Summary: A groundbreaking study published in Mayo Clinic Proceedings identifies specific words and phrases that doctors should avoid when communicating with seriously ill patients. The research, led by experts from Texas A&M University and Henry Ford Health, emphasizes how single words can significantly impact patient care and emotional well-being.
Journal: Mayo Clinic Proceedings, August 20, 2024, DOI: 10.1016/j.mayocp.2024.05.011 | Reading time: 4 minutes
The Power of Words in Medical Care
When facing a serious illness, patients hang on every word their doctor says. Now, researchers have identified specific phrases that clinicians should never use, as they can cause unintended harm and undermine the doctor-patient relationship.
“Because seriously ill patients and their families are understandably frightened, they ‘hang’ on every word their doctor will say,” explains Dr. Leonard Berry, Distinguished Professor of Marketing at Texas A&M University and senior fellow at the Institute for Healthcare Improvement. “Serious illness is not only a matter of physical suffering, but also emotional suffering. The doctor’s behavior, including their verbal and nonverbal communication, can exacerbate or reduce emotional suffering.”
The Impact of “Never Words”
The research team found that certain phrases can severely damage the therapeutic relationship. “Never-words are conversation stoppers,” the researchers write. “They seize power from the very patients whose own voices are essential to making optimal decisions about their medical care.”
Through surveys of clinicians, the team identified particularly harmful phrases. For example, telling a patient “you failed chemo” places blame inappropriately – as the researchers note, patients don’t fail chemo; chemo fails patients.
Building Better Communication
The study suggests alternative approaches to common scenarios. Instead of asking “Do you have any questions?” doctors should say “What questions do you have for me?” This simple change creates a more inviting atmosphere for dialogue.
When discussing difficult prognoses, the researchers recommend replacing definitive statements with expressions of concern. Rather than saying a patient “will not get better,” doctors can say “I’m worried she won’t get better,” acknowledging uncertainty while maintaining honesty.
Training the Next Generation
The research emphasizes the importance of incorporating communication training into medical education. “The emphasis in medical school is understandably on the science of medicine, but it is so important to incorporate communications training into the curriculum,” Berry states.
The study suggests using mentorship programs where experienced doctors can share successful communication techniques and help identify harmful phrases to avoid. This approach helps ensure that future generations of clinicians will be better equipped to handle difficult conversations with patients.
Glossary
• Therapeutic relationship: The connection between healthcare providers and patients that facilitates healing
• Prognosis: The likely course of a medical condition
• Agency: An individual’s capacity to act independently and make free choices
• Clinician: A healthcare professional directly involved in patient care
Reader Comprehension Quiz
1. Why are “never words” considered harmful in medical communication?
Answer: They can stop conversation and take power away from patients who need to be involved in medical decisions.
2. What alternative is suggested instead of asking “Do you have any questions?”
Answer: “What questions do you have for me?”
3. How should doctors communicate uncertain outcomes?
Answer: By expressing concern rather than making definitive negative statements.
4. What role does mentorship play in improving medical communication?
Answer: Experienced doctors can share successful communication techniques and help identify harmful phrases to avoid.
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