COMMUNICATION - Patient Perspective: The Right Words Matter

Patient Perspective 
The Right Words Matter

The number one problem with communication in healthcare is that people ask things like, ‘Is there blood in your urine?’ Patients say no, because they think they’re supposed to see literal blood.  Doctors need to ask this in a much simpler way, such as, ‘Is your urine any color other than clear or pale yellow?’ We don’t like to talk about gross things. That’s something that happened with my husband, Fred. They just checked the box and ruled out cancer. He had orange urine for a year. But he didn’t know that meant blood in his urine. He made the assumption that he wasn’t drinking enough water. He knew his urine could get darker if he was dehydrated or if he ate different things. The question is wrong – but it keeps getting asked in the exact same way. It’s such a powerful diagnostic. There’s a cascade: If you say no to blood in your urine, you don’t get labs done. If the verbal response doesn’t alert you to a continuous problem, that’s the end of it. I wish there was more utilization of things like McDonald’s uses – the repeat back. If people nod along, they may not be following. Society is teaching us to get along. So many patients don’t have that level of comfort and don’t want to feel stupid. It’s delicious to use complicated words – they’re so precise. But it becomes a code. And it’s hard to break the code in a clinical situation. But that’s why I never say RCC [Renal cell carcinoma]. My husband died of kidney cancer. We have to get away from big words, and from using acronyms for big words. 

Regina Holliday
Patient Activist 
Founder: the Walking Gallery of Healthcare