There are more than five million outpatient clinic letters written every month across the NHS in England. Typically, patients are copied into letters sent between hospitals and GPs. But for those without a medical background, deciphering what’s written on each page can be hard-going.
This is precisely why hospital doctors are being encouraged to write directly to patients they see, to explain a diagnosis or test results in simplistic terms.
New guidance from the Academy of Medical Royal Colleges sets out a series of steps to make letters and emails less confusing for patients and easier to digest. One piece of advice is that doctors should write in “plain English” when penning letters to patients, rather than using confusing medical terms or Latin.
The initiative, which is supported by the Royal College of General Practitioners (RCGP), has been led by Dr Hugh Rayner, a kidney specialist who first started writing directly to patients in 2005.
“I’ve only ever had positive feedback from patients and GPs,” he said. “The change may seem small but it has a big effect.”
The guidance recommends several changes to make doctor and patient correspondence easier to digest, including:
:: Sentences should be shorter.
:: Use “plain English” where possible instead of medical jargon, Latin or complicated phrases. For example, “twice daily” instead of “bd”.
:: Explain acronyms.
:: Explain what the results of tests mean. If they are upsetting, phone the patient instead.
:: Use images instead of words where possible. For example, charts, graphs or diagrams.
:: If the patient has a visual impairment, ask if large print would help.
:: For children and young people, include information that is appropriate for their age.
:: Use the second and first person pronouns rather than writing in the third person and use active rather than passive verbs.
:: Avoid words that are open to misinterpretation. Chronic is often taken to mean ‘really bad’ rather than ‘long-standing’, which is the medical definition.
A translation of medical jargon into plain English, according to The Academy of Medical Royal Colleges:
1. Dyspnoea = breathlessness
2. Oedema = swelling or fluid
3. Seizure = fit
4. Syncope = faint
5. Acute = sudden or short-term
6. Chronic = long-term or persistent
7. Cerebral = brain
8. Coronary = heart
9. Hepatic = liver
10. Pulmonary = lung
11. Renal = kidney
12. Paediatric = children’s
13. Atrial fibrillation = irregular pulse.
In response to the glossary of terms above, Ley Sander, medical director at Epilepsy Society and professor of neurology at University College London, disputed using the term ‘seizure’ rather than ‘fit’.
“The term ‘seizure’ rather than ‘fit’ does not class as medical jargon in describing epileptic seizures,” Sander told HuffPost UK.
“Some years ago people with epilepsy were asked in a national survey what their preferred terminology was for describing their epilepsy. People were adamant that ‘seizure’ was more preferable to the word ‘fit’ which carried much stigma with it and in some contexts was used as a derogatory term.”
Peter Rees, Chair of the Academy of Medical Royal Colleges’ Patient Committee said people should push for this guidance to be adopted at their local hospitals.