Changing the Way We Communicate About Patients


From BMJ Opinion: “A 53 year old woman with right lower quadrant abdominal pain. A 36 year old acutely suicidal man off psych meds. A 21 year old opioid abuser in withdrawal. An 80 year old woman with chest pain. On a single shift, I regularly read through the ‘one-liners’ of more than two dozen patients. To even keep track of who is who, I (along with most of my colleagues) end up remembering people by their presenting clinical symptom or main medical diagnosis. As much as we recognize this to be clinically necessary, what do we lose when we begin to think of patients in this way?

The loss of compassion and the risk of dehumanization in medicine is a real one. Studies show that empathy systematically decreases over the course of residency, while burnout increases. As much as this is a product of challenging schedules and tough daily work, we contribute to this decline in many other ways as well—notably through our routes of communication. Examples of this include how we write our medical notes, how we present cases on morning rounds, and how we talk about patients with colleagues.

The way we currently communicate reinforces a culture in which people become another case of ‘X’ disease. Our manner of speaking and writing about patients not only reflects, but also impacts how we feel about them. It can contribute to a steady loss of empathy and even, I’d argue, a deterioration in patient health outcomes. Studies have already found that patients who are treated by physicians who score higher on measures of empathy have better outcomes. Similarly, when the physician has a negative attitude, patients have been shown to have worse outcomes. While the link between language, empathy, and outcomes has not been studied, I think that they are connected.”

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