A couple of weeks ago, I was struck by a tweet from our friends @savvy_coop that encouraged us to stop saying “we are all patients”. It got me thinking about other terms/phrases in healthcare that we should stop using like “non-adherent patient”. This week on the #hcldr tweetchat, I thought we would discuss these types of terms and come up with better alternatives.
Occasional Users of Healthcare ≠ Patients
While it is true that everyone is a consumer or a buyer, it is a disservice to call everyone a patient. In my mind an occasional user of healthcare (getting a check up, visiting an ER once or twice a year) is not the same as being a patient (chronic condition, cancer, addiction). I consider myself lucky to be an occasional user of healthcare and I understand/appreciate that my interactions with the healthcare system are not a good barometer.
The team at Savvy Coop put it succinctly with their tweet:
Hot take 🔥— Savvy Co-op | #AskPatients (@savvy_coop) June 7, 2022
Saying “we are all patients” robs patients of their VALUABLE experiences and our health systems of the accountability to change and be inclusive. 🚫
We can do better! 📈
You Need to Ask Patients eBook 🔖⬇️https://t.co/X7gyuFddOk#HCLDR #AskPatients #DigitalHealth pic.twitter.com/lwPlVzB5om
I wholeheartedly agree…but I must admit, I’m at a loss when it comes to suggesting an alternative. Do we need to add a qualifier or change the phrase completely to: “We all use healthcare to varying degrees, some of us occasionally, and others more frequently – like those with chronic conditions, rare diseases, cancer, etc.”
I’m curious to know that the HCLDR community would suggest.
Another word that I’ve heard we should stop using in healthcare is “burnout”. Why? Burnout implies that the fault resides with the person suffering rather than the situation or environment that caused it. When we say a physician or nurse is “burnt out”, there is an implication that that individual is somehow different (dare I say defective).
ZDoggMD (aka Dr. Zubin Damania) shared a YouTube video that went viral prior to the pandemic that addressed this:
In his video ZDoggMD references the work of Talbot and Dean who wrote about physician “moral injury” in a Stat News article in 2018. If you haven’t read this piece, I would highly encourage you to do so.
As we deal with the aftermath of the COVID-19 pandemic, the issue of burnout amongst healthcare workers has become mainstream news. It may be the wrong term, but at least the issue is getting attention right? Or maybe not? Should we try in this case to swim upstream and use the term “moral injury”?
Incidentally, ZDoggMD made a follow-up video a few weeks later. You can see it here: https://www.youtube.com/watch?v=L_1PNZdHq6Q
Power of Words
What both these examples highlight is the power that words have in healthcare. Choosing the right words, especially in these cases above, is not about being politically correct or about offending/not-offending someone, but rather to ensure that we are painting as accurate a picture as possible. I certainly would not want to use a phrase that we inaccurate or that deflected attention from an issue or party that needs to be held accountable.
Join the next #hcldr weekly tweetchat on Tuesday June 21st at 8:30pm ET (for your local time click here), when the community will be discussing the following:
- T1 Why is “we are all patients” such a harmful term to you? What phrase should we be using instead?
- T2 Is it “burnout” or “moral injury”? Is it too late to start using a term other than “burnout”?
- T3 What other terms/phrases should we stop using in healthcare and what alternative would you suggest?
- T4 What can we do as individuals when we hear people using terms and phrases that are harmful or inaccurate?
Talbot, Simon G and Dean, Wendy. “Physicians aren’t ‘burning out.’ They’re suffering from moral injury”, Stat News, 26 July 2018, https://www.statnews.com/2018/07/26/physicians-not-burning-out-they-are-suffering-moral-injury/, accessed 20 June 2022
Mehta, Paulette and Mehta, Jay. “Reframing Clinician Distress: Moral Injury Not Burnout”, Federal Practitioner, November 2019, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6913604/, accessed 20 June 2022
Krug, Sarah. “The Power of Words in Healthcare: A Patient-Friendly Lexicon. Top 10 List #WordsDoMatter Project”, Society for Participatory Medicine, 4 January 2018, https://participatorymedicine.org/epatients/2018/01/the-power-of-words-in-healthcare-a-patient-friendly-lexicon-top-10-list-wordsdomatter-project.html, accessed 20 June 2022
Wible, Pamela. “Stop saying these 7 shaming words in medicine. Right now.”, KevinMD, 5 January 2017, https://www.kevinmd.com/2017/01/stop-saying-7-shaming-words-medicine-right-now.html, accessed 20 June 2022
Richards, Tessa. “Tessa Richards: Words that annoy, phrases that grate”, BMJ, 7 April 2017, https://blogs.bmj.com/bmj/2017/04/07/tessa-richards-words-that-annoy-phrases-that-grate/, accessed 20 June 2022
Neuberger, Julia. “Do we need a new word for patients?”, BMJ, 26 June 1999, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1116090/, accessed 20 June 2022
Photo by Total Shape: https://www.pexels.com/photo/healthcare-text-screenshot-near-green-fern-leaf-2383010/