Unfortunately medicine in stuffed full of acronyms, and we use them and abbreviations when communication would be helped by more clarity in writing it out in more detail.
For example: ‘Your patient was admitted with an NSTEMI Trop +ve MI and had a PCI to the LAD and then had a small DVT (R) and then a PE.’
That might be fine for the cardiologists to communicate with each other, but unless you are in the know, then you need time to decipher these mangled sentences.
Acronyms are used by people either to be lazy or to use a language that says, ‘We are specialists, you are generalists, and we are going to communicate with you in our language, because we are cleverer than you.’
Managers were always using forms of language that used to irritate me enormously. When I was on the Professional Executive Committee (PEC) of the local Primary Care Trust (PCT), the agenda and language was controlled by the managers.
I had to say to them, ‘I am not a stupid man – I know what all the words you are using mean individually, but they make no sense to me when you string them together like that. What exactly do you mean?’ This elicited two responses – the first was a pitying look as if to say that I was stupid, and then a wholly inadequate explanation of what they meant.
So I don’t like things that get in the way of unvarnished English.
My new acronym, that I have learnt makes me want to vomit; because that is what it is: VOMIT. It has been around for 10 years, and I have just become aware of the term for it. It stands for Victims of Modern Imaging Technologies. This is a good term as it places the importance where it should be – with the patients, who have to undergo these tests.
It would be a very good idea for doctors who performed these investigations, or those who requested them, should have to undergo these tests themselves. I have been very lucky that I have enjoyed good health until now, and have never had to have anything more unpleasant done on me than a blood test.
Actually, that was not entirely true: after the birth of our fourth child, my wife decided that our family was complete, and so I offered to take some responsibility for contraception in the JD household, and went to see my GP who was happy to refer me for the “snip”. The surgeon who I saw was a fine surgeon, but we had partied many a time as young doctors, and I knew him rather well.
‘Well, JD,’ he said, ‘I agree you are suitable for a vasectomy, do you want it done under general anaesthetic or local anaesthetic?’
It did not take me long to decide: ‘Mac, if you are going to have my balls in your hands, I want to be awake.’
That is my only experience of being on the wrong end of medical procedures, and I remember how vulnerable and powerless I felt.
So I quite often advise patients that they don’t need yet another test ordered by some doctor for which the grounds are weak indeed. That is why I feel that some procedures (for example, the temporal artery biopsy) are largely a waste of time. You can spend too much time chasing around checking up on variants of normal tests, or doing tests that don’t matter.
Ask yourself if the test is necessary, or if you are doing it to cover your back.
The Jobbing Doctor is a GP in a deprived urban area of England. You can follow him on Twitter @jobbingdoctor.