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Harvard Commentaries
Harvard Commentaries
Reviewed by the Faculty of Harvard Medical School

What Your Doctor Is Saying What Your Doctor Is Saying

Medical Terminology - The Case For Accuracy

October 10, 2013

By Robert H. Shmerling M.D.

Beth Israel Deaconess Medical Center

Healthy Lifestyle
What Your Doctor Is Saying
Medical Terminology - The Case For Accuracy
Medical Terminology - The Case For Accuracy
Some familiar 'medical' terms can be misleading. Even though it's good to talk about illness in understandable language, accuracy does make a difference.
Harvard Medical School Commentary

The language we use to describe our health is important. It allows us to communicate vital information with others, including health care providers. Yet many terms or phrases that seem well-established within the language of health and illness serve little purpose and may even confuse matters. They seem to mean something specific and sound "medical," but they either are too vague or refer to nonexistent conditions. There are a host of examples — here are some of the more common:

  • Nervous breakdown — Presumably this entity refers to a psychiatric illness that is severe enough to warrant urgent attention and/or admission to a psychiatric facility. However, it refers to no specific disorder and could be used to describe severe depression, anxiety or even psychosis, among other problems.
  • Rheumatism — This term is described in Dorland's Medical Dictionary as "any of a variety of disorders marked by inflammation, degeneration, or metabolic derangement of the connective tissue structures of the body, especially the joints and related structures ..." However, experts in arthritis do not use this term, as it has no specific meaning.
  • Sun poisoning — This vague term could refer to a number of problems related to prolonged or intense exposure to the sun (or another heat source), including heatstroke (marked by dry skin, dizziness, headache, thirst, nausea, muscle cramps and fever), heat exhaustion (marked by similar problems but with low body temperature) or sunstroke (characterized by seizures, coma and high skin temperature after sun exposure). A related condition, photosensitivity, identifies people who have rashes, fevers or joint pains even with brief sun exposure.

How Rumors Begin

If these terms have so little specific meaning, where do they come from and why do they persist? Although there are probably different origins for different terms, one likely explanation is that the medical community has discarded such older terminology, once viewed as medically valid, in favor of newer terminology. For example, medical practitioners in the 1500s used the term "rheumatism" to identify a host of ailments affecting the joints, but this term lost much of its usefulness with improved understanding about arthritic disorders and the ability to separate rheumatic fever from gout from rheumatoid arthritis, etc. By historical precedent, however, the term lives on. Others terms, such as "nervous breakdown" likely developed at least in part as a translation of medical jargon into lay terms. Although such lay-friendly terminology may seem helpful, there is a danger is using terms that are not accurate or specific.

Effective communication among people who are ill, their family members and health care professionals requires that all parties have a similar understanding of the underlying problem. Although it may not matter much for certain conditions, more meaningful information can make a big difference in many situations. For example, the term "heart condition" could refer to, among other possibilities, a leaky heart valve, a past heart attack or heart failure — and the differences between these conditions are considerable. Using more specific or descriptive terms helps improve the understanding of one's health and illness history for all concerned parties.

Improving Your Communication

Communicating medical information is clearly a challenge, but there are ways you can improve the situation. Learn all you can about your health and any illnesses you may have had. If you forget or do not understand your specific health issues, ask questions. Your own health care professionals can "translate" your medical record in a way that is accurate and that you and your family members can understand. In addition, there are often other sources of information that you can consult to learn more about your condition. Your health care professional can direct you to these sources, which may include medical organizations, articles, books and Web sites.

Finally, write down your medical diagnoses and conditions and keep this information current. Your health care professional likely tracks your health issues in your medical record, but there are good reasons for you to keep an accurate and updated list of your own.

Robert H. Shmerling, M.D. is associate physician at Beth Israel Deaconess Medical Center and associate professor at Harvard Medical School. He has been a practicing rheumatologist for over 20 years at Beth Israel Deaconess Medical Center. He is an active teacher in the Internal Medicine Residency Program, serving as the Robinson Firm Chief. He is also a teacher in the Rheumatology Fellowship Program.

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