“Progressing tumor”, “positive results”: patients are often confused by medical jargon

“Progressing tumor”, “positive results”: patients are often confused by medical jargon

By Amy Norton HealthDay Reporter

(Health Day)

FRIDAY, Dec. 2, 2022 (HealthDay News) — If you’ve ever left a doctor’s appointment confused, it’s probably not you: Medical jargon used by doctors can be completely misunderstood by patients, a new study finds.

Common medical jargon that makes perfect sense to doctors often gets lost in translation when passed on to laypersons, according to the new research. It turns out that many people mistakenly believe that it’s good news if a tumor “progresses” or if a chest X-ray is “impressive”.

And it’s no wonder, the experts said: In a frustrating oddity, the medical meanings of some words are the exact opposite of their meaning in regular English.

“There are words with perfectly good meanings in English, and we’ve co-opted them into medicine and given them different meanings,” said lead researcher Dr. Michael Pitt, associate professor at the University School of Medicine. University of Minnesota, Minneapolis.

A classic example is reporting test results, said Michael Wolf, a professor of medicine at Northwestern University Feinberg School of Medicine in Chicago.

A “positive” result on a cancer screening test, for example, means you may have cancer. A “negative” result is therefore good – the opposite of how people use these words in everyday language. (And by the way, if it’s cancer, your doctor might call it a “malignancy” instead, Wolf pointed out.)

Wolf, who was not involved in the new research, studies health communication and also directs the Institute of Public Health and Medicine at Northwestern. He said he was not surprised by the results: it is well recognized that medical jargon is a problem, that it confuses patients and that doctors need to be clearer in their language.

For Pitt, the results highlight an additional point: It’s not just fancy disease names or foreign acronyms that confuse patients — as many doctors may believe.

“It’s not enough to tell doctors not to use jargon,” Pitt said. “They need to know when they’re using it.”

The study, published November 30 in the journal Opening of the JAMA network, involved 215 adults who attended the Minnesota State Fair and agreed to listen to and read standard – and potentially confusing – medical phrases.

In some cases, they did quite well: 80%, for example, knew that an “unremarkable” chest X-ray was a good thing. In contrast, only 21% realized that an “impressive” chest X-ray was not good news.

When doctors use this expression, they mean that they have spotted something worrying. For a patient, “impressive” could easily translate to admirably healthy.

Study participants were also shocked by phrases such as ‘positive lymph nodes’ (a third didn’t know this means a cancer has spread) and ‘your tumor is progressing’ (a fifth didn’t know that was bad news).

And then there is the word “occult”. When doctors use it, they mean they detected something that was hidden – like tiny amounts of blood in the urine that can’t be seen with the naked eye. For most people, however, “occult” conjures up supernatural thoughts.

In this study, people rarely understood the meaning of an “occult infection” and were more likely to think it had something to do with a curse.

This raises the question: why do doctors use words that can be easily misinterpreted? It may come down to “forgetting the lingo,” according to Pitt.

“You’re taught during your training to use those words that make you sound smart,” Pitt said. And along the way, he explained, doctors can forget that there was a time when they didn’t know what those words meant — or, at least, didn’t know their medical significance.

Pitt said he hopes this study serves as an “aha moment” for doctors – showing that the words they assume are clear often aren’t.

It’s not that the jargon problem isn’t solved. The American Medical Association, for example, encourages doctors to use the “teach back” method – where, at the end of a conversation, they ask patients to say in their own words what they have just heard. .

Both Pitt and Wolf said it’s a good approach, but which doctors use it is another matter.

When doctors aren’t clear, patients shouldn’t be afraid to speak up, Wolf said. “Even if they seem rushed,” he added, “you have every right to ask questions.”

Pitt recommended “demanding” this learning time. “You can tell the doctor, that’s what I hear. Tell me if I understood correctly,” he said.

When it comes to his advice to doctors, Pitt said one thing he encourages is “emotional words.” That is to say, it is correct – and clearer – to say “it worries me” rather than to call an impressive x-ray.

SOURCES: Michael Pitt, MD, associate professor, department of pediatrics, University of Minnesota Medical School, Minneapolis; Michael Wolf, PhD MPH, Professor, Medicine and Medical Social Sciences, Director, Center for Applied Health Research on Aging, Northwestern University Feinberg School of Medicine, Chicago; Opening of the JAMA network, Nov. 30, 2022, online

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