I just read an article by PAMELA WIBLE, MD. another post-hippie era nutjob. The name of the article is,
“Stop saying these 7 shaming words in medicine. Right now.”
The premise of the article is that the words we use as practitioners when speaking to our patients are an important consideration. And if she had ended there, I’d have no issues. But, this wasn’t to be. She states that we shouldn’t talk down to, chastise, denigrate…etc. those under our care and, generally speaking, I agree. However, she takes these considerations way too far to the Left. I’m so surprised (Insert sarcasm here).
So, in my essay, I will take on her assertions and offer my personal and professional opinion on this subject point by point.
- “Don’t say COMMITTED suicide. Committed implies a crime. Committed rape, burglary, murder. Suicide is not a crime; it’s a medical condition that has been taboo for too long. Let’s come out of the dark ages and use proper language to discuss the cause of death. It’s died OF pneumonia, heart attack, stroke, suicide. Say died OF suicide (or died BY suicide).
Obviously, she is not a lawyer/prosecutor. The reason why she says “committed implies a crime,” is because It Is A Crime! Suicide or Attempted suicide IS illegal, i.e. a crime, in virtually every state in America. It’s a crime against the person. Attempting to equate suicide with some terminal or acute medical condition or injury is just plain silly. Afraid to offend the sensibilities of family and friends of the deceased by using the term Committed Suicide is to nullify the seriousness of the subject matter. Especially, where there may be a vulnerable person present or involved. Yes, we should be compassionate, but we, as practitioners should NEVER sugar-coat suicide in order to soft-peddle the lack of support prior to the act, or the personal responsibility of the person who ended their own life. Virtually every person interviewed who attempted suicide had clearly stated they the moment they attempted to take their life, there was “instant” regret.
2. “Don’t say she IS bipolar. People are people first. Some get physical and/or mental health conditions. The health condition is not their identity. She HAS pneumonia, heart disease, depression, not she IS pneumonia, heart disease, depression. Say she HAS bipolar disorder (or she is a person WITH bipolar disorder).”
This again is just silly. There is NO difference between her definitions…None! I’m diabetic…oh, wait. That’s just wrong! I have an endocrine system disorder. a pancreatic disorder, an Islet cell disorder, a carbohydrate/sugar intake disorder…etc. Where does the silliness end? I’ve never met a patient who has said: “I am a person with bipolar disorder.” It’s unrealistic for practitioners to converse using textbook language when speaking to patients. Honestly, you have to “dumb-down” explanations and terminology in order for the patient to understand their situation and choices. There’s not enough time in the day for practitioners and patients to engage in drawn-out conversations involving textbook definitions/terminology and still provide quality care.
3. “Don’t say he IS an addict. As in #2, people are people first. He is not a disease. He is not a behavior. Thus, he is not a substance abuser or an addict. He is a person who may have an addiction or a substance abuse disorder. Say he HAS an addiction.”
Please allow me to rephrase the above statement using different words…
“Don’t say he is a criminal. As in #2, people are people first. He is not a murderer. He is not a behavior. Thus, he is not a criminal or murderer. He is a person who may have criminal tendencies or psychological disorder. Say he has a “behavioral or psychological disorder with tendencies to harm others.” -Stupid, right?
Do you notice how she removes all stigma of an act(s) involving personal responsibility or culpability?
4. “Don’t say patient IS NON-COMPLIANT. Non-compliant blames the patient for not following a plan that she may have not understood or agreed to follow. Maybe she simply did not have money to buy the medication or the recommended treatment. Be precise and accurate with words, especially when placed in a permanent medical record. Don’t blame or shame. Be curious and engaging. Ask, “IS THE TREATMENT WORKING?”
“Non-compliant blames the patient for not following a plan…” Really? Who else is there to blame? It’s either the patient or the outside “caretaker” in the home environment. If the patient does not have the funds for specific medications, I’ve seen the physician, case manager, social worker, etc. assist many people. Many times, it’s the patient themselves who refuse to take responsibility for their own care. People with moderate to severe OSA (sleep apnea) not utilizing their CPAP machines for weeks, months or Years at a time. Or, cancer patients who refuse to quit smoking. I’ve seen patients on oxygen sitting in wheelchairs lighting up, the dedicated ones will place the cigarette right in their stoma. Sometimes shaming Works! Sometimes, “bullying” does wonders. Some people need an Honest “Coming to Jesus moment” to make an impression. Bottom line, if a patient makes a conscious choice to Not to follow a physician’s treatment plan or instructions that are the very definition of Non-compliance. “IS THE TREATMENT WORKING?!” Really, how exactly does one judge that if the patient is Non-Compliant!
5. “Don’t say PROVIDER. A provider is a person who provides something. How nebulous. In medicine, a provider is an economic term used to lump all the revenue-generators together into one pile (often to see how much more money can be squeezed out of them). It’s a dehumanizing word that lacks precision and, honestly, it’s offensive to the people who have spent so many years of their lives to achieve mastery in their chosen profession. Use proper terminology. Say NURSE PRACTITIONER, MIDWIFE, PHYSICIAN. If you must use a collective term, say HEALTH PROFESSIONALS. Sometimes, I say HEALERS.”
This one is just idiotic. In my years as a practitioner, I’ve NEVER heard ANY physician, practititioner…etc, refer to themselves as a “provider” to a patient. You’re the ONLY one, Dr., that I’ve ever heard of using the term “healer” (Except for those charlatan psychic healers). Physicians don’t heal anything or anyone. The body, under the right conditions, heals itself. You may offer treatments, surgeries and maintenance drugs but many times you engage in the prolonging of the suffering of patients trying to die as nature demands. Cuddos to you.
6. “Don’t say MIDLEVEL. What is that? Maybe it’s when an elevator gets stuck between two floors? Again (see #5) this is a word used by healthcare administrators to describe revenue generators who are somewhere halfway between a nurse and a doctor (I think). Use proper terminology. Say PHYSICIAN ASSISTANT or NURSE PRACTITIONER.
That may be a corporate term and, I’ve never heard a healthcare administrator use this term, ever. Just more nonsensical crap to increase her word count.
7. “Don’t say BURNOUT. Physician burnout is a term of oppression that blames the doctor for not keeping up with an inhumane schedule (30-hour shifts, 120-hour work weeks) in a toxic workplace that may include hazing, bullying, and no time to eat or take bathroom breaks. Even on their so-called time off, doctors may still be working on chart notes at home in bed on the weekends. Burnout blames the victim and deflects attention from the perpetrator. Speak the truth. Say HUMAN RIGHTS VIOLATION or HUMAN RIGHTS ABUSE. Don’t say burnout, say ABUSE.
I’ve seen some healthcare workers with/suffering “burnout.” And, I’ve never heard anyone say anything negative about these individuals other than criticising them for NOT seeking help or getting out long before they became a “problem.” As a matter of fact, it’s been my experience for the PEERS, so-called colleagues or “friends” to be the last ones to offer help or compassion for these people.
The only person who should be ashamed is you. To use terms like…”Human Rights Violations or Human Rights Abuse,” belittles the peoples of the World who have suffered ACTUAL Abuses of their Human Rights.
“Dr.” Wible, I think you belong in a commune somewhere in the Northwest where they grow hemp. I’m sure that they would eat up your mindless dribble…I mean since they’re almost always “high.”