It will come as no surprise to most of you that what doctors think they say and what patients hear are frequently not the same.
Every field has its own jargon, understood by the practitioners but not “outsiders.” Be honest: if you bring your car in for service and the service advisor says you have a bad solenoid, would you understand what this means? [engineers excepted]
A recent study published in JAMA Network Open described what researchers found when they asked a group of adults attending the Minnesota State Fair last year their understanding of common medical expressions used by doctors talking to patients.
Despite the fact that this was an educated group (90% had at least an associate degree and 65% a bachelor’s degree or higher), less than 10% correctly understood the question “Have you been febrile?” and 2% understood the statement “I am concerned the patient has an occult infection.” 11% knew what it meant when they were told “You will need to be NPO at 8 AM.”
A common cause of confusion is the frequent difference between common usage and medical meaning. In most circumstances, “positive” has a good connotation, but in “your lymph nodes were positive,” the opposite is true. Being told “your performance on the test was impressive” would make a student happy, but if your doctor says “your Xray findings were very impressive,” you had better worry.
Even doctors may miscommunicate if an abbreviation is used out of context. If one doctor says to another “the patient has MS,” does this mean they have multiple sclerosis or mitral stenosis? If it is one neurologist talking to another, the meaning will usually be clear, but if the neurologist is talking to a cardiologist, all bets are off.
How should this affect your behavior?
A good medical interaction should end with the doctor asking the patient to tell the doctor what they understood of the conversation, but this rarely happens in today’s frantic environment. You should take the initiative and tell the doctor what you believe they just told you. Do not be surprised if they say “no, that is not what I intended to tell you.” You can then hopefully get a clarification.
Remember: the only dumb question is the one you should have asked but did not. Do not leave a medical visit without being sure you know what you were told and understand all its implications.
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