No more taking tests, sending a patient home, or medicine that fails to work. “Outdated medical language that casts doubt, belittles, or blames patients jeopardises the therapeutic relationship and is overdue for change” argues an article in the The British Medical.
Common phrases like “take” a test or “send” someone home could make patients feel “childlike”; emphasise the doctor’s position of power, and even seem patronising, they claim. They also suggest that saying medication “failed to work” implies it was the patients’ fault so doctors should rather say a drug was “not effective”.
The recommendations are by consultant physician Dr Zoe Fritz and junior doctor Dr Catriona Cox, both from the University of Cambridge.
They deny that the changes are “a matter of political correctness”, saying that simple words or phrases, both verbally and in written notes, can “insidiously” affect the relationship between doctors and their patients.
Much of the language commonly used has been deeply ingrained in medical practice and is used unthinkingly by clinicians, they write.
In their editorial, Cox and Fritz suggested doctors should address patients with more respect, saying, for example, that terms like “compliance” and “non-compliance” with medication are authoritarian.
“Language that belittles, infantilises, or blames patients runs counter to the collaborative relationships we are trying to foster through initiatives such as shared decision-making,” they wrote. “We encourage all to reflect on the words and phrases currently used in practice … considering whether they hamper or help to establish a genuinely collaborative therapeutic relationship.”
Their editorial comes amid a huge row over the working hours of family doctors, the “postcode lottery” of GP access and face-to-face appointments.
The General Medical Council, which regulates doctors, has waded into the storm with new guidance that includes telling doctors they have a duty to respect a patient’s wishes for face-to-face appointments.
GPs should agree with a patient what type of appointment would best suit their “needs and circumstances”, says the GMC.
The new directive is included in a revised version of the GMC’s core guidance for all doctors, known as Good Medical Practice. It is the modern day equivalent of the Hippocratic Oath, outlining the professional values, knowledge and behaviours expected of UK doctors.
The 16-page document is being updated for the first time since 2013 to reflect societal changes, including sexual harassment and the increased use of social media.
Good-medical-practice---English-20200128_pdf-51527435
BMJ article – Presenting complaint: use of language that disempowers patients (Restricted access)
See more from MedicalBrief archives:
British GPs and practice staff quitting over face-to-face appointments
Getting to see a British GP is ‘like breaking into Fort Knox’
British GPs: ‘Rather in-person consultations than call centre approach’