Language as medicine: The way the doctor talks to the patient has a huge impact

“Long-term, unexplained complaints are complaints in which the GP cannot find a physically provable cause after a physical examination,” says Stourtenbecker. “But patients still have complaints. These are very common complaints, such as headaches, back pain and nervous bowels. Complaints that we all sometimes have, but sometimes they can persist.”

Do not use the negative form with the negative

Stortenbeker discovered that a doctor’s choice of words could make a big difference to this group of patients. “GPs are advised to communicate positively, but we have looked at my research: What is positive communication?” Stortenbeker provides an example of a physical examination of the lungs. Then the GP says ‘I don’t hear anything crazy. This is a negative formulation with denial.” She explains that it is best for the GP to send a message similar in content. “For example, the sound of the lungs being clean. In this language, we see after the consultation that the patient’s level of anxiety is lower.”

stigma

“There’s a kind of stigma around these patients,” says Stürtenbecker. “It’s quickly thought of as being between the ears.” “Perhaps the idea that patients exaggerate complaints may still be.” The researcher explains that patients with unexplained complaints were compared with patients with explicable complaints. “We looked at: How do they express these complaints? On all kinds of linguistic signs, including language intensity. And we didn’t actually notice these differences at all.”

“Both doctors and patients find this difficult”

What is the best way for a GP to say he or she can’t find a physical explanation for, say, persistent abdominal pain? “There are no rules. In fact, I don’t even think it makes sense. Positive language is important, but we are not positive teachers. I think it is really appropriate to say once also that there is no obvious physical cause.”

So be real, but don’t get discouraged. “The intent is that both clinicians and patients will feel better by communicating in this way. Both clinicians and patients find these types of conversations difficult.”