Entering medicine is like entering a foreign country, no one understands you, or takes you seriously, unless you speak the language. There are very very few patients who can speak the language of medicine. The doctor acts as a translator by taking the patient’s subjective symptoms and converting them into medical terms that any other doctor, reading the patient’s chart, can understand. One of the most important things I began to learn my first year in medical school was not “what to say” but “how to say it.” I try not to say “skinny” but instead “cachectic.” Instead of “trouble peeing,” “dysuria.” Tachypnea, bradycardia, sputum, diplopia, necrosis, etc. By using these terms, a doctor can save time when handing off patients or when someone else reads his/her note. Now, in my second year, I am beginning to develop my “what to say” skills. Having the ability to create a wide differential diagnosis list will definitely be in the patient’s benefit.
Let me take it a step further. What about using a literal translator? Living in California comes with the added benefit of treating a large population of Spanish-speaking patients. An MS3 once told me, it’s not if you’ll learn spanish, it’s when you’ll learn it. Luckily I grew up in Miami, Florida, so I have been learning Spanish since I had baby teeth. Using a translator can be essential to your patient’s care, and save money from a potential lawsuit. When using a translator, you should first meet with them and discuss the ground rules of the upcoming patient encounter. Direct your questions to the patient so they know they are taken care of. Do not speak louder or slower to try to make the patient understand you. Speak in short sentences so the translator does not have too much to remember. Be prepared to phrase things in different ways in case there is not a direct translation for the words you are using. Lastly, make the patient repeat back what he/she has heard to the translator so you can be sure she understands everything. You may have to be rude at times because this interview will take longer with an extra person helping you and you have a schedule to keep, but know that the patient’s care is paramount.
When talking to patients, refrain from using the medical jargon. Use simple terms and make sure they understand everything. Some patients may not speak up when they hear something they did not understand. I, myself, could be guilty of this at times. Always ask if the patient has any questions and understand everything you have said. Then, you can work on your subconscious communication in your body language and smile. A smile traverses all languages. Gracias 🙂