Losing their Patients: Medical lingo may confuse those not in the know

Wednesday, June 13, 2001 | 9:13 a.m.

When it comes to doctors' office visits, Dale Carrison is familiar with being both patient and physician.

Carrison, a doctor and director of University of Medical Center's emergency room, waited until he was 43 to embark on a medical career.

He said that when he was a patient, he would hear doctors use medical terms he couldn't understand. And there are many.

In the medical profession, chest pain is known as angina pectoris; a strained ligament is illiotibial band syndrome; nephrectomy is surgical removal of the kidneys; a headache is cephalalgia; and a stiff joint is known as ankylosis.

If a doctor should use a foreign term, patients, as Carrison once was, might let it slide.

"Would I ask them what they meant?," he said, referring to his days as a patient. "No. I'd go home and look it up."

Carrison knows that other patients do the same. "The patients nod their heads, wait for the doctor to leave, then ask the nurse, 'What did he say?'"

Or, he said, they'd leave without asking at all.

"People are embarrassed," Carrison said. "There is this doctor mystique and because people feel stupid, they don't ask."

As a doctor, "It really is important to look them in the eye, hold their hand and say, 'Did you understand what I'm saying?'"

But with so many people relying on HMOs for their health care needs, and the time constraints involved with those organizations, it's not likely that all patients will have such golden opportunities when it comes to doctor-patient communication.

"With managed care, physicians have limited time to spend with patients," said Jean Shipman, director of Tompkins-McCaw Library for the Health Sciences at Virginia Commonwealth University and board member of the Medical Libraries Association. "That leads to people wanting to find out more."

In the past 20 years Shipman said she's seen an increase in the general public researching medical information, whether inspired by television shows such as "ER," media coverage portraying botched medical procedures or because the Internet has made medical information easily accessible.

"The trend is for people to look up information about their health before they get to the physician," Shipman said, adding that it's an effort undertaken more often by younger people.

"Younger people are more assertive in seeking out what they want to know," she said. "They're more information aware."

Trade talk

But anyone walking into the world of medical terminology soon realizes that taking a trip through a medical dictionary is like walking into a foreign country.

Terminology is often derived from Greek or Latin words such as arthralgia (a pain in the joint), cholelithiasis (gallstones) and pruritus (itching).

A doctor may say rhinorrhea -- in other words, a runny nose.

"We switch back and forth (with terminology), and the problem (comes) when we forget to switch back and forth," Carrison said.

An even bigger problem is when patients don't ask doctors to translate what they are saying, he said.

Before turning to a career in medicine Carrison worked as a deputy sheriff for the FBI, and then in the auto industry.

"As a police officer I learned to read people. You can see it in their eyes if they're really comprehending it or not and you have to ask again," he said. "It's not so much that they say 'yes' as it is they nod their head. To us that means yes."

In some cultures patients don't want to understand the details of their ailments, Carrison said. "They want you as the doctor to take care of it," he said.

John Spilotro, who works in patient services for the local American Cancer Society, said some cancer patients he meets and advises would rather leave everything entrusted in the doctor's hands and know little -- if anything -- about their condition.

Others come seeking information and are given printed information written on a literary level that can be understood by someone with a sixth grade education, or on a level that can be read by someone with an 11th-grade education.

Spilotro said it's "not so much medspeak" that baffles the recently diagnosed cancer patients that he meets with as it is people who are still in shock from hearing the diagnosis.

"They hear the word cancer and they panic," Spilotro said. "When a patient hears that, a doctor could talk until they're blue in the face and the patient doesn't understand one word the doctor's told them.

"Some people are educated. They're articulate. But right away they're confused because of the diagnosis."

A doctor might throw out a few words the patient doesn't understand, he said. By the time they seek more information, they don't remember words.

In addition to disease terminology, Shipman said some people don't understand medical procedures they're about to receive.

"If you're told that you're going to get an MRI, (they ask) 'What does that mean actually?' " she said.

Or when a doctor tells a patient that he or she is being sent to an oncologist, the patient may not know what an oncologist does, Shipman said.

Deciphering definitions

To help people in their research, the Medical Library Association, a national association of health information professionals based in Chicago, publishes a free "Deciphering Medspeak" brochure to help translate medical terms.

Listed and defined are general prefixes, suffixes and commonly used terms, such as "carcin -- when used as part of a word, means cancer ..." and "embolism -- blockage of a blood vessel by a blood clot, a piece of tissue, an air bubble, or foreign object."

Medical Library Association also provides its list of "Top 10 Most Useful Websites" and a link to the Consumer and Patient Health Information Section.

The brochure was first issued three years ago on the 100th anniversary of the organization and can be obtained by calling the company or by going to the website at mlanet.org.

"We were recognizing that there was a lot of public interest in health through the Internet," Shipman said. "The brochure is to help bridge the terminology gap."

Carrison said he sees patients that come in to the hospital with information they looked up on the Internet. He said he has no problem with his patients being informed, But "a little knowledge is a dangerous thing."

A study published in April by Harris Interactive, a market research firm in Rochester, N.Y., cites that 75 percent of adults online seek health care information in such areas as providers, insurance companies and medical information.

There are online medical journals, chat sites, disease-specific and other websites, such as bytesizelearning.com, which offers help to people attempting to decipher medical terminology and even features humorous, game-like ways to learn medical terms.

On the website geocities.com/TelevisionCity/5196/ medical terms and hospital slang heard on "ER" is explained.

"One caution (with the Internet)," Carrison said. "You don't know who's (maintaining) that Internet site. If you're going to go to an Internet site, you need to go to a legitimate site."

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