Maybe it’s the ex-English major in me, but I think a lot about my language, both in the exam room when I converse with my patients and later in the day when I write my notes.
During medical school, I was taught to document if a patient was “non-compliant” or a “poor historian.” During the first two years of my residency, paper charts were still the norm, so brevity was key. But now I rely on electronic medical records, and almost all my patients use the portal. I am always aware that my patients can – and will – read their chart notes. They read not only my medical recommendations, but the words I use to describe their conditions, their habits, and their medical history.
My words help me express empathy, demonstrate understanding, and create partnership. They help me foster a working relationship with my patients rather than a hierarchical one. In my opinion, the content of my medical advice is important, but equally important is the way in which I express my message.
Sometimes I meet this challenge. I’m skilled at avoiding gendered language, referencing “pregnant persons“ or “those with prostates.” But whenever I utilize my clinic’s translator services, I’m forced to recognize how often I rely on regional colloquialisms. And sometimes I just plain botch it up. Even if I mean a word a certain way, I can’t always predict a patient’s history, bias, or trauma. I may intend to use a word neutrally, but to the patient, it’s associated with hurt. I have patients who embrace the word “fat” and others who find it harmful. I try to use the word only as a descriptor of tissue, with no more value or fault than “muscle,” “tendon,” or “bone,” but good intentions can only go so far. I’m sure I’ve hurt feelings, and that bothers me.
Still, I know my method of communication is an important part of my bedside manner. It helps my patients feel safe and listened to. It also helps me navigate tough conversations. When patients ask me about their lifestyle or diet, I try to use positive words or phrases, focusing on what can be added, like joyful movement or tasty, vitamin-rich foods, rather than what can be taken away. And I remind myself over and over again that even if I mess up, I’m doing the best I can and I can always seek to do better.
How about you? Do you sometimes agonize over your written charts? Do you have phrases you rely on or a favorite way of explaining something? How have you navigated your own relationship with language?
Each month, Dr. Sarah Halter, Family Physician at UW Medicine Primary Care Factoria in Bellevue, WA, shares reflections at the intersection of medicine, compassion, and weight-inclusive care. March’s column:
