Tuesday, February 28, 2006

Being PC

The new preceptor is nice, although I did get a bit of a mini-lecture for describing a patient as being non-compliant during one of my case presentations today. It was in the privacy of his office of course, and his point was that “non-compliant” is not the most politically correct of terms. What? What else do you call a diabetic with a fasting blood glucose of 420 and an HbA1C of 10.5? I call that less than two years away from toe amputations!

His point was that patients tend to sue physicians for saying things that they don’t want to hear. Huh? He gave an example of a physician being sued for describing a patient as being obese. He said that he would prefer that I say things like, “the patient is not actively pursuing a healthy lifestyle,” or “the patient has been advised of lifestyle modifications and medication regimens and is not currently following recommendations.”

What’s the point in being that verbose? I guess I’m more of a blunt person. I have learned over the years to withhold my opinion and often don’t comment if I have nothing constructive to add. However, if you ask for my opinion be it personally or professionally, I’m going to give it to you directly, and probably in ten words or less. I don’t see the point in sugar-coating or diluting information. If I have cancer, I want to know that I have cancer. I don’t want to hear that I have one apparently immortal cell that is reproducing at an exponential and incalculable rate, forming a tumor. Just give it to me straight. Period.

Perhaps I can trace this thinking back to my high school days of working for my hometown newspaper. The local editor, a woman I like to think of as my mentor, told me then to, "Think of every word you use as costing you a nickel. Don't waste your money on words that do not strengthen your position."

Besides, terms like obese can be objective based on calculations like body mass index, which takes height into consideration. Now if I say that someone is grotesque, or scrappy, then I suppose you have the basis for a lawsuit. Frankly, I found his dictation describing a patient as “a nice white lady” more offensive. However, opinions are just that—opinions. There is no right or wrong, even when you are talking about medical and professional opinions, unless of course, the advice is outside the accepted standard of care. If you want to ignore my advice, that’s fine. Even at this stage of my training, I have witnessed miracles in which healing occurred without surgery or medication, despite the recommendations of a specialist. I also have seen it go the other way, where patients expired waiting for a miracle. I suppose that the the fact that today’s recommendations become tomorrow’s contraindications are what drive people crazy about medicine. However, I find that there are few things more motivating than the challenge to keep up with that same plasticity.


As you can imagine, after essentially being on vacation the past two weeks, I found working 9 hours today especially painful. I was cranky by the time I got to the gym and even more so when I realized I’d somehow left my combo lock at home and ended up bailing on my workout.

Saturday’s long run was painful, as I struggled to even match the week before’s distance. On a happier note, over the weekend I finally found "Anything, Anything" by Dramarama on iTunes. I have been hunting for the song title and band name ever since I heard an opening band cover it at a New Year’s Eve concert a couple of years ago. Sorry, I’d share the actual song, but I don’t know how.


Chris said...

Love the suggestion about every word costing you a nickel.

"noncompliant" is politically incorrect? So what do you call a dead person? "Currently engaged in a prolonged state of unconsciousness"?

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Kate said...

I'll have to remember that one! If I end up dictating charts next year I want to at least keep the transcriptionist entertained! I once saw a surgical report in which the surgeon described cutting into a pocket of pus. I can't do his description justice, but he descriped pus shooting out like water exploding from the spout of a whale. It was hilarious, although I'm not sure the legal department found it amusing.