It is important for doctors to deliver medical information clearly, while also being sensitive towards the patient’s feelings. — Freepik.com
In a world where language holds the power to shape perceptions and attitudes, the discussion surrounding health or medical conditions is no exception.
The choice of words used to describe ailments, disorders and medical states can significantly influence how individuals perceive and respond to them.
Recent discourse has highlighted the transformative potential of adopting gentler terms, such as “plus-sized”, in lieu of stigmatising labels like “fat”.
By embracing language that is more empathetic and inclusive, there’s a growing belief that individuals are more likely to seek assistance and support without the burden of judgement or shame.
However, when health conditions are couched in gentler terms, there is also a risk that individuals may underestimate their significance, leading to delayed diagnosis, disease progression, and ultimately, poorer health outcomes.
Moreover, softened language may inadvertently normalise unhealthy behaviours, obscuring the true impact on well-being.
Effective communication
This is where linguistics in healthcare, i.e. the specialised use of language and communication within the field of healthcare, plays a crucial role.
“Medical linguistics is about effective communication within the healthcare context,” says Universiti Malaya Department of Rehabilitation Medicine associate professor Dr Julia Patrick Engkasan.
She adds that it encompasses not only the choice of words, but also body language, tone and active listening.
“How you explain a condition and what will happen to the patient, determines the patient’s understanding and next actions,” says the rehabilitation physician.
When medical terms and explanations are clear and accessible, patients are better equipped to grasp the complexities of their health issues, leading to more informed decisions about their care.
“When patients don’t understand what you’re telling them, they won’t be compliant with the medication,” she says.
Moreover, if a patient feels that their doctor is arrogant or uncaring, “the patient will not trust or come back to the doctor”.
And this can be especially critical for those with serious conditions like cancer, where ongoing communication and trust are vital.
Mental health therapist Shalini Devindra, who specialises in psychology and literature, emphasises the critical importance for healthcare professionals to be conscious of how they present diagnoses to patients.
“People are already struggling with the stereotypes, the perception, and how people are going to react to them when a label is placed on them,” she explains.
Labels can lead individuals to put themselves in a “box” and define their identity around a specific condition, which can reinforce negative self-perceptions and societal stigma.
Thus, Assoc Prof Julia emphasises the importance of a respectful and empathetic approach: “It’s better to ask in a way like, ‘Do you know what’s your weight?’ or ‘Do you know what would be an ideal weight for you?’”
By framing questions this way, medical experts avoid making patients feel judged or stigmatised, which can happen if they are told outright that they are obese.
This approach ensures a sense of collaboration and mutual respect, making patients more likely to comply with medical advice given by professionals.
Being sensitive, but clear
The challenge lies in balancing sensitivity with the necessity of delivering clear and accurate medical information.
Assoc Prof Julia emphasises the importance of certain key terms in ensuring that patients fully understand their diagnoses, while also recognising the need for empathetic communication.
Certain medical terms must be communicated explicitly to avoid misunderstandings about serious health conditions.
She illustrates this with an example: “You want to tell a patient that they have cancer; no matter what, the term ‘cancer’ needs to come out so that they know that it is cancer.”
She stresses that if such critical information is not conveyed clearly, patients might leave the consultation without fully grasping the seriousness of their condition.
This can have severe implications for their health and treatment decisions.
Therefore, she suggests providing more information, following the initial revelation.
This approach helps patients understand their condition more comprehensively and reduces the shock associated with hearing a serious diagnosis.
“A few things to do when you communicate about something serious or complicated is to always have educational materials ready.
“For example, if you’re talking about kidney disease, most people have never seen their own kidney.
“Always have a diagram or a picture to help explain it to the patient.
“Show them the kidney, explain how it works, and how their condition affects it.
“If you can, give the patient materials to take home.
“This is crucial because one consultation, no matter how thorough, won’t allow the patient to absorb everything,” she says.
Handing out flyers or diagrams means that they can revisit the information later, which is essential for their comprehension and retention.
A challenging task
As difficult as it can be for patients to digest, delivering a difficult diagnosis can also be one of the most challenging tasks healthcare professionals face.
Assoc Prof Julia shares: “One of the toughest jobs in terms of diagnosis and talking to the patient is to tell them they have a permanent disability.
“Some will cry, some will not believe it, and some will just completely shut down.”
This type of news is not only medically significant, but also deeply personal and life-altering, making the delivery of such information particularly sensitive and challenging.
Shalini agrees, saying: “Taking in this information, it’s overwhelming.
“There are stages of denial, anger, frustration and feeling depressed during all of this.
“A patient will require your compassion and empathy even more during that time, and to not be put off by emotions that might be stereotypically seen as negative.”
Assoc Prof Julia acknowledges that hearing terms like “cancer” can be abrupt and overwhelming: “‘You have breast cancer’ – It’s so abrupt that the patient is stunned.”
She suggests that doctors be conscious of the tone they use to deliver the diagnosis, looking into the patient’s eyes, then just keeping quiet for a while.
This approach will help to convey sincerity and compassion, which gives patients time to absorb overwhelming information.
Empathetic communication is essential when discussing serious health conditions.
While certain terms must be used for clarity, the manner in which they are conveyed can make a significant difference in how patients perceive and react to their diagnosis.
Assoc Prof Julia highlights the importance of understanding the patient’s emotional state and adjusting the delivery accordingly.
“You need to make sure that they understand what it is about.”
This requires healthcare providers and/or family members to be attuned to the patient’s reactions and be ready to offer reassurance and support.
Cultural nuances
The proper usage of language matters even more when it comes to communities that have diverse linguistic and cultural backgrounds, like in Malaysia.
This is where cultural competence comes in.
Assoc Prof Julia explains: “Cultural competence entails tailoring communication according to the population’s beliefs, values and practices.
“It’s about effectively communicating, regardless of language or cultural differences.”
This is as language encompasses not just words and terms, but also cultural nuances.
Says Shalini: “Certain words may carry different meanings or connotations in different languages or cultural contexts.
“This awareness allows us to provide more culturally-sensitive and effective support to our clients.”
“As professionals, it’s crucial to recognise these linguistic nuances and understand how they shape patient’s realities.”
Assoc Prof Julia notes that different cultures may also perceive and interpret medical information differently.
“For example, when advising on diabetic control to Indian patients, it’s essential to use examples relevant to their culture, such as avoiding Indian sweets,” she says.
“Medical students must be taught this skill, as effective communication goes beyond language proficiency,” she adds.
