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05/03/2013

Medical Slang Leading to Logical Fallacy: A Practice to be Avoided

Maurice Bernstein, M.D.

Medical slang is a form of slang used by doctors, nurses, paramedics and other hospital or medical staff. It is expressed either in informal vocabulary as words, abbreviated terms or also as acronyms (words made up of initial letters of the words the acronym represents) related to medical terms or conditions, persons or events. Presumably the basis for the use of medical slang is to communicate one’s concept or clinical finding or evaluation or diagnosis to other caregivers in a rapid and concise way. Unfortunately, the use of medical slang may lapse into derogatory expression or become ambiguous. Derogatory means that findings or persons are expressed in a disrespectful or degrading manner. Ambiguity can be related to the fact that an acronym or abbreviated word may not be sufficiently distinctive and can be used or interpreted for more than one medical term.

Examples of medical slang can be as benign as but also potentially ambiguous as the following medical transcription terms: “lytes”=electrolytes, “nitro”=nitroglycerine,”sats”=saturations, “crit”=hematocrit, “mets”=metastases, “osteo”=osteoporosis. On the other hand, medical slang can be derogatory even though amusing when applied to medical specialties. For example: “baby catcher” for obstetrician or “butchers” or “knife happy” for surgeons. Examples of medical slang as applied to patients include “dirt ball” for a patient who enters the emergency room filthy and smelling badly or “druggie” for patients known or suspected for illicit drug use or “goldbrick” for a patient who demands more attention than their (minor) condition warrants or the acronyms LOBNH for “lights on but nobody home” for a patient with suspected dementia and, of course, GOMER for “get out of my emergency room!”.

My argument is that medical slang generally can not only be or become disrespectful or ambiguous but also in the case relating to patients themselves, the derogatory descriptions may actually represent an action by the professional to create a logical fallacy. What is a logical fallacy? It is an error in reasoning that renders an argument invalid. Why attribute a medical slang expression as promoting a logical fallacy? First, a basic premise within the profession of medicine is the responsibility to obtain history and facts, if possible directly from the patient, and then to attempt to draw and present a conclusion from the facts. Drawing that conclusion is a logical exercise. Because, unlike the application of medical slang to “conditions” when this slang is applied to a person (an ad hominem), it may allow a fallacious conclusion by the healthcare provider originating the slang which rejects any argument or facts given by the patient since these arguments or facts are trumped by the provider’s own conclusion about the character or reliability of the patient. This is a logical fallacy since such a conclusion may be unwarranted. The explanation and facts provided by the patient must be logically evaluated separately for their validity and value and not invalidated by simply the provider’s personal decision regarding the patient as a person. The doctor can’t fairly make a judgment that the patient’s descriptions of pain should not be considered and reconsidered because the patient is known or suspected and described as a “druggie.” Some person on the street may say “that guy over there looks like a druggie” but that person is not required professionally to go beyond that assumption and so the statement may only be considered “unfair” or “uncouth.” My argument is that in a doctor-patient relationship such a slang expression by the doctor would represent a professional ad hominem improperly affecting the doctor’s judgment regarding the history and facts presented by the patient.

For a number of reasons, including medico-legal, there is said to be a diminution in the general use of medical slang. Hopefully this is true and will continue to diminish. Certainly, expressions by physicians, nurses and other healthcare providers which are non-humanistic, are demeaning to the patient and indirectly to the profession itself and finally, as a consequence, allows a logical fallacy to be exercised, which distracting from and preventing proper clinical evaluation of the patient, cannot be considered of value to be continued to be used in medical communication.

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