Blog | Thursday, April 9, 2015

Let's stop using adjectives to identify patients


We have all heard it; we have probably all said it:
• “My diabetics never follow my instructions.”
• “That schizophrenic is back in the hospital again.”
• “How should I screen cirrhotics?”
• “Did you hear about my CHF-er?”

It might be easy to say but it certainly isn't patient-friendly. Patients are people. Sometimes they have diseases or syndromes or symptoms. But diseases shouldn't describe our patients. Patients are not a disease, and certainly they aren't the “adjectival” form of the disease (e.g. “diabetic” for the disease diabetes). Ascribing these words and phrases to people can have a few effects:
• It anchors the doctors and/or the patients on the disease or diagnosis, when the diagnosis may not be correct or complete.
• It changes our focus from the person to the disease.
• It changes patient perception of the medical profession.
• And worst of all, it demeans patients

So let's think about rephrasing the above:
• “The patients with diabetes in my practice often have difficulty …”
• “The man with schizophrenia we both recently treated has been readmitted.”
• “How should l screen patients who have cirrhosis?”
• “Did you hear about Mrs. X, the patient with CHF I treated last week?”

Yes, it may seem like semantics. Yes, it takes a few extra seconds and a little bit of effort. I've personally had to focus on changing my own lexicon and occasionally find myself resorting to my older habits. But if you pay a bit of attention to colleagues from here on out, you might start thinking about how it sounds and try to make the change yourself.

Ryan Madanick, MD, is an ACP Member, a gastroenterologist at the University of North Carolina School of Medicine, and the Program Director for the GI & Hepatology Fellowship Program. He specializes in diseases of the esophagus, with a strong interest in the diagnosis and treatment of patients who have difficult-to-manage esophageal problems such as refractory GERD, heartburn, and chest pain. This post originally appeared at his blog, Gut Check.