by Jill Hilty, MD

Embracing patient-centered care is universally acknowledged as crucial for providing the best service to our patients. However, it’s essential to acknowledge the evolution of patient-first language in recent years. Many of us, particularly in the mid-to-late stages of our careers, may have been trained in a manner that inadvertently perpetuates harm to patients. Implicit biases influence not only our interactions with patients but also our documentation practices in health records, potentially passing on biases and judgments to subsequent clinicians. Recognizing this potential harm is paramount, and we must actively work to change ingrained habits.

My awareness of the impact of pejorative language heightened during my involvement in global health, supporting local clinicians delivering health care in East African refugee camps. In this role, I provide continuing medical education and work alongside clinicians as they treat patients from diverse backgrounds. Unfortunately, biases and prejudices are prevalent, with clinicians often referring to patients from specific countries or tribes using derogatory terms and stereotypes. I advocate for treating all patients with equal respect and providing quality care regardless of where individuals were raised or the language they speak.

Native clinicians often find themselves entangled in inter-tribal conflicts that have persisted for centuries, complicating care delivery in the diverse environment of refugee camps. Overcoming negative perceptions about certain groups is essential to ensure each patient receives the care they deserve. Modern medical training emphasizes patient-first language, refraining from using medical conditions as labels and instead focusing on patients as individuals experiencing specific health challenges.

Older training practices, which encouraged describing patient encounters in vivid detail including direct quotations from patients, may inadvertently convey disbelief or mockery. Negative descriptors like “aggressive” or “non-compliant” further perpetuate non-patient-centered practices and can stigmatize patients, particularly those who are already marginalized. Careful consideration of language is crucial, as it directly impacts the patient’s experience and the quality of care they receive.

For instance, encountering stigmatizing language in a patient’s previous medical records can influence subsequent interactions, leading to defensive attitudes and compromised care. It’s imperative that we avoid language that stigmatizes or marginalizes patients, recognizing our responsibility to promote positive change, starting with our choice of words in the electronic health records. By adopting patient-first language and refraining from judgmental descriptors, we can foster a more inclusive and respectful health care environment for all patients.


Categories: Communications, Colorado Medicine, Final Word