The Semantics of Medicine

I went to the Doctor last week. It was not my usual doctor, as it was a Sunday, and I had realised that I was out of one of my scripts.

I went to the Doctor last week. It was not my usual doctor, as it was a Sunday, and I had realised that I was out of one of my scripts. So, I went to a Medical Centre. The doctor was very pleasant. He took a brief history. However, he did something that is one of my pet hates. He asked questions as if they were a statement.

  • “You don’t have any Allergies?” “Well yes I do actually.”
  • “You don’t take a preventer for your asthma?” “Yes I do, I take Pulmicort”.
  • “You don’t have any other medical conditions?” Yes I do I have blah blah blah”.

I felt like I was constantly in the wrong, having to correct this very nice doctor. I had often wondered how patients felt when they were questioned in this way, and I got to experience it first hand.

I started to notice this strange phenomenon of history taking after I did the AMEE Certificate in Medical Education. One of the points that they make very strongly in the course, is at the end of any presentation, you should say

“What questions do you have for me?” not “Do you have any questions?”

The rationale is that if you ask “Do you have any questions” it can make the audience feel stupid, because you have just explained everything to them. If you say “What questions do you have for me?” the assumption is that there will always be questions, and the audience feels more comfortable asking them. Very subtle, but a significant difference.

I started noticing subtle differences in language after this. I was doing an assessment for the 2nd year Medical Students at UOW on history taking, and this questions as statements started to really annoy me, once I had noticed it.  Most of the students were doing it.

I mentioned it to one student, suggesting it was more appropriate to ask a question directly ie “Do you have any allergies?” Rather than “You don’t have any allergies?” To my surprise, the patient volunteer jumped in and agreed with me, saying that it made her very uncomfortable when doctors asked questions starting with “You don’t have…?” She said that there was a power gradient between the doctor and the patient, and the patient did not like disagreeing with the doctor. In some instances the patient may agree with the doctor just because they didn’t want to upset them or disagree with them. By the end of the session, I didn’t have to do anything, the patient was giving all the feedback for me.

{{commentCount}} comment(s). You must be logged in and AHPRA verified to view and comment. LOG IN

A/Prof Stephen Barnett

Stephen is a GP Supervisor, Medical Educator, GP academic and Medical Director of Medcast. He has completed a PhD on Virtual Communities of Practice in GP Training.

The latest healthcare news from medcast

Preoperative Assessment and Mallampati Scores
Preoperative Assessment and Mallampati Scores

The Mallampati Score or Classification is a simple and easy to use tool that assists in predicting difficult endotracheal intubation.

Better Together: GP Supervisor Education
Better Together: GP Supervisor Education

Q: What do fish and chips, Batman and Robin, and country and western music have in common?

2020, a year in review: Dr Carol Newall
2020, a year in review: Dr Carol Newall

We've asked some Community of Practice members to tell us about what 2020 has meant to them. Some things may surprise you...

2020, a year in review: Dr Genevieve Yates
2020, a year in review: Dr Genevieve Yates

We've asked some Community of Practice members to tell us about what 2020 has meant to them. Some things may surprise you...

Long COVID-19
Long COVID-19

Do we really need another syndrome?! Isn’t it just the same as recovery from any other infectious disease?

Keys to prevention in mental health - Alexithymia
Keys to prevention in mental health - Alexithymia

I first encountered the concept of alexithymia when I worked with people suffering from eating disorders. Many people experiencing eating disorders have great difficulty identifying and naming their own emotions.

Adult Basic Life Support during COVID-19
Adult Basic Life Support during COVID-19

Many healthcare processes have been re-evaluated in light of the current COVID-19 pandemic.

Who benefits from eMental Health?
Who benefits from eMental Health?

The answer to that question definitely depends on who you ask. Let’s start with the cynics and get them out of the way.

Fight back. Never yield: Atrial Fibrillation
Fight back. Never yield: Atrial Fibrillation

This is no time to yield to atrial fibrillation (AF). As a former clinical pharmacist and academic working in the internal medicine ward and ambulatory clinic of a busy teaching hospital in Ethiopia, I encountered numerous cases where patients suf...

KISS Guide to Evidence Based Medicine 2020
KISS Guide to Evidence Based Medicine 2020

This Hot Topics Keep it Simple Summary is a guide to evidence based medicine in 2020, straight from our UK partners, NB Medical.

A tree change is in the wind
A tree change is in the wind

Change seems to be the theme of 2020. In our region, as with many in Australia, it started with bushfires, before a jump to the left into ‘COVID Capers’.

Writing your COVID worries away - (with Andrew Gan and Dr Jet)
Writing your COVID worries away - (with Andrew Gan and Dr Jet)

COVID and all its attendant inconveniences (I guess some would say “tortures”) has forced many of us to revise our personal wellbeing plans and dig out some old strategies that we haven’t used for a while. It’s also made some of us realise that ma...

Malignant Hyperthermia
Malignant Hyperthermia

Malignant Hyperthermia is a rare and potentially life threatening genetically inherited condition that can be triggered by drugs commonly used in anaesthesia. If it is not recognised and treated in its early stages, MH can be fatal.

Restless Leg Syndrome - Podcast
Restless Leg Syndrome - Podcast

Restless leg syndrome is a common presentation in General Practice characterised by uncomfortable sensations in the legs. These sensations are associated with an irresistible urge to move the legs to relieve the symptoms.

Telehealth Fatigue
Telehealth Fatigue

My patients are loving telehealth. They love it so much that most of them are saying they don’t want to come back to face to face consultations. You probably need to bear in mind that my patients are long-term therapy patients that I know very well.

Paediatric Advanced Life Support Standards
Paediatric Advanced Life Support Standards

In order to achieve these standards, it is essential that medical and nursing staff who work with paediatric patients receive specialised education to manage a paediatric cardiopulmonary arrest.

Would learning something new wash your Acedia away?
Would learning something new wash your Acedia away?

Is Acadia running your life right now? Are you, like the solitary monks who used that term in the middle ages, suffering from the combination of boredom, frustration, agitation and lethargy that comes with physical isolation?

COVID conspiracies – should we ignore them?
COVID conspiracies – should we ignore them?

Like me, you probably spend a lot of time talking to people about how they feel about the COVID 19 pandemic, but do you talk to them about their thoughts and beliefs about it?

Medication Spotlight: Paracetamol
Medication Spotlight: Paracetamol

A frequently used medication in community and hospital settings is paracetamol (named acetaminophen in some countries). It has less adverse effects than other analgesics, as it has no effect on platelet functioning and allergies are very rare.

Helping prevent suicide among Australia's Indigenous Youth
Helping prevent suicide among Australia's Indigenous Youth

Suicide in Australia amongst Aboriginal and Torres Strait Islander peoples occur at twice the rate of the general population. Young Aboriginal and Torres Strait Islander people are at even greater risk, those aged 5 to 17 years, suicide is the le...

Join Medcast. It's free and you'll get instant access to essential healthcare news, research and more.

Already a member? Log In