I think most doctors will want you to at least show that you respect their opinion. When I go to the doctor these days, I don't talk in medical lingo, but I try to keep it concise and focused, and to not self diagnose. When they start telling you what they think, listen. Then you can respectfully ask questions if you want.
I had a really good experience with an NP at my gyn appt last year. She said, "Oh you probably know all of this already," and I said, "Why don't you tell me anyway, since I'm going to be a neurologist and have forgotten everything I know about gyn." She seemed thrilled that I wasn't going to be a big know-it-all.
OMDG--Yes, I think the approach of not trying to self diagnose is key (difficult...but key).
I know that anyone I see for any health complaint has objectivity and experience in their field---two things that I don't have.
As an aside, I was disappointed in the shin splint appt because I specifically went to see a SPORTS MED specialist who didn't ask me anything about my training, help me figure out why they'd developed, or provide me with useful strategies to avoid the injuries in the future.
The physio I went to did all of those things--plus ultrasound, massage, exercise suggestions, footwear analysis, referral to a podiatry clinic, etc. Lesson learned, I guess.
Oh shin splints. Dislike.
Well in my experience, about 10 years ago I had just become a CNA, and had to bring my daughter in to see a pediatrician and then stupidly used medical jargon only to be humbled that I didn't know enough terminology to understand all that the doc. was telling me so I had to ask what he meant and from then I stopped using medical jargon because I ended up not knowing all that I though I did. haha.
I never use medical terminology at the doc's office. When I take my kids in I don't tell them that I already listened to their chests with my own stethescope at home before deciding to bring them in. Once they know I was a nurse, they treat me much differently and not in a good way.
My own GP knows I used to work at the hospital (heck, we did rounds together) and he respects my experience and judgment when I think I need certain things for myself or my kids.
I usually avoid the jargon but try to make it clear I understand if they "accidently" slip in a big word. I think this is only going to get worse for me as I get further along in medical school and more used to talking with other physicians as colleagues.
In my job I am so used to constantly teaching and talking to laypersons that I speak mostly in the vernacular.
I hate to say, I do try and figure out what is going on with me before heading off to the clinic.
If I have a patient talking to me in medicalese...i usually don't mind... - I just look at it all as "words" and assume nothing until they infuse attitude into it....
I chuckled at this post. I try not to use any jargon.
My issue is I pick it up from the doctors and the reading just like I eventually develop a twang after a few months of living in Kentucky.
I'm a polyglot which is part of it.
I was once interrogated by a suspicious NP over the use of the word copious.
Apparently copious is owned by medicine and is involved in the secret handshake.
All I can say is I was an honors student and started junior level college classes at 16. I'm sorry I have an education!
Please forgive me.
M
DF--Yes, though I've been lucky (thanks to aforementioned physio) that I've never had a problem since--mind you I don't tack on nearly 1/2 the kms I used to...
Zazzy--So I guess absentB's thoughts on the matter were accurate. It's probably better to wear the parent hat in those situations (and not HCW hat), the last thing you'd want is your pediatrician assuming he/she didn't have to tell you something because you already knew it! =)
NotJ--Nice that you have that relationship with your GP. Mine is the same with me--he just asks what I want prescribed and why--then we come to an agreement. =)
Jen--It's true. Medspeak slips into your daily language pretty insidiously. I remember using the word 'ambulate' during nusring school and wondering why I got a funny look from a friend...isn't that how EVERYONE describes 'moving around'??
CC--It's true, it's the attitude that comes with it that probably puts me off and for the most part people don't have that.
POP--Hahah, that is hilarious. 'Copious'? Really!?! I suppose some people are worried that people read symptoms online and memorize them, then use the words to try and make a convincing presentation. Maybe that is why she grilled you? =) Oh, and hahah, you are forgiven.
Have you ever read this Resident's blog? She lives in Victoria- she documents her dx of Bell's palsy:
http://drottematic.wordpress.com/2010/12/14/i-have-bells-palsy-part-4-what-its-like-to-be-a-patient-as-a-physician/
Starts at Dec 11 and has installments - even documenting with video.....interesting
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