How much jargon slips into your communications? Does it help or hinder?
Incomprehensible jargon is the hallmark of a profession.
Kingman Brewster, Jr., (1919-88) 
Former President, Yale University
The line between serious and spurious scholarship
 is an easy one to blur, with jargon on your side.
David Lehman (1948-), U.S. poet, editor, critic
Do we use too much jargon? Some have observed that medicine may be the most jargon-ridden profession of all time. Others of us think that medicine’s use of jargon is surpassed by government bureaucrats and the military, but we must acknowledge that medicine gives them a reasonable level of competition. Those of us in healthcare seem to have special names and phrases for almost every ailment, management plan, instrument and body part. One of my anatomy professors published a paper in the mid-1950s in which he reported his calculation that first-year medical students need to acquire more than 20,000 new words and phrases, in addition to everything else they are expected to learn. Listen carefully to casual conversations among health professionals and you may find that a noticeable proportion of the words they exchange would be found in a medical dictionary but may not show up in ordinary school dictionaries. Yet, in my experience, when medical faculty are on the receiving end of someone else’s jargon, they are about as jargon-averse as any group. Think of the dismissive reaction of some medical faculty to the language used by professional educators.
A lesson from a “consumer” I had my first lesson in the risks of overusing jargon more than 40 years ago. I was conducting the wrap-up, feedback session at the end of a national conference that I had chaired on Self-instruction in Medical Education. The first audience member to volunteer a comment was a physician who rose to say, “I’m sure I speak for everyone here when I extend warm thanks for this ground-breaking meeting to Dr. Jason and all the jargonaughts.” Message received! Loud and clear!
Ever since that formative experience I’ve made a special effort to pay close attention to the words and phrases that my colleagues and I use in various settings. I quickly came to realize that words can have different levels of utility under different circumstances. In medicine, as in most other specialized fields of human endeavor, words are appropriated or invented as labels for objects, situations and conditions that are commonly encountered in daily work. We don’t just talk about pain in the back in the way that most people would. We typically seek to be more precise by identifying that the pain is in the cervical, thoracic, lumbar, sacral or sacro-ileac area. We might even choose abbreviations, referring, for example, to S-I joint pain. Dentists don’t say to each other that a patient has an infection on the cheek-side of their gum, in the right, lower area. They say, instead, that the patient has a gingival abscess on the buccal surface, below tooth number 26.
This “insider’s” vocabulary can provide a useful, time-saving shorthand among those who understanding what is being said. To them, such words are genuine aids to efficient, precise communication.
Although specialized words and phrases can enrich and lubricate the exchange of information among those who share a professional sub-specialty, those same words can be sources of bewilderment to those who are from outside the inner circle. For outsiders, the insiders’ words and phrases are dismissed as jargon. They are said to sound like unintelligible gibberish. As it happens, the word “jargon” is derived, in part, from the Middle English (12th to 15th century England and Scotland) word for “gibberish.” 
Do you adapt your words to your audience? Clinicians can find themselves with two different targets of their communication in the same room at the same time. A dental colleague who is sensitive to this potential problem acknowledges the problem up front. When he does his initial exam, he informs his new patients that he will be using dental jargon as a shorthand for communicating concisely and precisely with his assistant while they are pursuing their various tasks. He then adds, “I promise to translate the important information into plain English when we’re done.”
Put another way, the same words and phrases that can be elegant communication in one context can be unintelligible gibberish in another. Successful communication is comprised of many parts. What is conveyed (sent out) is one part. Whether it is understood and accurately assimilated by the intended recipient is another part, and equally important. A challenge we face as teachers, among the many that should be getting our attention, is developing the self-conscious, reflective routine of tuning in on our verbal habits. Might we have become automatic in our use of some words and phrases? Might we be automatically using jargon with our non-medically-qualified patients or students, and might they be too timid or intimidated to let us know we’re failing to communicate? You don’t have to be stuck with the name Jason or be familiar with Greek mythology to understand that we are all at risk of seeming like jargonaughts to some of those with whom we need to achieve successful communication.
Some questions for your reflection and possible comments:
  • How closely do you pay attention to the words (and possible jargon) you use routinely?
  • Are you in the habit of trying to adjust your vocabulary (including jargon) according to the “readiness” of those with whom you are speaking? If not, should you be doing so?
  • Do you help those you teach or supervise become sensitive to the role of jargon in their communication with patients and others?
Thanks,
  Hill Jason 
Hilliard Jason, MD, EdD


First posted: 10/20/08
Revised: 11/16/08

From Rethinking Medical Education goto:http://rethinkmeded.org