Doctors Talking with Patients/Patients Talking with Doctors: Improving Communication in Medical Visits

By Debra L. Roter; Judith A. Hall | Go to book overview

6
Giving and Withholding Information: The Special Case of Informative Talk in the Medical Visit

Part of the mystique of medicine is that it is written and often communicated in a foreign code. To make matters worse, the code has two forms: the scientific, anatomical, and technologically correct usage of terms to describe body parts, body processes, medical procedures, and medical treatments; and an even more impenetrable shorthand for these things, used in hospitals and medical records. There is some evidence that physicians themselves have trouble understanding this code ( Christy, 1979).

"Medicalese" persists despite its difficulties, and if a patient feels alarmed and confused after leaving the doctor's office, it is not unusual. It is a good guess that a doctor will use at least one unfamiliar medical term in any given visit. Barbara Korsch and her colleagues ( Korsch, Gozzi, & Francis, 1968) found that the pediatrician's use of difficult technical language and medical shorthand was a barrier to communication in more than half of the eight hundred pediatric visits that were studied. Mothers were often confused and unsure of terms used by the doctor to describe what was wrong with their children and what the doctor was going to do about it. Although one mother asked the doctor to repeat what he said "in English," this kind of confrontation appeared infrequent; for the most part, mothers did not ask for clarification of unfamiliar terms.

Other researchers similarly report that patients are confused, but are reluctant to ask for clarification. For instance, after observing over 150 medical visits, Svarstad ( 1974) found that both patients and doctors engaged in a kind of communication conspiracy. Physicians generally spoke as though their patients understood them, and patients acted as though that was indeed

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