This week, two bloggers posted lists of words or terms they felt should no longer be used when referring to health professionals or patients.
- Harrison Reed, a physician assistant who writes for In Practice, a blog at NEJM Journal Watch, wrote “Seven Medical Terms to Ditch in 2017.” On his list was LFTs (liver function tests); regular rate and rhythm (RRR): little old lady (LOL); AAM or AAF (other potential objections aside, these are often taken to mean African-American male or female, but can just as easily mean Asian-America male or female); and nauseous when one actually means nauseated. He also would like to see an end to the use of the modifier “midlevel,” as when it’s used to refer to NPs or PAs as “midlevel providers.”
- Over at KevinMD.com, physician Pamela Wible published “Stop saying these 7 shaming words in medicine. Right now.” Her list included phrases to abandon, along with replacements that she believes to be more accurate and/or respectful. For example, she advocates replacing “is bipolar” with “has bipolar disorder.” She also wants to replace the phrase “is the patient noncompliant?” with “is the treatment working?” “Noncompliant,” as she points out, conveys blame. (Nonadherence may now be the preferred term—there are many reasons someone may not be able to adhere to a treatment plan.) Wible also wants to eliminate the terms “burnout,” “provider,” and “midlevel.” I don’t agree with her that the term burnout places blame on the victim; to me, it describes a response without implying a failing. But I do agree with her argument against the use of the descriptor “midlevel” for advanced practice nurses or physician assistants.
Some words and phrases I’d like folks to consider using more accurately.
- The word “medicine” is often used as a synonym for “health,” as in “hospitals are medical facilities” and all who work there are “medical personnel.” Health care encompasses so much more than medicine—to lump everything under the medical umbrella diminishes the contributions of the other disciplines that collaborate to help patients achieve health. Recently, the University of Michigan changed its health center’s name from the University of Michigan Health System to Michigan Medicine. In my mind, that’s a step backward. Why not Michigan Health, as Indiana University did with “IU Health,” to acknowledge all the various facets that comprise health care?
- Similarly, the word “doctor” is used when people mean “physician.” “Doctor’ is an academic degree bestowed on someone who has achieved the highest level of study in a field. Physicians are MDs—doctors of medicine. But there are many professions for which the doctorate degree is given, including dentistry, psychology, physical therapy, pharmacy, social work, and yes, nursing. But because of popular usage and the way many regulations are written, most people think only of medical doctors as doctors. And at one point, in 2008, the American Medical Association wanted to limit use of that term to physicians, dentists, and podiatrists.
- I’d also like to see “plan of care” used instead of the archaic “doctor’s orders.”
Words matter, and there are many words and phrases we can do without. There are also some I’d like to see us use more of—such as collaborate, cooperate, and health care team.