Jargon dominates medicine and how doctors verbalize nouns

One of my interns was “running the list” with me last week (giving me a thumbnail update on the plans for each of our inpatients). It was standard stuff until he got to Ms. X, a 80ish-year-old woman admitted with urosepsis who was now ready for discharge. “I stopped her antibiotics, advanced her diet, called her daughter, and YoJo’ed her.”

Say whaa?

I’m pretty sure that the most valuable thing I’ve done in my 15 years running UCSF’s inpatient service has been to convince the hospital to hire a discharge scheduler, Yolanda Jones, a delightful woman with a big smile and the world’s most thankless job. When a patient is ready for discharge, the interns send Yolanda a note with a list of follow-up appointments, radiology studies, and other outpatient tests that need to be scheduled. She makes all the appointments, then calls the patient and intern with the info. Our hospital would cease to function if not for Yolanda; she is the unsung hero of the medical service.

And now, the process of asking Yolanda Jones to schedule discharge appointments had become a verb.

The next day, I was at a patient safety meeting. Somebody mentioned a bad error. “That case needs to be RCA’ed,” he said. Another new term – root cause analysis – had morphed from noun to verb.

I’m guessing every specialized field develops its own language, and that condensing common activities into verbs is universal. Yet I somehow suspect we use this type of shorthand more in medicine than in other walks of life.

We learn to verb-alize early in our career – the English majors among us undoubtedly recoil when they first hear these linguistic bastards, but everyone eventually gets on board. “She was surgerized,” “we digitalized him” (that’s the cardiac medicine derived from the foxglove plant, not the rectal exam; that goes by “rectalized”), “I heparinized him,” “we Swanned her” (or “lined her up”). The list goes on.

I asked my colleagues for some of their favorites, and heard a few goodies. Sumant Ranji recalled his days as a resident at the University of Chicago, where the housestaff used the term “housed and spoused” to refer to a patient who had somewhere to live, someone to take care of him/her, and was ready for discharge. As in, “she doesn’t need a SNF, she’s housed and spoused.”

And the new world of healthcare IT is exposing us to terabytes of jargon, and thus many new words to verb-alize. Our informatics guru Russ Cucina turned me on to the unique jargon of Epic, my hospital’s soon-to-be implemented IT system. Epic uses several words in interesting ways, Russ told me, including “Pended” and “Done-ed” as verbs. “Actions in Epic (orders, notes, etc.) are usually accompanied by a button labeled ‘Pend’ where you can put them in a holding state,” he explained. “Physician users of Epic universally start saying ‘I pended it.’ After something has been ‘pended’, you can reopen it and finish what you are doing, and there is a button labeled ‘Done’. Physician users of Epic start saying ‘I done-ed it’.”

Wow.

If you have any favorite medical verbs, I’d love to hear them. Until then, I’m done-

-ed.

Bob Wachter is chair, American Board of Internal Medicine and professor of medicine, University of California, San Francisco. He coined the term “hospitalist” and is one of the nation’s leading experts in health care quality and patient safety. He is author of Understanding Patient Safety, Second Edition, and blogs at Wachter’s World, where this post originally appeared.

email

Comments are moderated before they are published. Please read the comment policy.

  • http://drackies.blogspot.com Dr. Evil

    My faves…
    “TOBSH”(pronounced “Toe-Bash”) for those patients you’d like to T-ake
    O-ut
    B-ack
    S-hoot
    I-n
    H-ead
    We didn’t really take them out back and shoot them in the head as far as anyone knows…

    and for that short time from Match to Graduation we had the “FYIGMI”(Pronounced “Fig-me”) Warriors for

    F
    Y-ou
    I
    G-ot
    M-y
    I-nternship(“Residency” was more accurate, but doesnt make a pronounceable word)

    Useage: “Who are those students playing pool instead of going to Grand Rounds??”
    “They’re FYIGMI’s”

    Frank, MD

  • Jake

    Unique jargon is a fact of life in all sorts of fields, endeavors, etc, All of us should expect it (actually welcome it) among and between those in that field.

    The problem is when they start using those terms elsewhere, among those who do not understand the term. It is from that standpoint that those in the medical field are often guilty of a failure to communicate.

    My favorite example is the use of the verb “to present.” Typically, a physician says “The patient presented (here you insert your favorite symptom, situation, etc.).” No one else uses the verb “to present” that way–how do we get medical people to use it only among themselves? If you want to see a lot more examples of that usage, just read this blog.

  • JScarry

    I think you mean ‘verbing’, as Calvin so eloquently put it.
    http://johnscarry.com/Comics/Calvin%20VerbingWeirds.jpg

  • Hanzel, DO

    Attending: “The patient was taserized by police.”
    Me [blank stare, thinking "wtf?"] “Oh, ok.”
    I’ve always thought “tased” or “tazed” (pronounced the same) would suffice…

    Also can’t stand idiots that use “orgasm” as a verb. It’s a noun people!!!
    i.e. “I orgasmed” vs. “I had an orgasm.”

  • Molly, NYC

    Hanzel, DO (@4) – I feel the same way about the word “impacted.” They’d better be talking about a bowel.

  • http://promega.wordpress.com Michele

    Hi Ed,
    I was stumped recently while editing an instrument manual by the sentence “Use this sample to blank the instrument.” That sentence certainly “blanked” the editor, which is never a good thing. I added “blank” to our blog post “The Notorious Not-A-Verb List” http://wp.me/pnsRh-sO on our corporate blog. MD’s aren’t the only culprits; biochemists, geneticists, engineers, cell biologists and others of that ilk are just as guilty.

  • Jake

    Michelle said: “MD’s aren’t the only culprits; biochemists, geneticists, engineers, cell biologists and others of that ilk are just as guilty.”

    As an Engineer, I agree that she is correct. But those others are not usually so likely to use such jargon in a way as to not be understood by those who really need to understand something important for their health and well being.

  • Kieran

    How about upr and lr GI endoscopy: The pt. got Rotisseried.

Most Popular