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Saturday, 30 December 2017

The secret codes doctors use to INSULT their patients right in front of them - and why the lingo harms your health care


  • Doctors revealed some of the acronyms and made-up medical terminology medical professionals use to describe patients to one another 
  • The phrases range from darkly funny, to rude, to downright racist 
  • Doctors involved in discrimination research say that these are an institutionalized part of doctors poor opinion of patients 
  • Research has shown that discrimination in health care leads to worse outcomes for patients  


  • Medical jargon is pretty impossible for most patients to follow, but some of the terms you hear your doctor use may just be insulting industry jargon. 
    Over decades, doctors have ad-libbed a whole vocabulary to encode their frustrations with problem patients, communicate grim status updates, or even gossip about children. 
    In medicine, this slang is more than harmless insider-jargon: studies have shown that doctors' attitudes and discrimination toward patients can have a real affect on the treatment they receive and how well they recover.
    Medical schools have begun to recruit more diverse students in the hopes of changing the field's culture, but several young doctors who wished to remain anonymous told Daily Mail Online that discriminatory terms are still common.
    But discrimination is institutionalized and dangerous in medicine, according to Dr Peter Muennig and Dr Alex Green of Harvard University and Massachusetts General Hospital, and it's worth knowing some of these terms that doctors may use to mask the severity of a situation or downright insult you (warning: some of these are offensive).

    What's so funny: Doctors might get a laugh out of using codes to insult patients to their faces, but experts say that the harm this discrimination does to health care is no joke
    What's so funny: Doctors might get a laugh out of using codes to insult patients to their faces, but experts say that the harm this discrimination does to health care is no joke

    GOMER 
    This 'classic' term stands for 'get [them] out of my emergency room.' It has been used in hospitals for decades and is familiar to just about every doctor working, Dr Muennig says. 
    The acronym is a sort of catch-all term for any of the kinds of patients doctors don't want to deal with.  
    'There's a certain level of discrimination against the chronically ill, and that's where GOMER comes from,' says Dr Muennig. 
    In a recent interview with Daily Mail Online, he also said that this term is often used particularly to describe people who physicians suspect are hunting for pain medication. 
        
    Frequent fliers
    Patients may return to the hospital week after week - or even day after day - for a variety of legitimate or illegitimate reasons, earning them the title 'frequent fliers,' but certainly no points from doctors. 
    Chronically ill patients with conditions like diabetes must make regular appointments for dialysis. 
    Other patients become common faces in emergency rooms and clinics because of their hypochondriacs tendencies, constantly sure that they are gravely ill.
    Still other patients may just be looking for a drug fix, coming in with complaints of chronic pain, or in hopes that the physicians on shift will be more willing to prescribe than yesterday's were. 
    'It's most often used to talk about people with severe diseases like diabetes, or renal failure and diabetes,' says Dr Muennig.

    FLK 
    Doctors use this cruel acronym for 'funny looking kid' to describe 'those babies who are "syndromic" or [we can tell] something is wrong with them based on how they look,' a Chicago doctor told Daily Mail Online. 
    Children born with any of the three trisomies - genetic mutations that cause there to be an extra copy or partial copy of a chromosome - often have distinct appearances. 
    These disorders include Down syndrome, which is typified by a flattened face, smaller head and ears than normal and upward slanting eyes. 
    Doctors also use the FLK to describe babies that don't have a clear diagnosis, but whose 'abnormal' appearance suggests that there may be something wrong with them. 

    Crumping 
    Not to be confused with the dance style, doctors use 'crumping' when they have a patient that is 'crashing, but not aggressively,' the Chicago doctor told Daily Mail Online.
    The phrase is synonymous to 'circling the drain.' Rather than their organs suddenly failing - or crashing - these patients are deteriorating quickly, and often don't have much chance for survival. 
    'I don't think it's necessarily harmful to say "crumping" or "frequent flier,"' a New York-based doctor said, 'but I'm very careful as a physician to not use those words in earshot of a family, that would be strongly unprofessional.'

