Words used to describe doctors and the NHS have come into sharp focus recently. At long last, the powers that be have agreed to replace the misleading title “junior doctor” with resident”. One step forward. Simultaneously, the new UK Government are coming under fire for persistently describing the NHS as being “broken”. They have referred to some aspects of the service as being a “shame on the nation.” They have said that cancer diagnosis is “more likely to be a death sentence for NHS patients than those in other countries.” When healthcare leaders, media commentators and political opponents have challenged this language, the Government have doubled down and refused to apologise.
Words matter
As children, the adults around us may have told us that, “Sticks and stones will break your bones but names can never hurt you.” However, how many of us actually believe that? Words matter. They can have a major impact on the way we think, feel and act.
“Don’t think about a big red balloon that’s ready to burst!”
During our patient communication skills courses, we regularly introduce phrases like this, then pause for a moment as a springboard for discussion. No pictorial images of the big red balloon are required. Words are powerful in changing what we are paying attention to.
All too often, negative language will encourage a negative response. As a result, participants struggle to effectively interact, pushing each other in opposing directions. If we believe that we are participating in something that is broken, that we are somehow involved in bringing shame, then some of us may become antagonistic. Many are likely to become despondent, demoralised and detached. We’ve discussed before in our blog-posts that we risk the self-fulfilling prophecy of doctors who expect burnout to be part of their lives, rather than developing true resilience.
Our previous experience also shapes what we understand. In the past, there were common tales of patient interactions with major misunderstandings of doctor’s titles: “I insist on seeing the Senior House Officer and not just some Consultant….” “Junior doctor” was always an inappropriate, misleading title, and healthcare systems in other countries already use “resident” instead. But how many UK patients will think the resident actually lives in the hospital? It may well take a bit of explanation and some time to embed the change.
Moving forward
Change can be hard. It’s often easy in the early stages but difficult to sustain. It took many people and organisations a long time to move on from using Senior House Officer. In fact, some never moved on at all, and you may still hear that term hanging around. Change is a topic which is common to a lot of our courses. It’s relevant for teamwork, leadership, management, mentoring, teaching and patient communication.
If we want to get past the negativity, and to get helpful new language embedded, then we have to be part of the solution, rather than part of the problem. Everyone has a part to play. So, what can we do as individuals?
It has to start with our own communication and our belief in the impact of our own words. We have to find ways to reframe what we are saying to help both ourselves and others focus on the right things. We need to find the equivalent of moving on from, “Don’t think about a big red balloon that’s ready to burst” to, “Think about sitting beside calm water on a sunny day.” It helps if we can set ourselves reminders, to maintain awareness, and catch ourselves when we drop into the old outdated or unhelpful language.
If we lead by example, then it’s easier to support and challenge other members of our team – those who look up to us, our peers and our own leaders. This may require learning effective methods and developing abilities of providing constructive feedback and critique.
Change won’t happen by itself. What steps are you taking that will make a difference?
Stephen McGuire – Managing Director
