Ah, the lexicon of healthcare. We talk of practice transformation to promote care model development that enhances patient experience, improves quality metrics and moves us closer to value from volume.
For most on the front lines of care, we offer a perfunctory nod when terms like these are peppered throughout the familiar, prolix language of leadership—or just as frequently, we summon buzzwords and euphemisms ourselves when trying to sway a C-suite or grace the pages of a high-impact journal. And that's not always a bad thing; coded language helps us talk about the hard stuff of medicine, like "loss" (not death) or "long journeys to recovery" (a complicated prognosis).
In the corporate world, buzzwords have inspired annual contests; George Carlin famously derided the euphemization of language, suggesting that the more syllables, the less trustworthy. He had a point.
But as we roll our eyes at the dialect of the business of healthcare, we also do so as clinicians—trained to be precise in our language. We know that mislabeling or misrepresenting a chief complaint sets us up for a course of treatment that can have real (and dire) consequences.
If a patient presents with chest pain, for example, we need to know if it's a myocardial infarct, gastroesophageal reflux or a pulmonary embolism. We obtain a detailed history, consider past medical episodes, perform an exam, create a differential, order diagnostics, and outline a treatment plan. Before we ever label a patient's presentation, there's a process to ensure we get the language—the diagnosis—just right.
So while we'd never just slap a migraine sticker on someone with a headache and encourage them to schedule another visit, we do that sort of thing every day when it comes to our own systems.
If a clinician is overworked or reeling from the death of a patient or in conflict with a colleague? They're simply burned out. If a clinic has high attrition rates? They need practice transformation. To paraphrase "The Princess Bride": "You keep using these terms. I don't think they mean what we think they mean."