Time for clinicians to drop the jargon


Writing ‘ankle swelling’ instead of ‘peripheral oedema’, or ‘breathless while lying down’ instead of ‘orthopnoea’ in letters seen by patients improves their understanding of their illnesses and enhances their perception of the doctor’s professionalism, a New Zealand study has shown.

The researchers from the medical outpatient service at Nelson Hospital asked 60 literate, adult patients without any neurocognitive impairment to assess a ‘translated’ letter after they had received the original.

The changes focussed on medical terminology that doctors regard as standard language but can be impenetrable to patients.

Other translations included ‘unknown cause’ for idiopathic’, ‘heart ultrasound’ for echocardiogram’, and ‘fast heart rate’ for ‘tachycardia’.

Patients overwhelmingly preferred the translated version and 69% said it increased their perception of their doctor’s professionalism. About 80% said it improved their ability to manage their chronic health condition.

The primary outcome of the study was levels of anxiety and depression associated with their illness, but translation had no significant effect.

The researchers, writing in the Internal Medicine Journal, said there were moves worldwide to facilitate patients’ access to all their medical records, aided by changing technology, but little research on how they might interpret this potential flood of information.

“The use of technical language limits patients’ ability to fully engage with their practitioner,” they said.

“In an era in which physicians themselves are shown to have limited understanding of basic Latin terminology and abbreviations, it is unfathomable that patients remain required to integrate its use into their healthcare needs.”

GPs were also asked about impact of the translated letters. They were a little less enthusiastic, with some thinking that clear communication might undermine perceptions of professionalism, but they were equally divided about which version they actually preferred.

Meanwhile, a study led by Dr Matthew Winter and colleagues at Royal North Shore Hospital in Sydney found patients prefer learning about their impending surgery from iPads rather than directly from their doctors.

In a study presented by the doctors at the European Association of Urology Congress in Munich, patients about to have surgery for renal colic were randomised to learn about the procedure from a cartoon animation on a iPad or a discussion with a real doctor.

They understood the iPad version better, and strongly preferred it to a doctor’s explanation (80% vs 20%).

“Often doctors work in busy environments and time limits the quality of a consult and or verbal consent for a procedure,” Dr Winter said.

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