Speaking Over The Patient
Quote of the Day, to an 84 year-old Asian woman with Hepatitis C from an attending:
Doc: So we’d like to figure out what the subtype of your viral genotype is…
Patient nods.
This woman had no, I mean no idea what a genotype is, let alone a subtype of it. Please don’t forget, when you’re talking to a patient, speak to his or her level, not MEDICAL. I would look just as dumbfounded as my patient today, and probably nod as well if a lawyer spoke law to me, or if a mechanic spoke car to me. I’m sure I’m at fault myself sometimes, but I think I’m pretty good at catching myself, and pretty good at detecting the dumbfounded “what the hell are you talking about” look, too.
There’s evidence to suggest that patients will be more adherent if you speak their language, too. Everyone wins.
And just how will knowing the subtype of the viral genotype do anything to benefit either the doctor or the patient? Does it have any bearing on treatment?
Surprisingly yes, Ted. Subtypes 2 and 3 have an 80-90% success rate with Interferon treatment, whereas 1, 4, 5, 6, and 7 have much worse success rates.
There is also a lot of evidence that suggests adherence is increased when anxiety is decreased. One of the major sources of anxiety in patients is not understanding their treatment plan or dignosis. Again, everyone wins!
I use plain English because I usually feel kind of silly slapping around those big Greek words (also, i are proud two b a ingineer). As a result, several times a year a patient rips into me for speaking down to her. Sigh.
hi!!1 i’m a med student from mexico. i got to read your blog thanks to medscape… so far so good.
this subject always makes me nervous because sometimes i find myself (more often than i’d like) talking big medical words to patients… sometimes they’ve made fun of me!!!. so i’m still struggling with it, and i’m trying to learn how to explain things the easy way….