‘Belittling, Doubting, or Blaming’: Outdated Medical Language May Harm Patients

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Such language “can insidiously affect the therapeutic relationship,” authors say.

The language used during a medical encounter plays an important role in the patient-provider relationship, and if not carefully considered, can cause harm, according to a recent analysis.

Phrases like “substance user,” “fat,” “obese,” and “non-tolerating” hurt how patients relate to their doctors, and in some cases discourage them from returning for appointments, said Caitríona Cox, MBBChir, and Zoë Fritz, PhD, MBBS, of the Healthcare Improvement Studies Institute at the University of Cambridge in England.

“Language that is belittling, doubting, or blaming continues to be commonly used in everyday clinical practice, both verbally and in written notes,” they wrote in The BMJ.

Such language “can insidiously affect the therapeutic relationship,” they added. “Changing language to facilitate trust, balance power, and support shared decision making is unlikely to harm patients and should be viewed as a positive step in promoting a healthy therapeutic relationship.”

To make their case, the authors gathered recent research on commonly used language in medical narratives, and the effects of the language used, whether in health records or patient-doctor interactions.

According to research on what patients find offensive in patient notes, language that casts doubt on patient accounts, such as “presenting complaint,” “denies,” and “claims,” has negative connotations and can imply that what a patient says to their doctor is inauthentic or inaccurate, Cox and Fritz noted.

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