The Secret Language of Doctors

Dr. Brian Goldman is an Emergency Room Physician, Best-Selling Author, Radio Broadcaster and Medical Watchdog. His new book The Secret Language of Doctors has been extremely well-received and we asked him a few questions for further insight on this secret language.

Why did this story need to be told?

This book needed to be written because the slang exists almost everywhere. The slang used gives critical information about the culture of modern medicine and the challenges of delivering the best healthcare possible in the 21st Century. It’s important that the public see physicians and other healthcare providers as human beings and not as caricatures of false perfection.

What do you want the reader to walk away with after reading?

At different times, I want the reader to smile, chuckle, cry, and get angry. I want people who read the book to know about the the problems in the health care system that need to be fixed, and the difficult challenges involved in taking care of patients – especially those who are elderly with dementia, those with morbid obesity, and patients with mental health issues as well as addiction. I want them to see that if you listen for the slang, you’ll learn where the challenges are, and how to address them. Most important, I hope they’ll realize that hospital slang is not the disease but a symptom of a much bigger problem.

What is an example of hospital slang you hear often? What would patients be most surprised with?

Frequent flyer is the hospital slang you hear most often – so often that it’s almost considered acceptable. Frequent flyer refers to patients who return unexpectedly to the ER and other parts of the hospital so frequently that they’re on a first name basis with the staff. The term is ironic. To the airline industry, a frequent flyer is a beloved customer. In health care, they represent failure and futility. Calling them frequent flyers reduces these people to a stereotype. I’m against that. They come to the ER because they have no better place to go for care. The challenge is to develop a better model and a more appropriate place to care for them. When that happens, they feel better and stop coming to the ER.

What has the reaction on the book been from your colleagues in the medical community? Positive/Negative?

The universal reaction from colleagues who have read the book is that they love it because they see themselves in the stories and situations I depict in The Secret Language of Doctors. Some doctors have reacted to the pointed media coverage the book has received. I suppose that some are mad at me for violating the “code” by taking it public. I believe that showing the world that doctors are human can only improve their standing in society.

What’s the roadmap for hospitals moving away from the use of slang?

There are two ways to respond to slang. One is to post signs stating (correctly) that pejorative slang that demeans and disrespects colleagues and patients is unprofessional and unethical and will not be tolerated. While I agree with the sentiment, I believe treating slang in that manner will not eradicate it so much as drive it underground. I much prefer gently discouraging the use of slang, but if I hear it, I’m more interested in finding out and dealing with the issues that give rise to the slang.

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