The Power of Communication

Source: fernandozhiminaicela / Pixabay

As a physician, who has been in practice for over 20 years, my main role is to help patients discover what is wrong with them. Patients usually come to me with a set of symptoms and complaints. I synthesize this information along with diagnostic testing in the form of blood tests, imaging and various other tests and come up with a diagnosis.

The word diagnosis means the art of identifying a disease from its signs and symptoms. Modern medicine relies on diagnoses to prescribe a plan of treatment, which, often, involves pharmaceutical medications.

However, should we be labeling patients with diagnoses? The reason to question this is the psychological impact of diagnoses. There have been several studies looking at this exact theme.

One study was a meta-analysis which looked at the nature and prevalence of clinically significant psychological distress related symptoms in the wake of a breast cancer diagnosis.¹ In this study, 39% of these patients suffered distress, 34% suffered anxiety, 31% suffered from post-traumatic stress disorder, and 20% suffered from depression.

Another study looked at the emotional and psychological impact of a heart failure diagnosis, through questionnaires, and found that these patients scored in the moderate range on measures of anxiety and depression.² Even a diagnosis of a very common condition, diabetes mellitus, has been associated with distress and labelled diabetes distress.³

The question then becomes how do we mitigate the effects of diagnoses on our patients? This has to do with the power of communication. We must recognize that words are powerful and can have a profound effect on a patient.

I have learned this the hard way. As a critical care specialist, I often make the diagnosis of congestive heart failure in my patients. This is a condition in which there is an imbalance in the amount of blood a patient’s heart can pump and the circulatory needs of their organ systems. It can occur for any number of reasons, including a blockage in the coronary arteries, leading to a heart attack, a weakness in the heart muscle from toxins such as alcohol and cocaine, heart valve dysfunctions and abnormal heart rhythm.

If you are a layman with no medical background and you hear the term "heart failure," what do you think will go through your head? I learned this the hard way, because when I communicated these terms to my patients, they would go into significant mental distress. It is only then that I began to scrutinize what I’m saying to them.

I am telling them, in so many words, that their heart has failed, which in their minds, means that it is no longer working, which is not the actual case. They would then extrapolate this to mean that they do not have long to live and are going to die, which is rarely ever the case.

This is when I began to change my wording and terminology around the diagnosis of congestive heart failure when I communicated to my patients. I started using wording such as "heart dysfunction," a "weakened heart muscle" that still functions, "an imbalance in circulation," which affects the functioning of the heart or "an aberrant electrical conduction through the heart," which is affecting the heart muscle.

I learned the power of communication. However, the detrimental effects of labelling a patient with a specific diagnosis are not limited to congestive heart failure, as I have discussed in some of the studies I have mentioned. So, how do we mitigate the psychological impact to a patient of making a diagnosis?

This is a complex issue with no simple solution because our current medical system relies on diagnosis to prescribe a plan of care. The solution, however, begins with how we communicate with our patients. Each patient has a different constitution based on their psyche and experience. Although some may be able to handle the impact of a new diagnosis, others will not.

Anxiety Essential Reads

An Existential Perspective on Tariff Anxiety

Paranoia in Everyday Life

What if we could change our wording and use the word "imbalance" instead of diagnoses? Are not many of the diagnoses we make imbalances in physiology? For example, diabetes mellitus is an imbalance in carbohydrate, fat, and protein metabolism due to a lack of insulin production. Heart disease is an imbalance in the circulatory needs of the heart from a blockage in the coronary arteries. Cancer is an imbalance in cell growth and proliferation in a certain organ system. Asthma is an obstruction to airflow in the airways of the lung, which cause an imbalance in oxygen delivery to meet the body’s metabolic needs,

What if we reframed what we call diagnoses as imbalances, whether they be in the circulatory system, respiratory system, endocrine system, or any other system of the body? This would serve two purposes. We would not be labeling our patients by their medical condition, which can instigate anxiety, depression, post-traumatic stress disorder, and distress, as the previously mentioned studies have shown.

We would also be giving them hope because, by definition, an imbalance has a solution and can be corrected. I believe that the medical system at large is not yet ready for this paradigm shift, because the traditional way of assessing and treating symptoms is very entrenched.

However, what healthcare professionals need to acknowledge is that language and communication are a vitally important aspect of delivering effective care. The language we use has the power to devastate or elevate a patient’s psyche. This is why I believe the time has come to change our communication around interpreting a set of symptoms for the benefit of patient.

Even though this is not currently the norm, you can implement this change in the language you use when you communicate with your patients or clients. Do this and you will not only empower them, but you may positively alter the trajectory of their condition.

If you are skeptical then ask yourself this. What do you have to lose by doing this? If you scrutinize this question, you will discover that the answer is nothing — but there is so much that you and your patients have the potential to gain. Take this leap and watch how your attitude and your patients’ or clients’ attitudes transform.