July 23, 2014 — Blog Post
Coming to Terms: The Importance of Being Understood in Healthcare
The English language isn’t well known for allowing speakers to say clearly and concisely what they mean. We don’t have fifty words for snow (though meteorologists will try to convince you otherwise), and anyone who has ever watched a spelling bee or studied for the GRE will tell you we use only a fraction of the words that are at our disposal. Syntax offers no refuge: commas, commonly abused and neglected, have wreaked havoc on authors, journalists and Facebook posters alike.
The point is this: nuanced differences in language can dramatically change the meaning and the tone of what is understood, and nowhere is this more important than in healthcare. Imagine you are an emergency medicine physician attempting to diagnose a person with abdominal pain. You ask them to describe the pain they’re experiencing, knowing that different kinds of pain may indicate very different pathologies. It’s likely that their word choice, body language and expression of discomfort will differ from how you would attempt to describe the same feeling, or how others have described that pain in the past. Also, consider the number of patients that you as a physician will manage that hour, much less that day. Mix in the stress and emotion typically associated with requiring medical attention and how that might affect your patient’s ability to communicate. And of course, don’t forget the multicultural and multilingual nature of the United States—there’s a good chance that your first language isn’t the same as your patient’s. How confident are you that your patient understands what you’re asking, and that you understand what they’re trying to say?
The barriers to effective communication in healthcare settings are significant, but so are the stakes. Traditionally, the healthcare system has placed the responsibility for effective communication on clinicians and patients without offering any real resources with which to navigate such a difficult task. This is beginning to change. More and more, healthcare organizations are taking steps to empower both parties with the tools necessary for comprehension and communication. They are enabling what anthropologists would call “coming to terms,” or building a shared understanding of what certain language means and when to use it. By engaging patients in their own care, educating them about their own conditions and symptoms and offering them meaningful language to use when communicating with clinicians, hospitals are helping to bridge the gap between those receiving and those delivering healthcare. On the other side of the communication equation, clinicians are receiving more training in bedside manner (which includes communication), as well as support from care coordinators and patient advocates, who are specifically trained in effectively translating clinical language into meaningful explanations for patients, and vice versa.
As the healthcare industry continues to move towards a patient-centered model of care delivery, “coming to terms” will play an increasingly important role. Recognizing that even the most effective and well-trained communicators among us fall victim to the pitfalls and complications of language and interpersonal relationships, its clear that new avenues must be employed. Technology offers the opportunity to communicate across a variety of media, enables standardization of the information communicated and facilitates testing of effectiveness of the language employed as well as potential improvement. Of course, technology cannot do everything; human-to-human communication is essential to parts of healthcare and can’t be automated. But for those areas that are ripe for standardization, technology reduces errors, enables patient review of materials and provides access within and beyond traditional care settings.
By empowering patients and physicians to communicate effectively with one another, we can improve outcomes, increase patient satisfaction and ensure miscommunications in healthcare go the way of the Oxford comma.