Words matter.
Patients can get spooked by the words we use. All of us have heard vignettes of how some
inadvertent harsh words from a physician have caused injury. I know there were times that I wish I could
rewind and erase some errant words.
Sometimes, an innocent remark from the doctor doesn’t land
innocently. When I ask as a matter of
routine, ‘is there a family history of colon cancer’, as I do with every
patient, this may provoke anxiety in a patient who is seeing me for a bowel
disturbance.
Words Matter
We ask every patient who arrives at our ambulatory surgery
center if they have a living will. This
often causes the patient to utter a nervous joke. We then go on to ask if the patient has ever
been ‘a victim of abuse or neglect’. We
are required to ask this.. It would seem
rather unlikely that a patient who has just purged themselves for the pleasure
of a colonoscopy, would confess to a nurse that (s)he is meeting for the
first time that (s)he has been victimized.
Keep in mind that this a question follows a barrage of very routine
medical inquiries.
- Did you complete the laxative prep?
- When did you last eat or drink?
- Did you take any medications this morning?
- Have you ever been a victim of abuse or neglect?
- Who will be driving you home after the procedure?
Let me state unequivocally, that I am dead against all forms
of abuse and neglect, both foreign and domestic. I acknowledge that this is a serious problem
that is clearly under-reported, particularly among the elderly. I am skeptical, however, that querying our
patients who are poised for an endoscopic adventure about a personal abuse
history is likely to be enlightening. A
better case could be made for having these conversations in our office
practices after we have developed rapport.
Who makes up these silly rules? This is but one example of the documentation
abuse that has been foisted upon the medical profession by the government and others. I wish we could simply neglect to comply, but
this boldness would only generate more government abuse on us.
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