Jamie's mother was well into her 70s when she was first diagnosed with a serious heart condition that sent her to the hospital. Prior to that, both mother and daughter had enjoyed amazingly robust health that required little more than routine doctor visits over the years.
"We were novices when it came to hospitals," Jamie recalls. "I was nearly 50, but I really knew nothing at all. I mean, I knew what doctors and nurses were, but that was about it." When a woman in a flowered smock introduced herself as an "R.N.," Jamie had to ask what that meant.
"They took it for granted that we knew the lingo," she says. "Here I was already a nervous wreck over my mother, and every time anybody said anything to me it seemed to be in code, with initials and abbreviations and acronyms." Information about things like her mother's heart rate or blood pressure was delivered strictly by the numbers, with little context. "I didn't know what X over X meant, whether that was high, low or normal."
Unlike many patients and their family members, Jamie was not meek. When she didn't understand what she was being told, she made the clinician stop and explain it in a way she could grasp. The hospital staff was patient, allowing her to ask all the questions she needed to. But really, she says, they all came down to the same question: What does that mean?
"I know they were in a hurry. Wouldn't it have saved time if they'd just said it in plain English from the beginning?"
After Jamie reluctantly left her mother in the hospital and went home, communication with the clinicians remained frustrating. Whenever her cell phone rang and caller ID showed it was the hospital, she'd start to panic. "But the person calling would begin haltingly by asking, 'Is this, um …?'," Jamie says. "I could hear her shuffling papers to try to find the right form. She'd finally say my name, I'd confirm it was me, and she'd continue, 'I'm calling about, um …' and I could hear the papers being shuffled again while she tried to find my mother's name."
"The whole time, all I wanted to know was: Is Mom still alive?"
Jamie assured me that overall the hospital staff did a wonderful job of treating her mother and that she has nothing but gratitude for their skill, hard work and obvious commitment to care. I told her that a number of health care groups and individual hospitals are encouraging clinicians to adopt a more patient-centered approach to communication by, among other things, being better prepared before meetings and phone calls with patients or family members and by jettisoning the jargon.
"Well, good," she replied, pleased if a little skeptical. "Because you really shouldn't need a medical degree to have a reasonable conversation with people who work in the hospital."
Every Tuesday in this column, I address issues that touch, sometimes peripherally, on generational shifts in the American population and the effect on health care from both a patient and hospital perspective. I welcome feedback and ideas. E-mail me at firstname.lastname@example.org.