The emerging language of healthcare is setting us up to fail

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."

Three things happen when we get lost in vague language: We misdiagnose, we mistreat, and we miss connection.

At Beth Israel Deaconess HealthCare, we're beginning the important process of better syncing our language with our organizational diagnosis—and, in turn, our actions.

Take "teamwork optimization." Rather than deride clinicians for "poor teaming," with few resources to define and address the issue, BIDHC has upended how we approach collaboration, embracing a more meaningful definition of the term that can translate into more measurable improvements. We're bringing in best practices from think tanks to spur innovation on the practice-level, like staff co-location and open work clinical areas.

We're also rewarding clinicians for the behaviors themselves, like regularly participating in meetings. Indeed, team meetings are now hardwired into all 37 primary-care sites, with coached leaders to foster connection between physicians and staff, improve operational workflows, and educate teams on population health goals.

To see if our efforts work, we're not just looking at traditional outcome data (Ha1c spreadsheets are here to stay) but at staff attrition rates, and asking patients questions like, "How well did your team work together to care for you?" These aren't ambiguous concepts; they're actionable steps that are changing culture.

While healthcare professionals grapple with the maladies of our industry in a vernacular all our own, it's important to remember that we have a public that's listening. Millions of Americans, whose explanations of healthcare come in the form of incomprehensible EOBs, are left wondering what it means for them—like rising rates of burnout or the transition to value-based care.

As we drown in our own babble, then, our cries for help are both misunderstood and often fear-inducing. That's neither fair nor effective. Because when it comes to making the kinds of changes so desperately needed in American healthcare, we're going to need clinicians, patients, payers, policymakers, and the general public speaking in a shared language to achieve results that none of us can accomplish on our own.

Until we start attaching meaning to our vocabulary and coming up with concepts widely accepted and treatment universally embraced, we're going to continue swimming in unhelpful ambiguities that stymie progress—for all of us.