Using Medical Jargon Confuses Patients Amid Low Health Literacy Trends

In perhaps an unsurprising clue into navigating low levels of patient health literacy, new research published in JAMA Network Open found that patients have a far better understanding of their health status when their providers use jargon-free verbiage.

The analysis looked at common medical jargon that has a different, in some cases opposite, meaning in common usage. For example, telling a patient that test results are “positive,” indicating in medical terms that the patient has an illness. In laymen’s terms, “positive” can indicate that the patient is in the clear.

These findings come as healthcare providers work on improving patient engagement and activation among those with limited health literacy. According to the Department of Health and Human Services, only about 12 percent of Americans have proficient health literacy skills, meaning few people can both understand and use healthcare terminology.

The researchers said that despite this understanding and an acknowledgment that the best patient-provider communication is free of medical jargon, most providers are still using complex terminology.

The researchers were careful not to lay blame on or shame healthcare providers who sometimes use medical jargon with their patients. In fact, they stated that most providers intend not to use too much medical jargon during patient communication.

“The mismatch between our intent to avoid jargon and the reality of our frequent use of it has been called jargon oblivion,” they explained. “One potential reason for this disconnect is that, as health care professionals, we simply assume our patients understand the terminology we are using. No matter how intentional we are about minimizing jargon, we will not avoid using words and phrases that we fail to recognize as jargon in the first place.”

This study sought to do just that: uncover what medical terminology is particularly confusing for patients.

The researchers zeroed in on healthcare jargon that uses words or phrases that have a second meaning in everyday life. For example, the phrase “positive test results” to indicate the presence of a disease. In regular usage, “positive” indicates a good result, so this phrase might be confusing to patients.

The researchers tested this theory at the Minnesota State Fair, where they surveyed a 215-person cross-section of the public about what certain common phrases used during medical encounters actually mean.

Participants were given statements like “Your chest X-ray was unremarkable,” “The findings on the X-ray were quite impressive,” or “Neuro exam is grossly intact,” and asked whether they thought those were good or bad health outcomes.

Patients were also given a statement like “Your nodes are positive” and given multiple-choice options to decipher the meaning (“You are cancer free,” “The cancer has spread,” “The cancer has not spread,” and “Don’t know.”)

The results were generally mixed with a slight tilt toward limited patient understanding, the researchers reported. Particularly, patients were confused when given a medical phrase containing a word with a different meaning in regular usage.

For example, fewer than half of respondents knew that “neuro exam is grossly intact” is actually a good thing, potentially because they usually interpret “gross” to mean “unpleasant.”

It may be challenging for providers to rid their patient communication of these phrases because they are not wholly technical or scientific, the researchers posited. It may not occur to providers that a patient would not understand “grossly intact.”

Rather, the issue is that these terms have multiple meanings. It may benefit providers and their patients to consider how different words may be used in other parts of everyday life.

Patients also struggled to identify when a phrase was meant to convey good or bad news. Although most (96 percent) respondents knew that having a negative cancer screening meant they did not have cancer, fewer (67 percent) knew that “positive nodes” meant that the cancer had spread.

Similarly, 80 percent could tell that an unremarkable chest radiography was good news, but only 21 percent knew that hearing that their radiography was impressive was usually bad news.

Unsurprisingly, respondents struggled quite a bit with less commonly used words. Around three in 10 (29 percent) knew that “bugs in urine” meant a urinary tract infection, while 9 percent knew what febrile meant, and 2 percent understood occult infection (some, in fact, thought an occult infection was related to a curse).

The good news is that, when compared to previous similar studies, these results indicate that patient health literacy is getting better. Just two decades ago, patients were more likely to misunderstand “the tumor is progressing” and “positive nodes,” the researchers said.

The COVID-19 pandemic may be the credit for the improvement in patient health literacy. The advent of home COVID-19 testing, for example, help familiarize the masses with what positive and negative results in healthcare mean.

Still, the researchers found that phrasing without medical jargon is still best. When comparing “your blood test shows no infection” and “your blood culture was negative,” patients were still better able to understand the former.

Again, healthcare providers likely are not using medical jargon to intentionally confuse their patients. However, it can be difficult to assess what a patient will and will not understand when providers are so steeped in the science of their craft.

Future studies may look at other medical phrases that may contribute to patient confusion and health literacy woes, the researchers concluded.