Levy replied that he knows things are in flux. "But one thing that is pretty certain is that there will be a greater role for patients than in the past. I differ with Bob when he suggests that the formulation I present in any way diminishes or marginalizes the role of clinicians. Not so at all. It suggests, though, that those clinicians will need to expand their repertoire of skills to learn how to appropriately bring patients into the conversation about planning their care..."
Yes, clinicians do spend a lot of time gaining expertise, "but patients also spend a lot of time -- indeed their whole life -- learning and gaining experience about their own bodies and their own needs. It does not take away from one group to suggest that the other has something important to offer to the process of disease prevention or care."
And the ball is bouncing on many other healthcare terms, as well.
- In his blog awhile back, Levy used the word 'non-compliance' to describe a patient who doesn't take medications as prescribed. He too was corrected by a doctor who commented that the preferred term is 'non-adherence,' "which does not have the same power implications and insinuation of blame as the word 'non-compliance.' "
- Wachter says CPOE, which used to stand for 'Computerized Physician Order Entry,' has been changed to 'Computerized Provider Order Entry,' "because physicians are not the only ones writing these things called orders."
- Even the word "orders" is controversial, he says. It's now accused of summoning an "era where physician gave orders and everyone around them was expected to follow that. Now, the effort is to soften that and build in a term that celebrates collaboration," he says.
- Now some want to call physicians or nurse practitioners both 'providers.' "Some believe calling out professions individually continues to validate silos, when what we need is a continuum of different kinds of providers or caregivers, and there's no bright line between what a nurse practitioner or a physician can do; a legitimate argument if you're trying to create a team in a medical home concept," Wachter says.
- Lately, I've heard that some providers want to phase out terms like 'discharge' and 'handoff.' Instead of a discharge planner, the person receiving care leaving a hospital would instead be the responsibility of "a transition team." Could it come to this: "Good news, Mrs. Smith. I'm your transition planner and I'm here to give you your transition instructions."
- There's even an evolving lingo to describe medical mistakes. Wachter says Ken Kizer, founding president and former CEO of the National Quality Forum, first called them never events, "and the stakes began to grow, because the implication is that these things should never happen in healthcare and therefore everything we can do to promote that view, from not paying for them to requiring that they be reported to authorities or transparently available, all that became legitimized when you call them never events."