[lg policy] NYT: Rx for British Doctors: Use Plain English Instead of Latin

Fierman, William wfierman at indiana.edu
Thu Sep 6 12:46:27 EDT 2018

Rx for British Doctors: Use Plain English Instead of Latin
Specialist doctors in England currently write explanatory letters to their patients' general practitioners, rather than to the patients themselves, often employing medical jargon.CreditCreditAndrew Testa for The New York Times

By Ceylan Yeginsu

    Sept. 5, 2018

LONDON - Doctors have long been chided for their seemingly unintelligible handwriting. Now, they are being urged to drop the Latin.

In an effort to improve written communication with patients, an initiative unveiled this week by the Academy of Medical Royal Colleges - which represents 250,000 doctors in Britain - is encouraging doctors to ditch confusing medical jargon and instead write to their patients directly in plain, simple English.

The project says with more than five million outpatient visits a month in England, outpatient clinic letters are "the most written letters" in Britain's National Health Service.

Currently, the letters are sent to the patient's general practitioner instead of the patient, meaning that doctors have to write about their patients instead of writing to them, which can cause barriers in communication.

Dr. Hugh Rayner, a kidney specialist who is leading the initiative, said that while the change might seem small, it had already had an effect in the pilot phase of the project.

"Writing to patients rather than about them changes the relationship between doctor and patient," Dr. Rayner said in an email. "It involves them more in their care and leads to all sorts of benefits."
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He added that "this change could have a big impact."

Complicated medical terminology is often misinterpreted by patients and can cause confusion and anxiety, the academy says. The guidelines offered state, for example:

    * Avoid using words that can cause confusion, such as "chronic." While the term in medical circles means a longstanding condition, it is often taken by patients to mean "really bad."

    * When describing diagnoses, for example, instead of "renal," use "kidney."

    * Instead of "acute," use "sudden" or "short-term."

    * Instead of "atrial fibrillation," use "irregular pulse."

The guidance also applies when prescribing medicine: Doctors have been asked to use English such as "twice daily" instead of the Latin abbreviation "B.D." (bis in die).

Beyond that, when including test results, the academy says, their significance should be explained and upsetting or unexpected results should be communicated by phone instead of by letter.
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And when doctors have to deliver sensitive information, they could "soften the impact" by using a more distant or noncommittal style such as "during the examination, the tremor and stiffness in your right arm suggest that you have Parkinson's disease."

Lauren Cohen, a dental hygienist in east London, recalled receiving results for a medical condition by letter, but when she tried to call her doctor for an explanation, his assistant said he was unavailable for two days.

"I Googled the blood test results and they were off the charts," she said by phone on Wednesday. "I was in total panic and had to ask a doctor friend to help me interpret them, but even then I wasn't convinced as he wasn't a specialist."

Patients who participated in the pilot project said they found the new style of letters more "informative, supportive and useful."

"I appreciate the letter addressed to me - the patient," one participant wrote. "I can now understand the treatment I am having for my illness and I'm happy to know that I am making some progress along the way."
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