In Order for Doctors to Educate, They Must First Know How to Communicate

June 17, 2024. By Hannah Dibble.

2023-24 Schweitzer Fellow Hannah Dibble

Have you ever been in a doctor’s office and left bewildered because the provider used jargon or confusing language? Unfortunately, this is all too common. Medical schools are in a unique position to address that by adequately equipping their students will the skills they need to effectively communicate with patients.

A study in the Journal of General Internal Medicine, examined health care providers’ use of medical jargon and reported that providers use terminology not understood by patients as often as seventy times per encounter. An example of this was described by a medical student colleague after caring for a patient at a local clinic for those without health insurance. The patient had a diagnosis of pre-diabetes, hypertension, and hyperlipidemia and he was there because he was trying to manage all of that and “get his numbers down.” When asked what his previous care team explained those numbers to be, he remarked “I don’t know, I just know it’s why I’m on all of these medications.” This, unfortunately, is not an uncommon occurrence in clinic. Often medications are added to a patient’s regime with the explanation of a need to lower “his or her numbers” and not an explanation of why that’s important and what’s happening in his or her body. If patients don’t understand their diagnoses and treatment plans, how can we expect them to follow them?

Before attending medical school, I taught high school science for two years through Teach for America. In my preparation for teaching, I attended countless session on how to capture a high school student’s attention, how to use metaphors to teach complex chemistry topics, and how to check for student comprehension. While I don’t think I could ever feel fully prepared to teach a room full of high school students, I had the tools ready to do so.

I am now a third-year medical student at Wake Forest School of Medicine and current North Caroline Albert Schweitzer fellow, working to increase sun protective behaviors in people experiencing homelessness across Winston-Salem. In partnership with City with Dwellings, a local homeless shelter, fellow medical students and I teach modules on skin cancer and distribute sun protective gear, hoping to ultimately reduce the incidence of skin cancer in this population. During one of the first workshops, one of the participants was having a particularly hard time grasping why getting a tan is a form of skin damage. I thought back to my medical school lectures on skin cancer, searching for the words to describe the damage that the sun can have on your skin. Is now the right time to explain pyrimidine dimerization in DNA? Likely, no. Should I leave it at “because I said so?” Also, no. I decided to revert to the explanation of cellular damage that I used as a tenth-grade biology teacher, comparing our cells to Lego models and DNA to the instruction manual. The more sun damage you get, the more changes are made to the DNA causing future cells to be formed incorrectly. As more damaged cells build up, your risk of skin cancer increases. The woman nodded in agreement and proceeded to teach the women around her the importance of sun protection. She took control of her health because she understood the importance.

Overall, the use of medical jargon leaves patients feeling confused and vulnerable and leading to worse health outcomes. It is extremely important that medical schools recognize the role of doctors as educators and train them as such.

Hannah Dibble

2023-24 NC Schweitzer Fellow

Wake Forest School of Medicine, Class of 2026