What ’ s in a name ?
Medical terminology might influence patient decisions about the need for surgery .
By Conor Burke
Does the way in which a doctor describes a medical condition influence our decision-making ?
Researchers from the University of Sydney believe that it does , and found that in some cases the terminology used could make people up to 25 per cent more likely to have surgery .
Looking specifically at shoulder pain , the study by Dr Joshua Zadro , Dr Brooke Nickel , Dr Giovanno Ferreira , Dr Mary O ’ Keeffe and Dr Tessa Copp from the University of Sydney involved 1,308 people from five countries , some with and without shoulder pain .
They were allocated to read one of six scenarios , the only difference between each one was the term used to describe the person ’ s shoulder pain . They used the most common type of shoulder pain where people feel pain at the front of one of their shoulders , which is made worse by lifting the arm and lying on it .
This pain is often described synonymously as “ subacromial impingement syndrome ” or “ rotator cuff tear ”, “ bursitis ” and “ rotator cuff related shoulder pain ”.
Writing about their work in The Conversation , the researchers say that doctors often use a wide range of terms
for this shoulder pain , mainly “ because it ’ s currently impossible to pinpoint the exact cause of most shoulder pain ”.
They found that people who had “ rotator cuff tear ” were more likely to want surgery . In fact , they had 24 per cent higher perceived need for surgery than those told they had “ bursitis ”, the group with the least perceived need for surgery .
NEGATIVE VIBES Semantics is thought to play a role in the perception of other conditions as well .
The USyd team writes that wording can affect the way we see types of cancer , acid reflux , polycystic ovarian syndrome and even pink eye .
They point to research that asked parents to consider a hypothetical scenario in which their otherwise healthy infant cries a lot and “ spits up excessively ”. Parents who were told their child had “ gastroesophageal reflux disease ”, the fancy term for acid reflux , were more likely to want medication .
Another study looking at a scenario where parents were either told their child had an “ eye infection ” or alternatively “ pink eye ” ( both terms meaning conjunctivitis ), found that the pink eye group perceived the infection as more contagious and were more interested in antibiotics , even when informed that they wouldn ’ t help .
REFRAMING THE NARRATIVE The researchers argue that health professionals should be mindful of the
“ Changing how health professionals describe conditions to their patients is a simple strategy that could curb the rise of unnecessary health care .
words they use , and although it may be a challenge to change oft-used terminology , it would save on needless patient anxiety and unnecessary surgeries could be avoided .
In the instance of shoulder pain , this might save the 20,000-plus potentially unnecessary shoulder surgeries that are performed in Australia each year , which they estimate to cost over $ 200 million annually .
“ Changing how health professionals describe conditions to their patients is a simple strategy that could curb the rise of unnecessary health care ,” they write .
“ For patients with shoulder pain not caused by severe trauma , we suggest health professionals avoid telling patients they have rotator cuff tears as this may make some patients think shoulder surgery is needed ( which it isn ’ t ).
“ Health professionals could instead label people with this type of shoulder pain as having bursitis ( inflammation ), as this was the label that mostly made people think surgery was unnecessary .” ■
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