A new review of 87 primary care encounters1 found that providers used at least 1 type of medical jargon without explaining it to patients in nearly 80% of appointments, with an average of more than 4 uses of jargon per visit.
A team of researchers affiliated with the University of Central Florida in Orlando listened to audio recordings of these encounters and found that less than half of all jargon terms were explained and that, overall, providers used a jargon term around once every 4 minutes.
“Some use of medical jargon is unavoidable in provider communication with patients; however, for medical jargon to serve an educative function, it must be limited in amount so as not to overwhelm patients,” said lead author Ann Neville Miller, PhD, Professor and Interim Assistant Director of Academic Programs, Nicholson School of Communication and Media, University of Central Florida.
Jargon must be explained “because patients are often hesitant to admit they don’t understand and even jargon with which patients have passing familiarity, such as ‘viral sinusitis’ or ‘EKG,’ need provider input to fill in gaps and correct errors in patient understanding,” Dr Miller said.
New Classification System
“Research2 reveals that the majority of patients leave clinical encounters with faulty recollections of provider diagnosis and treatment recommendations and they may retain only around half of the medical information presented to them,”3-5 the authors write.
They suggest that there is often a “mismatch” between what health care providers think they have communicated and what patients actually hear, with providers “overestimating” how well their patients understood.6 Patients’ misunderstandings can have serious consequences, including “poorer treatment adherence, less patient satisfaction, and, ultimately, poor health outcomes.”7
The concern about jargon has become even more “critical” in light of the “current move toward patient-facing transparent records,” making it even more important for healthcare providers to “recognize the potential harms of using inaccessible language,” the authors state.
Dr Miller explained that although medical jargon has “been occasionally studied for decades, definitions of jargon have ranged widely from study to study.”
A new classification framework8 by Pitt and Henderson is “comprehensive” and “includes pretty much every type of jargon that has been identified in previous studies,” and the researchers therefore used this new framework as an approach to “get a broad picture of how much of each type of jargon was used in this type of medical encounter,” Dr Miller said.
The current study was part of a larger research project examining provider techniques for ensuring patient understanding during medical encounters in the student health center of a larger Southeastern university. Specially trained nurses recorded the patient encounters. The researchers excluded appointments involving women’s health, sexually transmitted infections, victim services/sexual assault, substance use disorders, behavioral health, or mental health.
Patients whose appointments were recorded were 18 years of age or older and had completed informed consent and HIPAA release forms. Transcripts of the recordings were then reviewed by the research team, who applied Pitt and Hendrickson’s framework.8
Additionally, immediately after the appointment, providers completed a self-administered questionnaire with open-ended questions that included the diagnosis, what instructions they gave to the patients and treatment, and why this was important for patients to do.
Patients completed a nurse-administered questionnaire, in which they were asked about their satisfaction with the appointment; their sense of self-efficacy, what the provider said was wrong with them; what they should do about it; and why it was important.
Nurses then rated patients’ responses as “very inaccurate,” “accurate,” or “very accurate,” regarding their understanding of the medical information they obtained during the appointment, and these scores were used to create a patient understanding index.