Jonathan Lewis, SPT
In school, you will be exposed to a vast and alien vocabulary composed of similar words that denote important distinctions: cerebrum and cerebellum, optical and ocular, eccentric and concentric, ligament and tendon – literally thousands more. And it doesn’t end with just the simple terminology. As you learn the lexicon of your new profession, you must also start integrating these terms into a nearly endless alphabet soup of acronyms. Knowing this shorthand – PICA, CSF, PNF, DM1, BP, PRICE, on and on – will become vital for your ability to be able to quickly and concisely communicate with your fellow students, clinical instructors, and professors.
Developing an ease with the vocabulary and its shorthand will pay off in a lifetime of effortless communication with other medical professionals. Additionally, maybe the most important aspect of becoming comfortable with this peculiar vocabulary is in the valuable seconds you will save when “charting” during your rotations. And speaking of rotations: you will find that any clinic you work at will have a culture that has developed its own argot to describe patients and procedures – slang terms that will have little meaning to anyone outside of that clinic.
It’s easier than it sounds, though. Your mental library of medical jargon will become effortless as you become immersed in reading studies, presenting papers, and cramming anatomy terms. However, the real trouble with using this newly acquired language – and the most difficult part for some new practitioners – isn’t in learning it. It’s turning it off.
When you’re in clinic, you might find yourself telling a patient that you’re going to “perform an HVLA manip – specifically a TJM – to treat their LAS.” You’ll be met with a blank stare. So perhaps you’ll change your approach. You might simplify your language and nonchalantly tell the patient that you’re going to “perform a maitland grade 5 manipulation on their talo-crural articulation and hopefully they’ll feel some relief following the cavitation.” That probably won’t help much, either. If your CI is kind, they will take pity on you and interject: “She’s gonna pop your ankle. Research shows that this helps with ankle sprain recovery.” You’ll wonder why you couldn’t say that – it was a simple, true statement that everyone involved could understand.
Don’t worry, we all do it. We spend years learning that language is important – A’s quickly turn to B’s or C’s on anatomy exams if we use ligament when we should’ve put tendon or vein when we should have put artery. This is for good reason though – we don’t lose those points because our professors are mercurial and censorious academics that love to make us suffer (although, it will feel like it at the time). Instead, it’s to teach us that, in this profession, specificity is essential.
The devil, we often hear, is in the details. And, for physical therapy students, our ability to accurately describe the details and recognize the distinctions is tested and honed every day during our didactics – and this is important. Picking up on the difference between, for example, referred visceral pain and skeletal-muscle pain is one of the reasons we will someday proudly call ourselves Doctors of Physical Therapy. Our ability to be specific allows us to differentially diagnose and refer patients – but it has the side-effect of developing in us the habit of using terms that very few outside of the medical community will understand.
This is why we need to practice switching gears and language often. This is why we need to look for the moment our patient’s eyes start to glaze over and adjust our language. The best therapist I ever shadowed used words like “ouchie” and “bum” with her patients. Her ability to communicate incredibly complex concepts to people of all backgrounds while still being a precise evaluator was amazing. However, this skill was something she had to learn and practice.
Our professors ask us to “avoid jargon” with patients and we attend lectures on the importance of medical literacy and access for all populations. However, after years of being immersed in the language and culture of the medical field, talking like a medical student is a tough habit to break.
However, to be a truly effective practitioner we need to break it. My advice? Start practicing from day one. Use the terminology with your peers and professors but when you’re speaking to people outside of the discipline, ask yourself “would I have known what this meant a year ago?” If not, see if you can adjust your language to increase understanding between you and your interlocutor without losing the meaning of what you’re saying.
This practice will pay off when you get to your first rotation, I promise.