The words we choose to use influence our aspirations, our imaginations, our strategies and our results. Since language matters, we need to choose our words carefully. Consider the following:
Customer, client, patient, person…
Care for, help, serve, engage, partner, advise…
Patient-centered, relationship-centered, person-focused, patient-driven.
These words are not synonyms. They mean very different things.
Edward de Bono, a physician and leading authority in creative thinking and innovation, said, “In a sense, words are encyclopedias of ignorance because they freeze perceptions at one moment in history and then insist we continue to use these frozen perceptions when we should be doing better.”
Doing Better with Our Words
In recent times, we’ve improved the words we use to better support the compelling changes needed in our health care system.
I invite you to watch a video sponsored by the Beryl Institute in which I describe the history of the patient experience movement. This history describes the evolution of this movement and the language changes accompanying each stage.
We now talk about patient experience, not patient satisfaction, and employee engagement, not employee satisfaction. Many of us take care to say patient- and family-centered care, not just patient-centered care, reflecting the importance of the family on the care team.
Yet, we have so much more work to do with our words, so that they drive positive change, instead of inhibiting it. For example:
Is everyone touched by the health care system a patient?
We typically use patient as the generic word for the people interacting with the health care system. This is hospital-centric and very limiting. The word patient works well enough when we’re talking about inpatients and outpatients who come to us for disease management and cures. But how about the newborn baby, the workers who receive training on safe lifting by a local hospital’s physical therapist, the parents attending a parenting class, the people in a smoking-cessation program?
The word patient works when we focus on making sick people well, but it fails to describe the people who are well and come to us to prevent illness and achieve optimal health. It reveals our focus on illness care, not wellness care and education. And what about the person who engages with us for home care, long-term care, health coaching and more? They are not patients.
Then, there are the words that sustain the destructive health care pecking order. Some words reinforce a power differential that interferes with effective collaboration, teamwork and mutual respect. How about encouraging more reciprocity and partnership by using health partner, care partner or care family, instead of caregiver and caretaker?
More Language Pet Peeves
Compliance. This word disempowers patients. We reveal an attitude that the doctor knows best and expects obedience. Adherence is so much better because it can apply to a plan that is developed with the patient, not for them. Yes, we might need to coach them so they can adhere to the plan they have embraced as their own.
Discharge plan. This term is a dead giveaway that we are provider-centric. This is about our action plan, not the patient’s. Why don’t we say transition plan, recovery plan, get-well action plan, home care plan or even post-hospital action plan? We need to rename this so that it is meaningful to the patient.
Superuser. Why not coach instead? For electronic health record implementations and other change processes, many of us create “superusers.” We super-train a squad of people and entrust them to train their colleagues. Superuser implies superiority. Coach conveys the relationship and function we want to support, and that’s so much better.
Difficult patient. This term is all about the caregiver, not about the patient. It is judgmental and lacks compassion for people who are anxious, struggling and not where they want to be. How about difficult-for-me people or distressed patients? If we change these words, we will be much more likely to act from a perspective of loving kindness.
“Tell me, what’s your complaint today?” This is the question commonly asked by physicians in primary care visits. How limiting, presumptuous and likely to be interpreted as judgmental! After all, who wants to be seen or treated as a complainer? What about, “Tell me, what are the goals and concerns that you want us to explore today?”
What about our verbs? Do we want to serve patients or help and support them? Serving doesn’t apply when we are wanting a more equal and collaborative relationship — a partnership. Do we want the team to serve or care for patients? Or do we want them to engage and partner with patients? Or perhaps both, depending on the situation?
Driving Transformation with Our Words
Those of us intent on strengthening the patient, family and co-worker experience need to heighten our self-consciousness about the words we use and intentionally choose words that move us in the direction we want. It’s a matter of aligning our language with our health care system of the future, not the past.
After all, as passed down to us through the Talmud, “Words create worlds.”
Wendy Leebov, Ed.D., is a partner with Language of Caring in Boynton Beach, Fla.