    Total body dolores
    Like many legitimate medical terms, this one is derived directly from Latin. 'Dolores' translates to pain so this 'literally means total body pain,' the doctor says. 
    The phrase is most often used between doctors, to describe a patient, as in, 'I have a total body dolores in room 109.'  
    He says he's seen this term used commonly to describe Latino patients in particularly. 'These patients can be very nervous,' he says, in part because English is often their second language, making the hospital and medical-speak even more frightening, 'and their anxiety manifests physically.' 
    Slang is used 'commonly with people of color, people using drugs,' he says. More common phrases like '"crack head" are commonly heard on the ward too.' 
    Although 'doloroes' means pain in Latin, a rather medical language, it means the same thing in Spanish, as well as being a woman' name. This all adds up to maximize confusion for patients. 

    Status dramaticus 
    A patient earns the title 'status dramaticus' when they are a '10/10 [for pain] always, although they look fine,' the Chicago doctor says. 
    'This is someone that wails shrieks, howls so loudly you can hear them from the hallways. Everything hurts and they make sure you know about it,' he says. 
    The problem with doctors using terms like status dramaticus, says Dr Alex Green, 'is that they're dealing with people who are sick, physically and sometimes mentally and these [dismissals] can be more directly harmful.' 

    WWWS 
    The acronym for 'wealthy white woman syndrom ' is 'actually bad because it's a term that is used when you're frustrated at specific patients and dismissing their symptoms,' says Dr Lisa Wang, a psychiatry resident in New York.  
    Research has documented that physicians are more likely to take women's pain less seriously than they would a man's. There is a widely held belief - though studies turn up mixed results - that women's bodies are designed for childbirth and their pain thresholds are higher. 
    A 2008 study from the National Institutes of Health also found that women wait 16 minutes longer to be seen in an emergency room than men do. 
    'As medical providers, on an unspoken level, I think [using these terms] is a coping mechanism, to make light of really difficult situations,' Dr Wang says. 

    Doctors use the term 'wealthy white woman syndrome,' jokingly, but women's pain is often dismissed by doctors and studies have shown they may wait up to 16 minutes longer to be seen in a hospital emergency room 
    Doctors use the term 'wealthy white woman syndrome,' jokingly, but women's pain is often dismissed by doctors and studies have shown they may wait up to 16 minutes longer to be seen in a hospital emergency room 

    HHS and Aye-aye-itis  
    Discrimination against people of color and those for whom English is a second language is rampant, as evidenced by the terms 'hysterical Hispanic syndrome' and aye-aye-itis.  
    'I hear "aye-aye-itis" used for a Hispanic patient who has many somatic complaints, none of which are related to their surgery or main problem, usually accompanied by "aye, aye,"' the 
    Chicago doctor says. 
    'Language barriers are a big discriminatory factor,' says Dr Green. 
    'There's an attitude of "oh, another patient that doesn't speak English, why don't they learn, it makes our lives so difficult,' says Dr Green, who has worked on initiatives to educate hospitals on language barriers and introduce interpreters. 
    'I roll my eyes every time I hear that [kind of term]' says a New York doctor. 'I call it out because it gets at the rampant cynicism to the job.'
    In one Harvard study, 20 percent of a group of 8,000 Latino people reported experiencing discrimination at a health care facility or clinic. 

    Slugging 
    'A slug is someone who is reluctant to get up out of bed after surgery,' says the Chicago doctor. 
    'They tend to be slow, in pain, and want to stay "one more day longer, please,"' he says. 
    On one hand, 'poor effort,' as he calls it, can have a negative impact on the quality and timeline for recovery, but there is a darker side to this tendency too. 
    A hospital bed might be the safest and most certain place some patients can stay, especially for those who are not financially secure or may be struggling with addiction. 
    'When you have patients showing up drunk every single night, always overdosing, not taking their blood pressure medications and coming in because of it, it becomes easy to blame patients, though I don't think you should,' says one New York doctor. 
    Dr Green says that 'a lot of it derives from [doctors'] systemic frustrations with the medical system back-firing back onto patients.'


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