THE LANGUAGE OF HEALTH CARE: The alienating language of health care

Abstract

Please e-mail letters for publication to Dr Kamran Abbasi [[e-mail]]. Letters should be no longer than 300 words and preference will be given to letters responding to articles published in the JRSM. Our aim is to publish letters quickly. Not all correspondence will be acknowledged.

I think Cayton has missed his target with this editorial. ¹ The key aim of medical practice is for doctors and patients to work together. To present medical practice as being either doctor or patient centred is a false dichotomy, and creates an unnecessary division.^2,3

All specific human activities, from medicine to patient representation, generate their own specific, in-group vocabulary. For me the main issue is not the group specific vocabulary but the difference between descriptive and evaluative uses of language.

In medical practice, and NHS management, we need descriptive terms for the events we see. So the term ‘frequent flyer’ can be useful shorthand for describing, ‘a 79-year-old woman with multiple pathologies, poor social circumstances, and a propensity to suffer exacerbations of one or other of her many illnesses.’ It is not a judgement against the lady, who will be treated properly by staff.

In medical practice we have to use labels. The process of diagnosis is one of knowing when one is justified in attaching a disease label to a patient. The art of medicine often consists of knowing when this is, and is not, appropriate.

Most medical terms are descriptive. Some are evaluative, and we need to be very careful when we choose to use these terms. As doctors we mainly use language for description, so that we can communicate effectively as we care for patients. Mr Cayton may be surprised when he appreciates how much most NHS staff do care about, and connect with, the patients, whether because of, or despite, the language we use.