As a veteran journalist, I've done a lot of thinking about the communication process and its role in improving the quality of life.
After spending 10 years as editor of a healthcare business news publication, I've witnessed how effective communication is as the crucial first step in advancing the public's understanding of medical issues.
Healthcare, as we painfully know, has a language all its own. Whether it's to simplify, impress or confuse, the endless list of acronyms, ologies/ologists and tongue twisters is part of the landscape.
The healthcare industry accounts for almost 15% of the gross domestic product and nearly 10% of the jobs, yet most people have a hard time holding a casual conversation about the way the system operates. The confusion in terminology also makes it difficult for politicians, the media and patients to comprehend the process.
Demystifying healthspeak will take on greater importance as consumers become more involved in their medical decisionmaking. Sometimes the discussion will involve life-and-death issues. What percentage of the population, or, for that matter, of your organization's employees, knows the difference between advanced directives and living wills?
Where some see lemons, others see lemonade and the opportunity to collectively move us closer to the same healthcare wavelength. In the past few weeks, no fewer than five healthcare dictionaries have crossed my desk. Some capsule comments follow:
Ellen Freudenheim, author of HealthSpeak (Facts on File, New York), believes "the language of healthcare is almost as complicated as the system itself."
Freudenheim, a freelance writer with a master's degree in public health, offers definitions of 2,000 nonclinical terms. This is a well-organized, easily understandable guide to the healthcare maze. It also breaks boundaries between various disciplines. For example, it defines "brain death" and then guides readers to references on advanced directives.
HealthSpeak defines continuum of care as a "conceptual sequence of medical and support services, ranging from preventive care or wellness education at one end of the spectrum, and hospitalization and intensive care at the other end. In between are a series of gradations, including self-care, outpatient care, home healthcare, intermediate and skilled-nursing services."
The Managed Health Care Dictionary by Richard Rognehaugh (Aspen Publishers, Gaithersburg, Md.) is comprehensive enough to appeal to a professional readership, yet offers basic definitions suitable for a consumer audience.
Rognehaugh defines continuum of care as "a spectrum of healthcare options, ranging from limited care needs through tertiary care, to provide the appropriate expertise for the patient without providing a more expensive setting than necessary."
Kathleen O'Connor's Health Care Glossary of Terms and Definitions (The Understanding Business, San Francisco) is a 58-page, pocket-size guide. It also summarizes hot topics and lists books, resources, telephone numbers and Internet sites for additional healthcare information. The publisher is marketing customized bulk orders with the client's company logo printed on the cover, an introductory letter from the CEO and inclusion of a reply card.
Health Economics Solutions in conjunction with Philadelphia's Thomas Jefferson University Hospital issued A Health Economics Pocket Glossary (IMS America, Plymouth Meeting, Pa.). Most of the 101 terms have an academic heritage but are quickly moving into the vernacular of medical practitioners and administrators.
Eight, count 'em, eight, definitions of cost are given, as well as listings on cost analysis, cost benefit, cost-benefit analysis, cost-benefit ratio, cost-effectiveness analysis, cost-effectiveness ratio, cost-efficacy analysis, cost-minimization analysis, cost outcomes, cost-of-illness analysis and cost-utility analysis.
As part of its 1996-1997 Integrated Health Care 100 Directory, St. Anthony Publishing (Reston, Va.) offers a 105-page managed-care glossary. The definitions, acronyms and abbreviations are especially appropriate for healthcare providers interested in learning more about insurance and capitation.
The directory itself is a ranking of the 100 leading healthcare delivery systems, of which 76 are privately owned. Collectively, the 100 systems cover more than
31 million lives, generate about $82 billion in annual gross revenues and include 935 hospitals.
There is more to communication than memorizing or understanding a glossary of terms.
Two Boston colleges have teamed to offer a master's degree in health communications. The Emerson College-Tufts University School of Medicine awarded its first 22 diplomas in May. Some 60 students are enrolled in the two-year program.
Scott Ratzan, M.D., and Norman Stearns, M.D., who direct the Emerson-Tufts program, believe medical communication must be driven by more than scientific gobbledygook and financial mumbo jumbo. Students utilize their science framework in combination with courses covering communication theory, marketing, negotiation, medicine, management, psychology, government, education and public health.
Students are instructed in market-based consumer research, medical ethics, new communication technologies and dealing with the media. Each student also must complete a live on-air interview with a local cable station.
The goal is to prepare healthcare professionals to effectively develop, deliver and evaluate health promotion and disease prevention strategies.
Let's face it, the successful healthcare executive of tomorrow will have to do a better job of communicating with staff, patients and payers, as well as participating in health policy initiatives.