Advice

I give a lot of advice in the course of the day. One might say it’s how I make a living. Some of my advice is pretty general (try get some exercise every day) and some rather specific (you have a weight goal of 153 pounds). But no matter what I say, I choose my words very carefully and use precise language.

I find that the best way to convey information is face to face. That way, I can tell if a person is following me. I encourage follow up questions and I may ask the patient to teach it back to me. I also like to give the patient some written information, often in a follow-up note. Many doctors are using discharge instructions for office visits, but I find that prewritten templates are too generic and sometimes make no sense. A non-smoker doesn’t like being told to stop smoking.

Telling a patient, “call if you are not better” is not nearly as helpful as, “Call if you have a fever greater than 101 or if you are short of breath.” Doctors tell patients to “push fluids” – but what does that mean? Far better are the instructions, “you should be urinating light yellow urine every two hours while awake.”

I also need my patients to choose their words carefully. It’s always best to use natural language rather than medical jargon. When a patient says she is worried about “osteo,” I have to wonder if it could be osteoporosis, osteopenia, osteomyelitis or a number of other “osteos.” What does IBS mean? Even worse is the made-up jargon used to push pharmaceuticals.

It might be hard to take advice, but my goal is that least the patient will understand it.