Improving register
Flexibility: Matching your English to your patient
You need to be able to speak differently to different types of people, and in different sorts of situations, in order to communicate as effectively as possible. This is called being 'flexible' with your language. Being an effective communicator means being able to master different levels of language.
Aim to match your patient's level of understanding
Perhaps one of the most important elements of language flexibility is the ability to pitch your language at the patient's level of comprehension. This is determined by a number of factors, one of which is age. For example, elderly patients may prefer to be called by their title of Mr or Mrs, while a young person may prefer you to use their first name.
Consider your patient's level of education
The level of education and language will also impact on this communication. For example, a nurse will have some understanding of medical terms, while a professional may require a higher complexity of language; you could use words like 'seizure' or 'epilepsy' rather than such words as 'fits' or
'funny turn', which you would use for someone with less understanding.
Consider your patients' wishes regarding management
The extent to which a patient wishes to be involved in their own managment will also determine the level of language you need to use. Some patients may like you to recommend dose changes in their insulin, while others may wish to discuss their daily activities and how they can adjust their doses of insulin themselves.
Examples
Listen to the audio recordings below, where the same information is being conveyed in very different language. Think about how the language is being changed around from recording to recording. Think, too, about why the speaker is choosing to do this.
- AUDIO Example 1: Doctor talking to elderly patient
To expand/collapse this audio's script, click here.SCRIPT 1: Mrs Smith, your recent diabetic tests are a bit high. They’ve been high for a while now and what this means is the tablets are not working as well as we would like. We need to change this. As we’ve talked about before the next step is insulin. Insulin is very different to the tablets. Insulin needs to be given as an injection. And I know that you’re not very keen on doing this as you’re not sure how you’ll manage but what I’ve arranged is for the district nurse to come and give you a hand and she’ll help you with the insulin injections.
- AUDIO Example 2: Doctor talking to young patient
To expand/collapse this audio's script, click here.SCRIPT 2: Mary, thanks for coming in today for the results of your recent blood test. As you know we do the blood tests every few months to see how your sugar levels are. We agreed to try the tablets but they really aren’t keeping your sugar levels low enough. The next step is insulin. And I know you’re not keen, but I think it will give you much better control and make life easier for you. It must be hard for you with study, and part time work, and social life, late nights, sleeping in … to juggle your diabetes. Insulin that you administer with your meals will give you better flexibility in that you can decide what time you’re gonna take it.
- AUDIO Example 3: Doctor talking to educated professional (same topic)
To expand/collapse this audio's script, click here.SCRIPT 3: Mrs Smith, I have your blood test results from your recent test. Your haemoglobin A1C, as you remember this is the one that shows your control over the last three months, is a bit high. Your result was ten and as you know we aim for a result of seven or better. We’ve discussed this before but I think this further indicates that your oral medication is no longer effective and so its time to introduce an insulin therapy for your diabetes. (To appear after audio has played)
- AUDIO example 4: Doctor talking to another doctor
To expand/collapse this audio's script, click here.SCRIPT 4:Thanks for reviewing Mrs Smith. She has a five year history of type two diabetes mellitis and her most recent haemoglobin A1C of ten indicates she’s got very poor control on oral hypoglycaemics. Hence we need to commence an insulin regime to improve her control and I wondered if you can assist us with this?