During my first clinical clerkship on a nephrology ward, we went on rounds and the chief resident attempted to explain to a patient why her kidneys didn’t work: “…your disease is of inflammatory origin.”
I thought: “What? Inflammatory…as opposed to…? I have no clue what he just said! OK I’m still a beginner. I have only studied two years of medicine, but odds are.. that’s more than the patient studied!”
Six years or more we spent to learn how to use the medical language. And it is important to use it when talking to colleagues to minimize risk of misunderstanding.
But to make sure that we are also understood by the patients, we have to learn a different skill: we have to switch from medical to nonmedical tongue.
So, how can we make sure, the patient understands us?
- Make sure you want to be understood. In some cases, when doctors use their fancy language, I get the impression we don’t want to be understood, for example when they fear questions they can’t answer. Or when we talk about malignant diseases and survival rates or about complications. The truth is, patients can smell that.
So be optimistic but also honest and clear.
- Give only important information. Think about how detailed the patient’s understanding about his disease has to be: What’s the relevant information for her?When you give her a diagnosis she doesn’t need to know pathological features and serum markers.Example 1: A patient with membranous glomerulonephritis doesn’t need to know what distinguishes it from membranoproliferative GN. It’s more than enough when he knows, that there is a reaction comparable to an allergic reaction going on in his kidneys, leading to loss of function.Example 2: Explaining a procedure: when explainig a cvc insertion you don’t have to explain the wire and the dilatator. All he has to get is: small needle for anesthesia, big needle, then catheter, then suture.
And the risks of course should be explained more detailed and precise for legal reasons.
- Get rid of all the fancy language! Nobrainer, right? This means:
No thrombus only blood clot.
No colonoscopy, rather camera in your rear…
That can also cause irritations. Many sophisticated patients will insist, that you use the fancy language again.
They argue, that they have an uncle who is a doc and they’ve watched Greys’ anatomy for years. But the problem is, you don’t have the time to find out whether they speak medical before you talk to them. So don’t speak medical.
- Lastly, make sure, the patient understood you. Ask if he has any questions left, or better: how he feels about what you’ve talked about.If you obey these rules every patient will get what you just talked about!
As with every skill the nonmedical talk has to be practiced. For that I use two exercises.
Exercise No. 1: If you have kids around, you can practice this everyday: Go to your nephew or niece (3-5 years) and explain him how a car insurance works. (Might wanna warn his parents, so they don’t think you wanna sell him anything).
Exercise No. 2: Imagine you met a person who lived in the year 1700. Explain to this person what a Burger king drivethrough is and how it works. You can’t use any vocabulary, the person would’t understand. (Car, hamburger, etc.)
These exercises will get you started!
Question: What is your number one trick to make sure the patient (or student or customer …) gets what you want? Please leave a comment!